Self Catherization: Issues and Problems

I guess I don't know what prophalactive antibiotics are.  I can easily look it up online.  I was under the impression that health experts discourage doctors from giving too many antibiotics, and they have to be taken for a full regimend like 2 weeks etc.  I don't know how you can take an antibiotic like you would an aspirin or something.  I know this is what you mean when you talk about only treating the infections that need it.  Not sure how to tell the difference.

Keith,

Yes, too many antibiotics are not a good idea. But an intelligent and occasional use of antibiotics prophalactively (protectively) is not the same as misusing them. For example, it's pretty common for doctor's to give one or two doses of antibiotics prior to certain procedures like cystoscopy or urodynamics. In these cases, since it's preventative, you do not have to take the full course/regimen. I'm talking about something like that. Not treating an infection but preventing one in certain specific circumstances. Like I said, I've only done it maybe once a year. I take aspirin much more often

Jim

I have tried hydrophilics with separate water packets but wasn't aware Coloplast made them. Is that what they gave you -- a separate packet that your break -- or were you just instructed to add water? Other than Speedicath, and the one you mention, Coloplast has a new Hydrophilic called the Speedicath FLEX Coude which is different from the regular Speedicath Coude. The new FLEX coude comes ready to use like the regular Speedicath but it comes folded up and the tip is rounded as opposed to bent. Some might argue technically not a Coude, but it's designed for the same purpose, ie difficult to navigate urethras caused either by BPH and/or strictures.

Jim

The Speedicath Flex that Jim mentions is definately worth a try.

I went to the Coloplast site & tried to find a link - I'm not great with a computer.  It does mention them; add water and wait 30 seconds.  Evidently the water activates the slick solution.  Seems kind of awkward to tear open the end, hold under faucet, wait for about 30 seconds, ready to use.  They're called a self cath plus;  hydrophilic straight cath.  I didn't understand that I needed to ask for speedicath.   I can make these others work but they sent me 5 boxes of them!  The Flex Coude sounds great, especially for traveling, but expensive I'm sure.  Well, I'm grateful that THIS is the problem I have and not some other.  I can deal with this.  

Money is part of it with me.  I've been getting these supplies for about 2 months now and I haven't gotten a bill yet.  But the business told me that the speedicath with coude is @ $7.50 apiece.  The regular non-hydrophilic are only about $1.70.  That may be why the rep sent me these because I mentioned the big difference in price between the coude tip and the regular.  I have a medigap plan that is a Plan F high deductable, so I have to satisfy $2200 before they pay my 20% copay for Part B.  I figure these bills will be coming eventually.  

Reputable distributors will let you return or exchange any cathter you don't want. No reason to use your second choice. If you google "Speedicath Price" you will see that the straght is under $2 and the Coude is around $3. Something wrong with anyone chaging you $7.50!!!

As to insurance, I have Medicare Plan F Supplemental as well. Covers up to 200 free catheters a month, Coude or straight, no deductible.  If you're going to use catheters, I would call a couple of Plan F providers (they all have the same rates but customer service may vary) and get a plan like mine, that covers your catheters for free.

Jim

Keith, I tried Coloplast before settling on SpeediCaths, which I have now used for 3 years.  The Coloplasts I tried had a little conteiner of water, sterile water, contained within the plastic sleeve holding the catheter.  As I recall, the instructions at the time were to "pop" the water bubble, wait 30 seconds, then open the outer package and remove the catheter.  I switched form Coloplast after TWICE getting catheters with the inner bubble filled with AIR, no water.  I didn't want to have to always have a backup catheter just in case.  

Additional thought: dangerous to introduce tap water to the package, for reasons of possible contamination.  I would never do it.

I never had a minium and have ordered as few as one box (30 catheters) at a time. All you need to get 200 a month is an Rx that says you need to cath 6x/day. I would call up your Plan F provider and get some clarification rather than guessing. Tell them how many you need a month and make sure you're covered. If your doctor needs to re-write your Rx, now is the time to get it done. Free is great. Out of pocket can be real expensive with these things. 

Jim

Hi Keith,

I just noticed your post as I have not been here for a while. I have Medicare A and B and Plan F through United Healthcare. I also get Coloplast hydrophilic 14fr coude tip catheters and use 4/day. These catheters are paid for through Medicare B - you do not need any supplemental health insurance to get them. I get mine through Byram Healthcare. Medicare will pay for 120 catheters/month and you can order up to 3 months supply at a time. So for me, I get a notice every 3 months from Byram when I have a 10 day supply left and then I order online. I say to just "maximize" my order which is the maximum Medicare B will pay for which is 360 catheters per 3 month period. You need an order from your doctor sent to Byram ( or whoever else you use ) indicating why you need these. It can be any doctor - I just use my PCP. Good luck.

