catheters

[sphinx]

I was at the uro's office today and his NP was teaching me to do my own bladder instillations. I didn't realize till after I was home (at 5:30) that i forgot to ask if I could wash and re-use the catheters? And if so, how do you clean them? Do other people re-use theirs?

[GriffsMommy]

That's so weird that you posted about this. I am going to have my NP at my gyns office so me how to self cath so I can do the self instills as well. I know that each practice is different. I have read where some use a new one each time and some wash and reuse them. I would really call tomorrow and find out what they recommend and how to clean them if they say that is okay.
Was it hard to learn? The NP has an hour set aside for me tomorrow morning to teach me, I hope that's enough time.

[Berkshire Road]

I was told, by my doctor, that one catheter can be washed and re-used up to three times. I did not get cleaning instructions, since I have no real reason to want to re-use them. Sorry.

[sphinx]

I wouldn't say it was hard to learn...but that doesn't mean it was easy to do, if that makes sense! I already knew how to mix the meds in a syringe, so that was easy for me. I also spent quite a bit of time looking in a mirror for the right spot! I found it ok, but once I tried to get the catheter into it, that's when it was tricky. I was aiming for it, but with the slippery-ness of it all, the cath slipped into the "other spot" twice. She then guided me to my urethra. I'm to practice this week and if I do ok, I don't have to come back for a second "lesson". She also gave me some macrobid to take everyday that I am cathing.

I'm going to call today about the washing.

Good luck to you, let me know how it went!



Was it hard to learn? The NP has an hour set aside for me tomorrow morning to teach me, I hope that's enough time.

[GriffsMommy]

Thanks for the info. She has me watch with a mirror but she actually did it. I think I will be able to do it. She gave me some swabs with badidione on them ( I know I spelled that totally wrong) and she said when I wipe with them it will kinda pool right at the urethra which will make it a lot easier to find. She gave me the pediatric feeding tubes to use for caths and gave me some lidocaine to put on the caths. She also gave me all the other supplies I will need to mix up the meds and gave me the rx's for the meds. I went to Walgreen's and they weren't sure about how to order the heprain so I should be hearing back from them once they get that figured out. Hopefully they can get the stuff for me by tomorrow because I'm flaring so bad I might do them for a couple days in a row.

[GriffsMommy]

I forgot to add that my NP said it was okay for me just to rinse my caths and reuse them a couple of times. She really didn't give me any other instructions other than that and to let them air dry. Because she only gave me a couple of the caths I probably will reuse them at least a few times until I get to the pelvic pain specialist next Wednesday because I am in a horrible flare and I'm going to try to do the instills up to 1 time a day to try to help with the pain.

[sphinx]

Well I'm glad it went well and that you feel you'll be able to do it.....my local pharmacy (CVS) couldn't get the heparin or the lidocaine for me, I ended up going to the pharmacy at one of the hospitals here and they got it no problem! Only thing now is I have to get these adapter things to connect the syringe to the catheters, because the caths have a "funnel" opening and the syringes have the leur-lock end (that screws on). The catheters I have are 10 french female intermmitent catheters. they are very tiny! The good news is, I did my first instillation all by myself today, just before my shower! Yay! The angle was sort of awkward, different than at the office, but I got it right the first time! I was so excited when I was done I stood up and am like "YEAH!" put my fist in the air like victory, lol! Who'd have ever in a million years have thought I'd be excited about catheterizing myself?! Anyhoo, I'm to do it everyday, and if symptoms start to improve, go down to 3 times a week.

Hope you are feeling better SOON!

[sickofmybladder]

I do not reuse my catheters but I do know some people do.....

Regarding your leur lock issue - I ordered 60 cc catheter syringes and they work perfect for the end of the catheter - just a thought.

[sphinx]

But do you have to get 2 different kinds of syringes? One with a leur lock to attach the needle to draw up the meds and a second with the catheter tip?


Regarding your leur lock issue - I ordered 60 cc catheter syringes and they work perfect for the end of the catheter - just a thought.

[L. Thomas]

The link in my signature.. helpful hints
I have attempted to give the instructions I was given. Remember this is not medical advice but suggestions to help you with instills. I know how REALLY REALLY apprehensive I was at first.

I do reuse the catheters(cleaning instructions in helpful hints). I can use each catheter a total of 4 times. I use a 30cc lure loc and 8fr pediatric. feeding tube. I can draw all the instill meds in the one syringe and the ped. feeding tube will attach without any problems.

If you go to a pharmacy that provides insulin and supplies for diabetics you will probably get help as they are use to dealing with meds in a vial. If they can't help you I am sure they will know where you can go. I go to Kroger's (a chain grocery) and have no problems getting the meds.

Be sure to check your insurance for added benefits. My insurance will cover 90 day supply for 30 day copay for routine meds. My insurance will also cover syringe and catheter but I have to get them from a durable supplies store.

