Yesterdays problem was Bugs not being able to pass urine. We ended up in A&E where they inserted a catheter and discharged her with a leg bag and an add on one for nights. The hospital were going to write to the GP to request District Nurse involvement to change the catheter. I tried to shortcut this stupid procedure by phoning the GP but they only deal with calls after patients have gone by which time no secretary available to type letter. So they say it will be done on Monday. I demanded that they email and will see what happens.
The catheter has to be changed next week but the hospital did not say when or how long it would have to stay in.
Questions:
How often should it be changed?
Is there any way of shortcutting this daft system of paper pushing to get to DNs quickly?
If a lady has a catheter fitted, is there still an urge to urinate in the normal way? I ask because Bugs kept getting up in the night to go to the loo and took a lot of persuading to go back to bed.
Thanks.
Written by
Tokki
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Hi, Don't Panic!!! When S had his put in, it had to be changed after four weeks, then onwards every 11 weeks. This may be different for Bugs, but I am sure the change won't be due until next week.
Phone the district nurses on Monday morning and tell them, they may well all be ogres, ( part of the training!), but they can come out quite quickly, if needs be.
As to the feeling of wanting to urinate, I had one many years ago, after an op, it is a very funny sensation, which in the fog of sleep, might well be thought of as needing to go to the loo. S never gets that feeling, apart from when the bag is full to overflowing, (one time when he was in hospital) or when the bag got blocked. As long as both of those aren't happening, she should be fine, it's just a matter of getting use to it. But do mention it to the DN's when they come, if it carries on happening. If it gets blocked, dial the emergency number for the DN's or 111, straight away!
I know this is all very strange to you, but honestly, if Bugs needs one permanently, they are the best things since sliced bread!!!
Thanks. Problem sooner rather than later. Leaking. No number for DN. Had to use 111 who then phone duty Dr who then phones DN. Timeframe for response 6 hours. Meanwhile have Bug sitting on a pile of towels.
Heady we were told catheter should be changed every 4-6 weeks? George has his changed normally 5 week if he has had a urine infection they change it mid infection, Yvonne xxxx
Think there must be a wide range of different catethers. I am sure a lot if the problems that occur, depends who changes the Catether. S's previous one, was changed by the hospital, it lasted the whole 11 weeks, without a moments trouble. Had a new one fitted last week, by the DN, so will be interested to see what happens this time.
In the US , catheter is changed once a month. We have a home health nurse come in and do it. She then take s his stats and makes sure everything is good! I don't know about women, but my husband does not have the urge to go....We do go to the bathroom to empty the bag when it hits about 600 MLs that about every two hours. I try to give him at least 2L of water a day. He has a PEG tube so I can control his intake pretty easily.I also give him 1/2c or 120MLs of pure cranberry juice throughout the day via the PEG. I think this has helped with preventing infections....I tell you I was a scared bird when B first got his cath....the fine ppl here got me through it.....and now cath is working out pretty well!
Sorry don't know anything about ladies and catheters. My hubby has an external convene but nothing like this suitable for a woman. Good luck getting it all sorted because it makes such a difference to the person with PSP and an even bigger difference to the carer forever washing clothes and bedding. Marie
There are different types of catheters so depends on which one you have for duration of when needs to be changed. Hospital ones are normally for long duration so 3 months. The leg bag needs to be changed weekly though. You can also get different length leg bags so ask DN to get ones supplied that fit the leg correctly with no kinks in the tube. Depends on persons height too. We had to try a few to get right one for Mum so it was as comfortable as could be for her. She also wears trousers so wanted one that could be emptied easily at bottom of leg.
When Mum had her catheter she felt the urge to go still for a while.
