how to do instills "neatly"

[barbclay]

When I do my instills everything comes in a vial, and I have to use 4 little vials of heperin, 10ml of lidocaine (it comes in a 50 ml vial) and 3 ml of sod. biocarb (it also come in a 50ml vial) I use a a needle to get itinto a syringe. I gocs OK it use elmeron insread of the heperin. The first time that I used the elmeron I lost most everything trying t get the elmeron caps. open and mixed in the syringe. It went everywhere. second try, not much better. Anyone have any tricks to make this easier? It is such a messy thing to do. What am I doing wrong? thanks for any help!!!!:confused:

[kadi]

I first put a paper towel down on the counter, so there's a clean surface. I use a sterile urine cup (one of those ones we use for "samples") to mix the medicines. Then I draw the medicine solution up into the syringe. I put some KY on the paper towel, run the catheter through it to lube it. I put the paper towel & syringe on the edge of the bathtub & cath myself sitting on the edge of the tub, so I don't spill onto the floor. When I'm done, I rinse the syringes & cup with hot water, dry them with a paper towl & store them in a brown paper bag open at the top inside a plastic drawer under the sink that I keep my instillation supplies in. This system has worked well for me for about 2-1/2 years. :) These treatments have been my miracle - hope they work as well for you!

[bunnykinb]

When you cath yourself at the edge of the bathtub, how do the meds get into the bladder then?

[GriffsMommy]

I like Kadi use one syringe for each of the meds that I use and then put them into a sterile cup. I then draw the meds up into a 60 cc syringe and that is what I actually use to do the instill. I have found the easiest and most comfortable for me is on the bed. I set up a containter for the hospital to catch my urine from the cath and rest the mirror on the container so I can see what I'm doing. I insert the cath with the other end in the container so any urine is caught in it and doesn't go anywhere. After the urine is done draining out then I attach the syringe to the cath and push the plunger until all the meds are in my bladder. Gotta remember to remove the cath with the syringe still attached or all the meds come right back out the cath. I forgot about this one time and lord was I ****** when half of the meds came flying back out of the cath.

[kadi]

I put the large syringe full of the medicine mixture on the edge of the tub with me & put the medicine into the catheter (and then the bladder) while I'm sitting there. You don't have to be lying down to put the medicine into your bladder, depressing the syringe pushes it through the catheter & up into the bladder.

[ICNDonna]

The important thing is to be sure to pull the catheter out before you disconnect the syringe from it.

Donna

[L. Thomas]

I have been doing instills since '04. A mirror on a stand will help you learn your anatomy to self-cath. I don't have elmiron in my instill so everything is drawn from a vial. I use negative pressure to fill the syringe. My instill is a total of 11cc and I use a 30cc syringe.

There are lots of ways to do an instill. Give yourself time and don't get frustrated trying to learn. I try to explain how I do an instill in the link Helpful Hints for Home Instill (link in my signature).

You have a lot of support here.

[bunnykinb]

What if the catheter still has some meds in it. Do I take the catheter tip syringe out of the catheter end while the plunger is down? Then, pull the plunger back out, attach the syringe onto the cath again, and plunge down? The nurse started pulling the plunger up from the syringe to get the rest of the meds in, and it hurt. She said maybe because of the suction.

[L. Thomas]

There will always be a small amount of instill left in the catheter. Some people like to pull a little extra air into the syringe so that they can get a little more instill into the catheter. ( if their instill is 15cc they will pull the plunger back to 17cc, turn the syringe catheter tip down and then push the plunger so that the coctail is instilled and then the air fills a little of the catheter)

[lissad]

my method is similiar to Griffsmommy however I find I need extra light while lying on the bed so I enlisted my husband's help , he is the flashlight holder . Now after 2 yrs of doing this we have it down to a system thus reducing the amount of time the cath. is in me . Recently I re-started DMSO which must be done at the URO's office and the nurse had some good advice : push the catheter as far into the bladder as possible to ensure the whole bladder is coated and do not connect the 60 cc syringe to the catheter until you have drained the bladder . If connected the urine will not drain . Also If you do not add an antibiotic to your rescue recipe you may want to take something after to just ensure there will not be an infection . The first few times are tough but it does get easier . Good Luck !

