Self Catherization: Issues and Problems

Hi, Jim,

My samples of the new Speedicath Flex coude catheters arrived this afternoon, and I just tried one, a FR14. The tube is much more flexible than the regular Speedicath and the Coloplast Self-Cath. I wasn't able to get the Flex past my difficult areas. When I tried, it felt like I was trying to push a box cutter through.

That's not to say the Flex won't work for other guys. It depends on your architecture. I will try the Flex again when I cath before bed. Now that I'm used to the "Jimjames dive bomb" techique, a super flexible catheter tube gives me less control of the catheter. And catheters wtih more control help me finesse my way through my tight spots.

Also, I don't like the plastic sheath on the outside of the Flex. It doesn't allow me to see what I'm doing and gives me less control. I couldn't see a way to remove it either. When I use a LoFric Origo, which comes with a plastic guide, I remove the plastic guide before doing the dive bomb.

Looking forward to reviews from other guys who try the Flex. My first impression isn't very positive. I'll try it a few more times and see if I can get it to work. I may have to try a larger size--maybe a FR16.

Stebrunner

Srebrunner, How did you contact them ? Web site ? Phone number ? Hank

Hi Steb,

Do you usually use a 14? I think you should def try a 16 then. I use FR12, but ordered samples in 12 and 14. Mine should arrive this week but unfortunately -- rather fortunately -- I won't be able to use them until I need them which might be some time. 

Jim

Hank,

Call your cath distributor first and tell them you want samples but ask for both your regular French size and one size up. Your regular cath size may not work because of the added flexiblity. If your distributor doesn't have them, call Coloplast directly.

Jim

Hi, Hank,

When I first started CIC, a Coloplast rep out of Minneaopolis called me and sent samples. She got my phone # from my doctor, and he gave her a prescription for Speedicath FR14 coudes. I kept her phone #, and called when I saw they were offering samples of the Flex. She would only send FR14 samples of the Flex as that is my prescription on file. Google Coloplast's corporate web site--call them and find out the rep's name for your area of the country. You may also be able to get samples from your healthcare supply company, but that may take longer.

Stebrunner

Hi, Jim,

In Speedicaths I use FR14 coude, and in Origos, I use FR14. The prescription that Coloplast has on file for me is FR14 so that's the only size my rep would send. I do have a request from my healthcare supply company for samples in FR12--but now I'll change my order and put in for FR16 samples.

Stebrunner

Hi Stebrunner,

That's right, they can be a stickler on the prescription,  I forgot. For similar reasons, had my rx changed a few years back to something like: 200 catheters a month, straight or coude, FR 14 or FR12. 

Jim

Hi, Jim,

Last night before I went to bed I tried the Flex catheter again--and failed again. I don't think I even made it to the prostate area. There are some tricky spots before I get to my external sphincter, and the plastic sheath over the outside of the catheter tube, combined with the greater flexibility of the catheter, made it very difficult to finesse my way through those spots.

I get the feeling the Flex is designed for the SCI folks--who don't have a huge prostate in the way of CIC. Your dive bomb techique has realy spoiled me. It gives me a lot more control of the catheter. Wish catheter manufacturers and healthcare providers would learn it.

It seems that my bladder stone removal has messed up my urethra and/or prostate. Since my stone removal in mid February, my natural voids have dropped from 100 to 200 ml down to 50 to 100--most NVs now are around 50. There also seems to be some tricky spots before I get to the external sphincter now, and it's more difficult to get past the sphincter. My cathing time is still better than it was before I had the PAE, but much slower than pre stone removal. I hope this setback is temporary, but it's been over a month since the stones were removed.

Stebrunner

I believe I read here that one fellow was stopped and questioned, and after a short back and forth with security as to what the catheters were for, actually offered to demonstrate what they do right in front of them!!! They let him go through.

Other than that, I haven't heard of any problems but certainly can't hurt to have a doctor's note specifying that both catheters and supplies are needed. I also made sure to conform to airline regulations regarding carrying fluids for my hand cleaner, etc. 

Jim

Hi, Dennis,

I just got back last night from flying to Florida for hernia surgery and had no trouble at all with airport security. To be safe, I carried catheters and cathing gear in both my carry on and checked luggage. Before I went to the airport, I called TSA for advice, and I did bring a note from my doctor--just in case.

Found it a little tricky to CIC in the airport restrooms. A few stalls didn't have any place for my gear and/or were poorly lit. Also, ended up with urine on my finger tips that I couldn't clean off before putting my gear away. Need to figure out a better system for that.

Traveling (it was a long flight with a layover and plane change) threw off my CIC schedule, and twice during the trip I forgot to use the antibacterial wipes on the head of my penis. So far no UTI--perhaps because I use the Jimjames divebomb technique and have been taking D-Mannose.

Also glad to report that my hernia repair did not affect the easy cathing I've been experiencing the past couple of weeks. My NV volumes have increased, but I think that's due to the drugs I'm on to manage pain and swelling.

Have a great trip!

Stebrunner

Glad things went well with airport security and hopefully your hernia surgery. My travel kit always contained a small container of alcohol hand cleaner (or a small pump bottle). I often used that more than once during the process whenever I felt  my hands or anything else might get compromised. Also carried several folded up paper towels that could be placed on surfaces where I laid out my supplies. I have also forgotten to clean the penis head and meatus on occasion and hoped for the best. On a couple of ocassions where I really felt I compromised things I took one Macrobid for antibiotic prophalaxis. 

