Hello Ron I am a C4/5 paralyzed from the neck down. I went with the suprapubic about 4 months after my accident, while at rehab.
Your concern about the bladder no longer expanding: I've thought about this also but have never asked a urologist about it. I've been a quad for 20 years and went to my urologist the 1st part of last month and he said "for having a catheter as long as I have I've got the best looking bladder that he's seen in a long time". Maybe I'm just lucky. As far as care for the catheter: I change my catheter once a month. I dress the catheter morning and night. I use a clean washcloth for washing and rinsing and drying. I get half the washcloth wet and put soap on one corner and wash the SP site with that corner and then rinse it with the other corner and dry it with the rest. I put a small amount of Silvadene around the site with a sterile Q-tip starting close to the catheter and working my way out to about the size of a quarter. We start by the catheter and go out so that we don't start away from the catheter and bring germs and towards the catheter. After putting on the Silvadene I use a 2 x 2 IV sponge (they come to to a package and each one has a slit then it) I put one over the SP site from the bottom and the other from the top, and then tape the top to my belly with paper tape (about 2 inches long). I do have a piece of what I call " proud flesh", it's a small piece of meat that protrudes by the catheter. Sometimes it's fairly small and sometimes it's larger, maybe as large as the small canned pea. It's not really a problem but occasionally bleeds now and then. I have had it cauterized a couple of times with something like a "soldering gun", but that's been years ago and I haven't bothered with it lately. I've always had pretty good luck regarding UTIs until about the last 5 years, but still not too bad. As far as public events: I used to use a bedside bag at night (2000 mL) and a smaller leg bag during the day, with an electric valve that I could run few my wheelchair to drain the bag. But that started to have some electrical problems along with getting plugged. Besides those problems and having to clean the leg bag and the night bag each day I just started to using the old night bag all day 24/7. Changing the night bag once a week sometimes twice if the tubing gets cloudy. But what I really like, is that I have a cloth bag and tubing that I bought online (I believe it was on eBay, for about $25. It was from a individual person that makes them and then sells them. They come in different colors but I prefer black, because it tends to blend in to my wheelchair.) When I put on a new night bag I run the tubing from the bag through the black cloth tube/sock, and then attach the bag to my catheter. When getting dressed I run the bag down my pants leg and when I get in the chair. On the chair I have the cloth bag hanging behind my foot rests, pretty much out of sight except during weight shifts where I recline/tilt. Usually these bags come with a slit in the bottom with a Velcro closure on it, so instead of taking the night bag out of the cloth bag you can just open the bottom and drain it from there. Although I don't recall how long the tubing is on my night bag it's long enough that made can drain it into the toilet or on the ground. I can usually go all day (draining it at 1 o'clock when my aide leaves, until 8:30 PM). If you know somebody that sews, I would think they're pretty much a piece of cake. PS I don't know that having a bag on 24/7 instead of changing to a leg bag morning and night, is any better or worse for you. I would think that it may be better because the system stays sealed until you change to a new bag. I did mention to my urologist that I was doing the 24/7 thing and he seemed fine with it. "But to each his own" Randy On Tue, May 1, 2018 at 3:36 PM, Eric Olson <[email protected]> wrote: > Could it be a prostate problem? An enlarged prostate can make it harder > to pass a catheter. I would think your urologist would have thought of > that though. Supra is nice. I've had mine over 15 years > > On Tue, May 1, 2018 at 1:02 PM, RONALD L PRACHT <[email protected]> > wrote: > >> I cant understand how this can change in the matter of a few days but it >> did. Im home alone most days and have little help. ive got to keep the >> foley in a month, then the deciding starts. Im sure when they pull the >> foley that the catherization tube will slip in at first. Will it stay that >> way.............probally not. Im on Flomax now and oxybutin, im hoping that >> helps.............not sure if it will. I don't fully understand why the >> spincter is spasming or staying closed. I guess I will try anything to get >> it working, but at some point Im going to have to look into a superpubic. I >> cant see how a condom cathe could work very well long term, and wont work >> at all without removing the spincter. I just don't want to make the wrong >> decision. Ive already screwed up on my syrinx and letting the docs put a >> patch in my stomach after my appendix burst in 2011. I just want to know >> when the smoke clears if the superpubic sucks that I did all I could to >> keep what little life I have rolling. I have very little support guys. >> Thanks for the help. >> >> Ron >> >> >> On Tuesday, May 1, 2018 12:13 PM, Quad Dude <[email protected]> >> wrote: >> >> >> Hi Ron, >> >> The only 2 alternative solutions I can think of will likely be >> unappealing to you. >> >> Since it appears your bladder sphincter is clamping down too hard, you >> could get a sphincterotomy which debilitates the bladder sphincter and >> allows for the free flow of urine, however, you would need to wear an >> external (condom) catheter from that point forward. >> >> Another possibly more appealing solution could be to get a suprapubic >> catheter placement. This is done through a simple surgical procedure which >> creates a pathway from your abdomen directly to your bladder and your >> bladder would empty through this pathway via a Foley catheter. The side >> benefit of this method of bladder management is it "frees Willie" and can >> make day to day management a bit easier. The procedure is also reversible >> as the passageway from the abdomen to your bladder will close on its own >> over a relatively short period of time (multiple hours or days) if you >> remove the Foley catheter. >> >> These may have already been discussed with your urologist. I definitely >> encourage getting 2nd opinions before opting for any surgical procedures, >> urology or otherwise. >> >> I hope you find an acceptable solution that works for you. >> >> Steve - C4, 30 years, auto accident >> >> On Tue, May 1, 2018 at 4:37 AM, RONALD L PRACHT <[email protected]> >> wrote: >> >> Im a c7 quad, 20 years post that has been straight cathing for 20 years >> with little issue. Three years ago I started leaking a bit but just dealt >> with it until the tubes wouldn't go in( pass sphincter) without an hour of >> pushing and sometimes 5 tries. 3 months ago things got so bad that my >> bladder was full and I couldn't insert the tube at all and my body went >> into severe autonomic dysreflexia. I was taken by ambulance to the hospital >> and they inserted a foley for 3 weeks. After the foley was taken out they >> gave me some antibiotics and the tube was slipping in like butter for the >> next 8 days. Out of nowhere the tube started getting harder and harder to >> get in until it was near impossible. I was put on that drug that stops or >> decreases bladder spasms back at the urologist visit after the emergency >> room deal. Went back to the urologist today and they had to give me the >> nurse, she tried to run a cathe tube in me but it wouldn't go so she tried >> a caude cathe tube with the bent tip. this got through and urine came out >> but lots of blood came out as well which never has happened. Finally the >> doc came in and tried to get a foley in and finally did after awhile. The >> blood wasn't coming from the bladder, it must have knicked a wall. My last >> urologist visit they ran a camera in and it looked great no false passage >> or issues. The question is why is the tube not getting past the internal >> spincter? I suggested trying Flomax and im already on oxybutynin. if there >> is no blockage or false passage then the spincter has to be in spasm or not >> opening right? What else should I do? I have this foley now for a month >> that I didn't want but I got anyway. I guess if I take the Flomax and >> oxybutynin and after the four weeks remove the foley and im sure the tube >> will go in but within a week it might start giving me trouble again. I >> don't really understand how the spincter could give me this much trouble >> and if it is what else I can do. I fear that im going to get a permanent >> bag soon because they are tired of me. maybe they can rescope me to be sure >> next time as well........im at a loss. >> >> >> Ron >> >> >> >> >> >