In the beginning I needed instills everyday but now I usually don't need one more than 1 a week (except March-April and Sept-Oct..seasonable allergies)

[sickofmybladder]

I personally use the following supplies: (which I also purchase from durable goods)

10 cc syringe
18 gauge needle (this syringe and needle are what I use to draw my meds - the needle "snaps" onto the 10 cc syringe)
60 cc catheter syringe - I put all the meds I draw out with the other syringe into this one
10 French Female Catheter (the red ones) - the catheter syringe slides right onto the end of the catheter

I think it's just a matter of what is available in your area -

Congratulations Again. :smile tee

[Taramc]

Hey guys,

I started doing instills in April and quit in June after SO MANY of them caused urethral problems for me afterwards. Then I discovered pediatric cathters (thanks Briza if you stop in here) and they're great.

Also I started using Lidocaine gel on mine in September when I gave into instills again. That has made things more comfortable than the sterile lube gel alone.

LOL at the mirror and the catheter slipping into that 'other' place. I spent 45 minutes trying to figure it out my first time - all I had was a pamphlet and I'm sorry, but the illustration was wrong on the location of the urethra! I should scan and post it (don't worry I won't). I was sore for a week from trying to punch a new hole in myself.

Anyway I read in the pamphlet that it helps to put your finger in the 'other place' to avoid that, and from there you can feel the cath going into the right place because there's not a whole lot of space between the two.

As for washing the catheters, I boil them and re-use them up to 3 times. In fact I boil absolutely everything from the needle used to get the marcaine out of the vials, to the cup I mix the stuff in, right before cathing. I have a boiling party in my kitchen. And I take 1 Bactrim each time.

AND, I have some advice that might not pertain to a lot of you because it entirely depends on your domestic situation. BUT, after getting frustrated a couple times I recruited my husband to do the caths. He says it's a piece of cake - takes all of 2 seconds. IF any of you have somebody who'd see the humor in this and do it for you, they have a MUCH better viewpoint.

As for getting the MARCAINE and HEPARIN. The doctors should really inform us ahead of time. I had to call every pharmacy in the book, too. You'll find them at UNIVERSITY or HOSPITAL pharmacies, and nowhere else. AND if your Rx is for 5ml of Heparin, beware they normally come in 1ml bottles and you'll have to ask for the pharmacy to order 5ml bottles.

Ok, final question: ANYBODY trying to crush Elmiron and mix it in? It stops up my cath..

Thanks everybody!

[sickofmybladder]

As for getting the MARCAINE and HEPARIN. The doctors should really inform us ahead of time. I had to call every pharmacy in the book, too. You'll find them at UNIVERSITY or HOSPITAL pharmacies, and nowhere else. AND if your Rx is for 5ml of Heparin, beware they normally come in 1ml bottles and you'll have to ask for the pharmacy to order 5ml bottles.

I agree the doctors or at least the nurses should be more helpful with this part - I did manage to get my meds at Walgreens - but if you could have seen their face when I brought the first script in...ironically they had the hardest time with the Sodium Bicarb in my "recipe" .... it's quite an experience that's for sure. And your right about the Heparin - I use 2ml/cc and I have to use 2 of the teeny tiny bottles per instillation - I'll admit that I couldn't initially draw out the heparin - my husband had to point out that the needle was in the vial further than the heparin - I was trying to draw air (remember it's only 1 cc) :bonk: - Haven't made that mistake again.

[jen74]

I personally use a new cath each time, it is safer in regards to preventing infection in my opinion. I mean you are inserting a foreign object into your body after all. I like to be safer than sorry I guess.
Jen

[jmcraig]

Hello everyone,

I am a pharmacist with CVS and I do home instills. And YES CVS can order the lidocaine and heparin for you from our wholesaler for the next day delivery. Actually any retail pharmacy can order them for you it just depends on the pharmacist and how much they are willing to help their patients.
Janet

[sickofmybladder]

JMCraig -

Thanks for the info - I did go to CVS initially (right across the street from Walgreens) and the pharmacist said they could not get heparin - could it be an area issue? (She told me I would have to go to a speciality pharmacy)

Thanks
Becky

[L. Thomas]

Hey guys,

. Then I discovered pediatric cathters (thanks Briza if you stop in here) and they're great.

Anyway I read in the pamphlet that it helps to put your finger in the 'other place' to avoid that, and from there you can feel the cath going into the right place because there's not a whole lot of space between the two.

As for getting the MARCAINE and HEPARIN. The doctors should really inform us ahead of time. I had to call every pharmacy in the book, too. You'll find them at UNIVERSITY or HOSPITAL pharmacies, and nowhere else. AND if your Rx is for 5ml of Heparin, beware they normally come in 1ml bottles and you'll have to ask for the pharmacy to order 5ml bottles.

Thanks everybody!

If you have any compounding pharmacies you can get meds that are in a vial. My MD tells you about a pharmacy before you leave the office. He does this because there are a lot of pharmacies that do not stock meds in vials. The pharmacy will FEDEX the meds overnight for patients that live out of town. I live 90 miles from his office so he thought it might be a problem for me. Our hospital is mainly a ER facility and will not fill Rx's and there are no University hospitals near.