Neil

Hi Neil,

It sounds like you have a Medicare Advantage program instead of straight medicare with a supplemental Plan F? With the Supplemental Plan F, you can get 200 catheters a month with no co-pay, even more if you get an exception. You can also see any doctor who takes Medicare. 

Jim

Hi Jim,

I just have straight Medicare B and in fact I was getting my catheters (120/month) before I signed up for AARP Plan F. Medicare B covers medical devices. But I got Plan F ( whose premiums just went up 30% !!) to cover all my prostate tests and procedures and my varicocele embolization safaris - as long as all these tests and visits qualify under Medicare then Plan F pays for everything with no annual deductible. Mine is through Texas where I maintain my primary residence. But Medicare B covers all my catheters throuhg Byram healthcare. It is a great system for which I am very grateful.

Neil

Keith - just wanted to add that I started basic Medicare B last July 16 and started getting 360 catheters per 3 month period last September at no cost to me. At that time I did not have any supplemental insurance. I started United Healthcare Plan F in Feb of this year for other issues. It had no impact on my catheter orders. My Plan F premium was $110. /month with no deductibles or other costs. Everything is paid for by United as long as the procedure is covered by Medicare. My premium just increased this month to $140 but it is still worth every penny. While this is for Texas, the Medicare B is Federal of course so I do not understand the problems you are having. My doctor sent a prescription to Byram last Sept. and a few weeks later the Speedicaths started to arrive with no problem or cost and continues to this day. Byram Healthcare has been outstanding for me - maybe try them for yourself. Let me know if this helpful or not - I am just trying to help from my own experience.

I meant to write "last July 2016" and not "last July 16".

Thanks for the info Neil.  I just went on medicare last December.  I'm new to it and to cathing.  I've been trying to get some samples because there are a lot different catheters out there and I'm planning on doing this for quite some time.  My Urologist, after seeing me for the first time, scheduled me for pre-op and surgery about 3 weeks later, then ordered me a 3 month supply of fr14 non-hydrophilic coloplast catheters; 270 of them (from Byram btw)  I was surprised at the size of the order.  Anyway, I began to read about other kinds and wanted to try something a little less traumatic to my urethra; the 14 were a little difficult to push through my prostate. Byram sent me out another 30 day supply.  

Maybe you don't worry about trivial amounts of money but I'm just trying to save on my 20% of part B medicare.  My plan F medigap policy is a high deductable F.  It pays just like a regular plan F after the $2250 deductable is met.  Until then it pays nothing but the premium is only $44 a month.  I decided to gamble on not needing it for a few years; at least not to the extent of it exceeding my premium savings.  I HAVE been wondering lately if maybe catheters aren't subject to the deductable on my policy.  Its been a couple of months and I haven't gotten a bill for the first order yet.  I'll have to dig out my policy and see for sure. 

 

Hi Keith,

So is it correct that you just have Medicare part A right now and not Part B? I also tried to avoid paying for Part B for a year and it sure took a lot of effort to get it a year later and I ended up paying a 10% premium hike over what I would have paid had I started it when I started Part A.  But it is certain that just under Part B you can get up to 360 catheters of your choice per 3 month period at no cost to you. You do not need any supplemental insurance for this - it is all federal. But I must say that 20% of my social security is now being clawed back though I still appreciate it.

I have a 240gm prostate which is very difficult to navigate. I use Speedicaths 14fr hydrophilics coude but also add some gel to them so the catheter slips through easier. I just hang the catheter on the wall and pull down the green sleeve part way and squeeze a few globs in the top ( from a height of a few inches so I don't touch the sterile foil with the tube) and then a few minutes for the gel to mix with the saline in the pack and coat the catheter -it works like a charm - like going to power steering!

My uro also had me scheduled a year ago for a prostatectomy but then I dsicovered jimjames and CIC which has worked out great fro me. I hope it does for you too. What state are you in? Take care. Neil

Hi Neil:  I didn't answer you before because there is some misunderstanding here regarding insurance coverage and I 'm not sure where it is; and I know this isn't a thread regarding insurance.  But no; I've had part B eversince I turned 65.  Medicare part B does pay for up to 200 catheters a month and pays 80% of that.  But the other 20% has to be paid out of pocket or with a medigap plan such as plan F, G, or N.  I elected to go for a Plan F high deductible ($2200) so I have to rack up that much in 20% charges before it pays anything.  If I get 120 catheters a month my 20% would be $46 a month.  If I had a Plan F no deductible I'd probably be paying about $90 more a month in premium than I am with my high D one but it would pay for my catheters.  I think when people say they are getting 150, for example, free from medicare they are referring to the 80% they pay.  The other part is not free or must be picked up by a medigap plan or out of pocket.  I called my medigap plan today and they said that even though I haven't gotten a bill yet from them; I will be responsible for the 20% until the $2200 is satisfied.