Catheter legbag needs changing every week. I found mine was blocking due to constipation so call outs to the DN were frequent. I felt when I went but it was better than the alternative. Eventually I decided to try pads which means I don't have to worry about calling any one out,it's not easy making myself understood when you live alone with PSP.
hi, myjual. How are you doing these days? I'm always glad to see your name come up here, and think about you more often than you might imagine. Love, Ec
My wife had a semi permanent urine catheter fitted last March. She pulled it out had a blockage and a defective catheter all in first 4 weeks since then no problems. It is changed 12 weekly but the balloon is checked weekly similar to PEG. Margaret had lost control of urine so saved pads and multiple night trips. Once she was used to the loss of sensation of full bladder she relaxed and stopped trying to get up for toilet trips. Leg bag easy to empty (get a normal 2lt plastic jug and keep it for the duty). Can check colour and smell for early signs of UTI.
A lady's urine catheter is a lot simpler than male catheter and fewer issues once settled down. Hope Bugs settles it will certainly make her care easier and will allow more freedom to go out well for a few months. For self conscious issues M now wears trousers with wide legs to mask the bag. Suggest experimenting with different types of leg strap and position as M found some straps too tight and others in awkward position.
I could write a book on catheters for females with PSP. My wife used one off and on during her last 3 years of life. They were lifesavers. But they can also create UTI's, although she can still get them without having one inserted. My wife never mentioned anything about a sensation of having to urinate and never requested to go to the bathroom (loo), except when the bag was full and needed emptying. There are different opinions on how often you need to change them. Most believe it should be changed every 4 weeks, which is why the US' Medicare system only allows reimbursement for one per month. I've had heard they were going to recommend an even longer period of time. For me, whenever I suspected she had a UTI, based on the color of the urine or the smell as I would empty the bag, I would remove it myself. You can only test the urine via a "clean catch", which isn't possible with a Foley cath. The nurse at the urologist office showed me how to safely remove and insert a Foley. Once you learn the proper way, it's a piece of cake. And I felt like I could do it better than some of the nurses at the hospital. I once watched 2 nurses attempt to insert it and they each slid it into her vagina instead of her urethra, so they then had to start all over with fresh supplies.
After my wife had a Foley in for 2 weeks, I generally would remove it and then just straight cath her for a few days, before going back to the Foley. Usually her Foley looked pretty funky after being in there for a couple of weeks. Since our insurance would only pay for one Foley per month, I searched on the web and found a place that I could buy them for about $1.30 a piece, so I would just buy about 50 of them, which would last me for about a year or two. Spending about $60 and not worrying about insurance and their rules and regulations was so much easier. I also bought my own UTI test strips, so I could test her urine at home and not have to run a sample over to her doctor's office all the time. Those were about $75 for 100 strips.
The leg bags could be a nuisance, as you never know when a leak might occur. And some had drainage valves which were easy to come open and cause a real mess. My favorite leg bags are made by a company called Hollister (product # 9814). They have a couple of sizes, but I preferred the smaller one (540 mL), as my wife's leg wasn't that big. These bags rarely leaked and lasted much longer than the others. And I liked the valve on them, as it flips up and down (up for closed and down for open). So you could look at it and know whether you have it closed or not, versus the valves where you twist the cap to open or close. In the US, Medicare allows you 4 legs bags a month and 2 night bags a month. The night bags are super sturdy and could probably last several months.
Foley caths were truly a blessing for us. With a Foley, I could have my dad stay and watch my wife at times. He could take her to the bathroom and roll her pants leg up and empty the leg bag, all while allowing my wife to maintain her privacy. And no more wet beds and clothes. I still kept her in Depends (adult diapers), as she would sometimes have spasms which caused some leakage via the urethra.
Hi Tokki. Ask whether you need to keep a spare at home. Our DN' office did not store them and we had a bit of a problem during an emergency. No need to mention that I was reprimanded for not being able to mind read!! You will find the catheter easier to manage than the frequent toilet visits. Good luck. Maddy
Thanks to all for the great advice. Not sure where we go from here as leakage yesterday plus infection and fall at 04.15 today has put Bugs in hospital. 7 1/2 hours in A&E and still no bed. At least I persuaded a junior that she could not be discharged.
I don't mind that some medics have not heard of PSP, or come across a case, but when they try to bluff their way through... I have respect for those who admit to its rarity and then seek much more info.
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