Catheter questions

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Poor you. I do feel for you both.
I was shocked, and somewhat alarmed, to hear the Nurses don't do washouts any more??? (maybe different Areas work differently). AND that a Carer managed to pull the Catheter out???
We have had a lot of conflicting/different information too.....some Nurses say infections cause bypassing, some say a Catheter size that is too big (yes, not too small) can cause bypassing, some say the bladder going into spasm caused by the Catheter touching the side can cause bypassing.
I would be interested to know what you have been told about tube positioning - does the Catheter have a thigh strap to help keep it in place? Is it detached from her leg at night?
Regards.
Pauline_1702 wrote:
Sun Feb 10, 2019 9:37 am
Poor you. I do feel for you both.
I was shocked, and somewhat alarmed, to hear the Nurses don't do washouts any more??? (maybe different Areas work differently). AND that a Carer managed to pull the Catheter out???
We have had a lot of conflicting/different information too.....some Nurses say infections cause bypassing, some say a Catheter size that is too big (yes, not too small) can cause bypassing, some say the bladder going into spasm caused by the Catheter touching the side can cause bypassing.
I would be interested to know what you have been told about tube positioning - does the Catheter have a thigh strap to help keep it in place? Is it detached from her leg at night?
Regards.
Yes, me too about the washouts, they did one few months back, so it must have changed since then. I managed to pull one catheter out quite early in my "career" as a carer, so I can't say too much, here's hoping she'll be extra careful in the future.

The first bit of conflicting information was when the DN said that to reduce bypassing they reduce the size of the catheter. The size relates to the bore of the exit tube. When her catheter was first fitted (in hospital) she bypassed very often, they increased the size from a 12 to a 14 and the bypassing dropped by about 90%.

With regard to positioning, my wife has quite long legs, we initially had leg bags with a short tube (70mm from memory) the bag always ended up with its top right on the knee which never looked right/comfortable to me. I should say that I use a thigh strap on the catheter tube and a stretchy net-bag around the leg bag. I made up (from other bags) an extension piece for the leg bag tube (about 70mm long) which solved the fitting problems as it dropped the leg bag below the knee.

During an appointment at the Urology Dept at Southampton General - my extension tube got a bit of a verbal pasting. I explained the reason for it and that I disinfected it whenever I changed the bags, but they said use a bag with a longer tube.The next size up from the 70mm [or 140 with extension] is 250 mm, which I said would be too long, but they just said to strap the catheter outlet further back up the thigh - the DN didn't like that at all as the tube goes down, and then back up again (although it's mostly horizontal as she's seated all day) and said it can lead to bypassing, but in fact we've been doing it like that and it hasn't been a problem months now, until the last catheter change.

No problems now since the catheter was repositioned on Friday evening.
I'm glad you seem to have solved the bypassing issues - long may it continue.

Mother started off with a size 12, then it was upped to 14. She has been having a 16 Open Ended (as opposed to side openings) for a few years now.

I think Mother has quite long legs too; she was 6 foot(ish) tall in her younger days. When I have to change the leg bag (every 5 days), the top of the leg bag fits into the Catheter about a third of the way down her thigh. The leg bags we use are called Prosys 500ml Long Tube Click Close Tap leg bags. The tube goes down the outside of her knee and the bag fits below her knee and rests down the side of her calf.

I guess everybody is different and its whatever works for you.
Regards.
Ayjay wrote:
Thu Jan 31, 2019 8:15 am
A couple of things that someone may be able to clear up for me, the first I'm just curios, the second is more important.

My wife had an indwelling catheter fitted back in May while in hospital, there were some problems initially until they increased the size from a 12 to 14, (the size relates to the bore of the tube, I'm told). She did still by-pass now and again but nothing like as often. She takes one drug to control bladder spasms and when this was changed (she's at home by now) the by-passing stopped. She did still frequently spit the whole thing out (still inflated) which DN said was caused by bladder spasms. She gets no by-passing at all now, but (and here's the curious thing) when she sits on the commode for a poo, she often pees into the commode as well. How does that happen?

In March she is due to have a Supra Pubic catheter fitted, What I'm not sure of is that there appears to be nothing done to block the normal exit from the bladder, so why does the wee go down the catheter tube and not just out of the bladder and down the urethra as per normal?
Hi Ajay
I just wondered how things are going with your Wife's Supra Pubic Catheter?
Best regards.
Pauline_1702 wrote:
Fri Apr 12, 2019 10:23 am

Hi Ajay
I just wondered how things are going with your Wife's Supra Pubic Catheter?
Best regards.
A bit early to say yet, it only went in at 5:30pm yesterday, but it's all working OK at the moment, urine has cleared from last night's pink colour to normal pee colour.

As is usual with Soton General there were elements of farce on view: they brought her back from theatre on a different bed to the one that she was hoisted from to go to theatre. The mobile hoist wouldn't fit under the bed, the nurse raised and lowered the bed several times before realising that the offending bed base didn't move at all, just the bed. I went out for a smoke at one point, when I returned, she was on the bed with the sling we use to get her in and out of the car nicely installed under her on the bed, it's the wrong sling, it won't work with the mobile hoist.

Here's another comment/complaint, when you go in for "Day Surgery", it's very common for everyone to have the same appointment time, so why do the reception staff have no idea of where you are in the order of things? It must be one of the most common questions that they get asked.
Gosh, only had it done yesterday evening, sorry I wouldn't have asked so soon had I known that. I thought it was happening in March.
Oh dear, what a mix up with the sling/bed etc, I do feel for you.
I hope all goes well now.
Best wishes.
DN has been this morning to inspect the wound site and change the dressing, she said it's looking perfect, no problems at all. That's a bit of a relief as I've seen a fair few horror stories with wounds infected and not healing properly for months.
Ayjay, great to hear some good news for a change.
Yes, very pleased for you both. Hope all continues well!
Not so good this morning. Wednesday is a *no-carer day* so the washing and dressing is up to me. I was a bit suspicious of the smaller than usual amount of wee in the night bag, but before I could investigate that further she asked for the commode - usually the rolling associated with washing and dressing triggers that, so this was earlier than usual, (but not significant).

Removing the bed covers, I then spotted that the tube at the top of the leg-bag was full of wee which wouldn't drain into the bag when encouraged - also the Brolly sheet was wet and stained, hence the light load in the night bag. Removing her knickers, I could see that the wound site was weeping and the skin was a bit red in one area outside the dressing. I put her on the commode and changed the leg-bag.

Back on the bed to get her washed and dressed and she managed to fall off when I'd rolled her away from me to wash her bum. This is the sort of thing that really bugs me - she doesn't appear to have the nous to know how not to fall off - and it applies to many other situations too - her hand was under the mattress to support her but had it been on top she wouldn't have rolled off. I picked her up and put her back on the bed - seemingly no harm done.

The DN is coming later today to take a look.