Jim

Hi Jim.Need your advice. Is it better keep a schedule or wait till i get the urge to pee? Meaning CIC. I find at times usually after 6am cath. i can wait till 12 noon before i cath again. At times, I'm over 400ml, but mostly under .sometimes only 150 ml.May 3 rd i  will see a URO that does uro lift.

thanks my friend Jim,

frank ,

If you're mostly under 400ml at 12 Noon, and feel no urge to pee between am and 12 Noon, then I see no problem waiting Noon to cath. Cath schedules should be flexible based on urine output which can vary from individual to individual and also vary due to time of day. Good luck with your appointment on May 3rd. Let us know what he says. 

Jim

Jim , Thanks for that reply. My Uro says the urodynamics test could not  

show a neurological problem. I know i have an enlarged prostate,I don't know what my bladder problem is?Does this make senseJIm?

thanks 

frank, 

Your bladder can be stretched and therefore not functioning properly without a neurological problem. So it makes sense. 

Jim

I travel by air several times a year, on domestic flights and international.  As suggested above, I pack catheters in BOTH my checked and my carry-on luggage, in case of lost suitcase.   I figure simpler is better, so carry as little as necessary.  At home I have bottles of alcohol, but for travel I always carry the little sealed alcohol wipes; those 2 x 2" envelops fit into the "change pocket" of my jeans easily and snugly.    I almost never need to cath on flights, but when it happens, I stick the SpeedyCath onto the wall or hang it on something that the package ring can hang on. If nothing looks suitable (or near the end of a long flight) I just tuck the cath pack under my arm until I'm ready.  I clean the tip with the alcohol towellette, then use the World-Famous Jimmy James Dive Bomb Technique, never needing to clean my hands!  

I've never been questioned about the catheters, neither here nor abroad, but will certainly remember the "Want me to show you how it's done?" line.  

"Awareness" is a part of this game.  If you listen to your body, it will usually give you signs that a stop-n-pee moment is at hand.  My bladder was horribly atonal after my emergency 2.5 liter cath-draining 2 1/2 years ago.  I could go to 800 or 900 cc without noticing!  

Using JimJames' method, I began "listening" for my bladder signals.  Initially weak, they became stronger and more clear with time.  And gradually, my signals alerted me sooner and sooner, and these days, they sound off at 300cc.  And SOONER, like at 200cc, if I am under-hydrated, as the urine becomes thicker, more acidic and potentially toxic.  The bladder knows!  :-)

At those times when I cath, the pee is notably darker and stronger smelling.  These days, I do my best to stay hydrated...

JIm, There must be a way to repair a stretched bladder? or is there?

frank,

When you say "Awareness" when you get the urge to pee,I get this urge sometimes 1 or 2 hours after cic. Then again i might not get this urge for 5 hours.If i  followed thru with the Awareness,i could be doing CIC 8 0r 9 times a day. Whats your opinion on this?

Thanks,

frank,

I hope so. my bladder is pretty stretched. my doc mentioned something about a pace maker for the bladder if nothing else works. Has anyone heard of that?

Good question Frank!  

If this were happening to me (and I'm not a doctor, don't even play one on tv...), I would note and jst ride the preliminary urge untilo it subsided.  THen when it reappeared, I would cath and see what the amount was.  If THAT time it was around 300cc, I would repeat, knowing that my bladder was sounding off at 200cc, not a time when (other things being equal) I would see the need to empty.  If the amount were 400cc or more, I would do the cathing with the first signal, to catch it at 300cc or so, where it should be.

My sorta-former-uro-doc's PA offered this, which (as I recall) was a transmitter implant above the buttocks, that would send a "release" (or maybe warning?) urge that would cause the bladder to release.  I'm sure you can Google it.  I was not interested, and have stuck with CIC for the better part of 2 1/2 years...

Sometimes a stretched bladder can be helped by decompressing it with CIC. Sometimes it can't. A prostate reduction surgery can sometimes help by making it easier for the bladder to pump. But sometimes it can't. That's why in your case none of the doctors are making promises to you. Let us know what the Urolift doc says.

Jim

If you don't have to cath between 6am and Noon, you should be able to keep it to six or less self caths a day. If you have more urges than that, a urine log would be helpful where you not only write down the times and amounts but also whether you had an urge at that time and how strong it is. And the 6x/day is not in stone. With me, I did 6x/day for quite a while, but every once in awhile ran over and did 7 or 8. No big deal as I see it.

Jim

Stebrunner,  thanks for the help.  My NV, is getting better, and I don't think it's my imagination.  What is helping is that whenever I am using the catheter, I push by tensing my stomach muscles. The flow, becomes strong when I tense up, and so when I am doing NV's I notice more urine flowing out.  It's been 8 months or so since I started CIC.

Hi Catoonman, I can appreciate your humor. You are saying you would follow the urge and cic. That could be up to 8 times a day.The amount is mostly under 400.ml .If the amount is 400 or over,then go back to the urge and cic. Is this about right?

Frank

Sounds about right to me (although remember, I'm an artist, not a doctor!  I keep a cathing log, and know the amounts, and also have learned by bosy's TYPICAL rhythmns.  Of course, just when I get comfortable, it thorws me a curve and I'm up at 2:30 am to pee, with absolutely no reason!  :-)  But yes, I do my best to keep the amounts at 300cc.  I KNOW that feeling.  And it's more than just the urge.  Sometimes when I have an urge when I'm sure I'm not "full," I will relax and empty the little bit that collects below the prostate (as it does in my case usually), and then wait for the "full" urge.

I cath typically 5 to 6 times a day, and rarely as often as 7 times...