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Old 12-17-2014, 07:00 AM #1
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Frown Foley Catheter Question....Nurses?

Haven't posted in awhile since it seems all I have to mention are complaints, but here goes another....sorry

A short background.....SPMS, legs don't work, use a powerchair, can't tell when I have to urinate, severe lymphedema in my lower legs and feet from immobility, now have a pump/boots that help if I could use it more often. I have a home health nurse who comes in twice a week to care for my legs and also my indwelling Foley catheter. An aide also comes in twice a week for three hours each time to help dress, bathe, light housekeeping, etc. Cleaning people every Wednesday afternoon who also grocery shop, pick up prescriptions, bank, etc. They've been helping me for 16 years so have become good friends....two sisters around my age.....71....diagnosed in 1990 but believe it began in 1976 after third child was born. Divorced same year as diagnosed, so have traveled this MS road mainly alone.

Anyway, the problem, have used the foley a little over two years now. Have had quite a few UTI's. The doctor doesn't want it changed more than once a month to try and avoid infections. Now some urine, sorry for the gross subject, goes into the bag, but alot of it is coming out "normally", leaking around the balloon. The result is that I'm wet quite often and my skin is getting really irritated. Can't change pants myself.....can't reach and legs weigh a ton to try and lift.

Have an appointment with a urologist (oh joy -- NOT), Jan. 9, but nobody seems to know what to do in the meantime.....pcp, nurses, etc. This is disgusting and I really need some help/suggestions from anyone having experience with catheters/nurses here. There HAS to be a solution, I can't be wet all the time, especially with holiday visitors, etc.

Did I mention..........I HATE THIS DISEASE!!!!!

Thanks for reading this and any help. I'm about at the end of my rope with this problem.....on top of everything else.

Merry Christmas
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Old 12-17-2014, 07:54 AM #2
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Judy

I don't have a solution but just wanted you to know I care and will keep you in my prayers.

Seems like the aides would have seen this problem before and have some suggestions. Maybe they aren't allowed to suggest or endorse things because of liability.

I certainly hope the Urologist can do something to help. Do you have anyone to accompany you to your appointment? Sometimes it helps to let someone else hear what the doctor has to say. If you're like me you can think of several questions to ask.....but after I've left his office!
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Old 12-17-2014, 11:31 AM #3
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hi judy, i'm a judy two (ha, ha...get it?)

uh, my sense of humor is waning.
is it possible that the baloon inside your bladder isn't blown up enuf?
when they insert the catheter they then blow up a small balloon to hold it in place so it doesn't slip out.

i'd check about that. you might also call the company that supplies your catheters. they might have some advice.

i also know of a procedure where they put something in from your abdomen; something like a colostomy. i wonder if that might be better and help with infection. i don't really know anything about it tho.

please let us know what you find out.
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Old 12-17-2014, 11:57 AM #4
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Hi Judy., think of you often and pray daily for you..
Hope you find a solution for your MSesy problem..
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Old 12-18-2014, 01:23 AM #5
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I am a nurse also and agree with Nurse Judy. How long has tis been going on with the catheters leaking and if has not been very long could it be that this particular batch of catheters are faulty since it really sounds like the balloon is slowly leaking or wasn't inflated enough. have the nurses ever tried to inflate it more when they come during the one month period of time that it was inserted. And yes, there is a procedure where a catheter is inserted into the abdomen. When I was working it was jsut done as a same day surgery procedure although it only lasted a couple of hours or less. But that same type of catheter is inserted into s small hole that the urologist makes in the abdomen. This was only used for patients for patients they knew were going to be forever long term. Now Judy mentioned a procedure something like a colostomy. That is a whole different thing. It is a surgical procedure in which the tube that goes from the kidney to the bladder (making the bladder non functional)is rerouted to the outside of the abdomen and you wore a collecting bag on your stomach which you had to empty when you saw that it was full.

You are very right, it is a mess and it shouldn't be happening. Could it be that you are having bladder spasms which is squeezing some urine out each time you have a spasm?
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Old 12-18-2014, 09:14 PM #6
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Have you called your doctor to tell them what is happening? I'd do that if you haven't.

Best wishes for a quick improvement. I hate this disease also!!
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Old 12-19-2014, 05:31 AM #7
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Thank you all soooo much for taking the time to answer trying to help me find a solution to this disgusting problem. Unfortunately I've either tried or at least discussed them....yes, with my doctor.....my pcp. Haven't tried the neuro, but think I'll give him a try too.

I believe the urologist will discuss having a suprapubic cath. put in. That's what some of you were mentioning...the same day procedure. At least that would eliminate the irritation in that......"nether region".....hmmm. The home health nurses are able to change them too. From what I understand, if it doesn't work or makes a bigger problem, the hole will close up on it's own. Sounds kind of creepy, but at this point I'll try just about anything.

Was that other procedure an "illiostomy"? My mother had a colostomy years ago and I remember talk of it also. Now that I'd try to avoid if at all possible because it's so permanent.

The nurse had talked about inflating the balloon more, but I don't know if she ever actually did it. One time when it felt like it was coming out when I was transferring back to my chair from the toilet, it did! Obviously the balloon had deflated then!!! I occasionally have bladder spasms, but take medication for them, plus I definitely can feel it when they happen.

For some reason, the past couple days haven't been as bad. Still leaking, but not as much. Just another MS mystery I guess. Maybe my bladder is positioned differently since I did have three C-Sections. My doctor always said I was a challenge!!

I'll keep you all posted if anything changes and also after my urologist appointment. Thanks again, so much, for all your help. Even if we all don't have the exact same thing, we do "get it" and try to help.

Thank you, thank you, thank you!!!
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Old 12-19-2014, 01:30 PM #8
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Hi Judy. I use a foley & leg bag. I'm paralyzed chest down for 25yrs.
First off, balloon's job (for men anyway) is to keep foley from pulling out, not for sealing. Balloon gets inflated inside bladder not urethra creating a large water balloon you can't pass.

Foleys come in gauges which is word for diameter, from pasta size to pencil thickness. What's the numbers on your foley wrapper? Example 18F is 18gauge which I use.

Once a month?? Not me. Once a week at most. Plus balloon loses approx 1/5th of its water by then (my brand cath's anyway).

Wrapper states balloon on mine to be inflated 10cc's, I only 6cc cause it's plenty & afraid of it popping.

Let's start with what size you have & you're not the 1st woman to tell me it leaks.
Ed

edit- "gauge" was probably wrong word cause higher gauge #'s usually mean smaller not larger as in needles & wire. Larger # for foley = larger diameter though for sure. Sorry!
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Old 12-19-2014, 01:53 PM #9
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i would think that the number 1 goal is to keep you dry to prevent skin infection and breakdown. once you have skin breakdown it's harder to deal with. i would think the urologist is a good one to ask about that.

then the goal would be to prevent bladder infections.

i don't know enuf about this issue to say more but i hope you can get a handle on it with your team of medical professionals.

keep up posted.
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Old 12-20-2014, 01:39 AM #10
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Judy, an iliostomy is where the ilium part of the colon is used to divert the bowel contents to the outside. Given and iliostomy and a colostmy I would rather have the colostomy. You are thinking of a urostomy. It diverts the ureters to the outside. And if you don't have a good seal between the belly and the bag it can be a pretty big problem. I am trying to think of the stuff we used to put on our babies for diaper rashes. White and sticky stuff. Something to do with zinc. It might act as a good barrier for the skin against the urine. And yes, suprapubic catheter was the type of catheter I was talking about. A lot of my paralyzed, permanent use catheter patients had one.
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