I found several pharmacies in my hometown (8,000 population). In fact the only pharmacies I could not get the meds were WalMart, Walgreen, and Rite Aid.

I use 10fr pediatric feeding tube but some people find this one too slow. Anything smaller will take you forever to drain the bladder and instill the meds.

As you look in a mirror and pull back the folds of vulva skin holding it with 2 middle fingers, gently swipe down from the top across the area above the vagina the urethra will "wink or open" so you can see the opening of the urethra.

Once you learn how to find the urethra with a mirror and practice for a while you will probably be able to find the opening while sitting on the commode by just the "feel" and you won't need a morror. If you can learn to do this you can do instills anywhere anytime.

My MD’s nurse took tons of time with me in the 3 visits I made for instillations at first. The first session I held the mirror and she explained how to do the instillation. The second session she held the mirror and I did the instillation while she “talked me through it”. The 3rd session I did the instill without instruction from the nurse but she answered any questions I had as I did the instill. I also learned how to draw the meds.

I use “negative pressure” to fill the syringe. If you know a nurse she can probably show you how to do this. If you accidentally allow meds to “go back into the vial” the vial is contaminated and the vial must be discarded. Negative pressure keeps this from happening. If you insert the needle into the heparin vial and pull it down to the side as close as possible to the point of insertion just turn the needle so the slanted side of the needle next to the wall of the vial and you can draw just about everything out of the vial.

If you are having trouble filling the syringe, save empty vials and use the syringe and needle to fill the vial with colored water. Then draw the meds into the syringe. You will be able to see if you are contaminating the vials. My instructions on how to fill the vials was emphasized more than actually performing the instill.

( :( sorry this post is so long)

[sphinx]

When the NP first gave me the scripts for the meds and supplies she did give me the name of a medical supply store/pharmacy nearby. But when I got there, it turned out that they had not had a pharmacy there in 2 years! (I told the NP about that at my last visit!). But I was able to get my caths there, but that was *all* they could get for me. The pharmacist at CVS (who knows me quite well, lol) said she could not order the heparin, but could order the lidocaine, but it would be a different amount. As for being able to get injectables through them or not, it's kind of weird. I get my injectable methotrexate and the syringe/needles for that there, but my Enbrel has to come from a specialty pharmacy.

Anyhoo, I had no problem getting the meds at the hospital, but it's just a pain cuz you have to pay to park and stuff.....much rather go to a loacal place! I did talk to the guy at the pharmacy that we use at work, and they may be able to get the stuff for me. If they can, I might go through them next time, they are very close to my house.

As for learning, I am feeling like an "old pro"! The second day was not as good as the first, but since then, no problems at all. I just sit on the edge of the toilet, and the beaker I "catch" the urine in I put right below me, and set the mirror on top of that...because if I put it on the floor, I just can't see that far. I can see better this way, and can tell right away when it's in the urethra, and move the mirror away before I insert it further and urine comes out. I honestly still can't imagine doing it without a mirror though! I am going out of town overnight next weekend....part of me just says to skip it while I am gone, but honestly it is *really* helping! And because it is helping, I really want to bring it along and do an instill both days. Has anyone travelled on a plane with the needles and stuff? I am worried I won't be able to.


Thanks for everyone's tips and support.....it means sooooo much to me!:smile tee

[L. Thomas]

set the mirror on top of that...because if I put it on the floor, I just can't see that far. I can see better this way, and can tell right away when it's in the urethra, and move the mirror away before I insert it further and urine comes out. I honestly still can't imagine doing it without a mirror though! I am going out of town overnight next weekend....part of me just says to skip it while I am gone, but honestly it is *really* helping! And because it is helping, I really want to bring it along and do an instill both days. Has anyone travelled on a plane with the needles and stuff? I am worried I won't be able to.


Thanks for everyone's tips and support.....it means sooooo much to me!:smile tee

When I was learning I used a mirror with a "lighted back" that was on a stand.

You will learn to do it without the mirror. Just give yourself some time and don't get discouraged.

Some of the people that need to take meds etc. that have posted here say it is not a problem if they put the supplies in the luggage that is checked. They recommend calling the airline. Heparin, lidocaine, and sodium bicarboante are very stable and according to my MD will travel fine in the storage area of the airplane.

[ICNDonna]

I wouldn't put glass vials in a suitcase to check through. I remember one time when we were sitting in an airport waiting for a flight and I looked out a window and observed somebody's suitcase falling from a cart --- then the cart ran over it!

Donna

[Taramc]

Hey out there, I forgot to mention what a pain it was to get the CATHETERS, too! This applies to people in the US I guess.

I thought I could just run to the nearest medical supply place, Praxair. But after they finally found the catheters my urologist recommended, they said 'oh we don't take your insurance.'

SO, it's not like going to the pharmacy. You have to find a place that works with your insurance. THEN you have to drive there with an example of your catheter, because somehow it's not clear to them by what the urologist writes on the prescription paper.

After I did all that, I started getting calls from some medical supply place that works with the place I found that takes my insurance. I didn't even know who they were. I order replacements through them, apparently. WHATEVER!