[jen74]

When I do my instills ( my husband does it for me), I have to be lying flat. I cannot bend my knees even to much or it hurts like heck going in. I have never cathed sitting up, I think it would hurt soo much going in being all bunched up like that. Do you gals feel pain when you cath sitting up?
Jen

[L. Thomas]

When I do my instills ( my husband does it for me), I have to be lying flat. I cannot bend my knees even to much or it hurts like heck going in. I have never cathed sitting up, I think it would hurt soo much going in being all bunched up like that. Do you gals feel pain when you cath sitting up?
Jen


No I don't have any pain, or at least it is not more uncomfortable than lying down.

[crazy_beautiful]

well well ladies... let me tell you, THANK YOU... cuz I have been doing it the hard way :biglaugh: I have been drawing out each medicine out of the vile and putting it in the huge seringe, one at a time... glad I found you..

[woman9469]

I have felt the way you feel for months and finally, after reading a tip on this site, have figured out the way to do these neatly and without my husband having to do the actual instill for me every day. Once you get proficient you can fill those syringes and get the duty done very quickly and neatly!

I use a "urine sample cup" that you can purchase by the case or singly if you want at your pharmacy (I get the sterile ones that come sealed in individual bags (good for traveling too). Getting a sealed cup is a personal pref. because I'm just a sterility freak.

After washing my hands, Elmiron goes in first since it needs to disolve. Just hold the pills over the cup and open one at a time and put the powder inside in the cup. I then use an alcohol swab and, one at a time, swab each vial (largest ml meds to be drawn and empytied first) draw with the syringe, and empty into cup. It's also easier (learned this from my husband who is a Dentist) if you pull some air into the syringe by pulling back on the plunger of the syringe then insert in vial, and push that air you just pulled into the syringe into the vial. The force of that little bit of air in there will work nicely when you start the draw. The fluids will flow into the syringe quickly and neatly. Then I cap the cup and "swirl" it around a little to mix since you don't want any air bubbles (like sudsy looking water) in there when you instill. Little trick -- once you fill the syringe each time, you can also then recap the needle, then unscrew the needle off while holding the syringe straight up and down at first, then point into the cup and push the meds into the cup quicker and neater without them going back thru a tiny syringe hole.

To do the instill I put lidocaine jelly (Rx from doc - nice cuz it lubricates and numbs also) on 2 inches or so of the end of the cath, sit on the toilet, swab one swipe front to back w/the betadine, insert cath (it's easier to find the area to insert it without looking if you just hold open the vaginal area and start sliding the tip of the cath starting from the top area where your urethra is. You will feel it go in and once urine starts dripping out the other end, you know you've got it! I make sure the other end of the cath is facing/hanging over the toilet seat into the toilet (not in the water) for any urine that will come out. After the bladder is emptied, I take a 60 ml syringe (good size for me for my amount of meds) pull out the plunger, place the large cath tip end into the cath end, and pour the meds inl You can instill either by using the force of gravity or by putting the plunger back in and slowly pushing the meds thru (easier for me).

This was a breakthru for me to learn to do on my own thru the help of my hubby, the doc and the advice I found on this site! Most importantly, I personally use a 16-inch male catheter (10 french - nice and tiny) that is silicone (nice and see thru). This way you have lots of length to work with without the cath falling out and that size is so nice and tiny it just slides in. Also I can see the meds going through the clear cath tube so I know when to pull it out so I don't push air up there and I don't waste any meds!

I'm sure others might have better ways too! This just works well for me after a year of trial and error and having to bug my husband to do these instills for me EVERY day. I needed my independence back!

[bunnykinb]

All these tips sound great. My stomach muscles are tight when I am curled up trying to put the meds into the cath tip syringe. So, I can see where this can cause pressure on the bladder and may cause the catheter to slip out. Last week, the nurse only had me use the urojet instead of the saline solution that comes with the hydrophilic cath. I didn't feel any pinch nor did the meds leak out. The problem this time was the meds that were stuck in the cath that looked like it wanted to go up.

My urologist is really patient. He said it may take me awhile and that is ok. I want to just be able to freely do it myself so I don't have to make so many office visits and have more freedom.

[woman9469]

I did the same thing with the stomach muscles. It's harder to get it in and stay in! Started with the 10 fr. skinny cath deal........ seems to be better. I'm not sure what you are mentioning that you used this last time. Can you explain? Maybe it's better then what I'm using...???

Good for you for your effort! Doing it ourselves gives us back a little bit of some of the independence we lose from this disease......keep your head up!

[bunnykinb]

I am using the hydrophilic disposable catheter samples. I tried using the saline solution that comes with the pack but it made the catheter more slipperily. I tried 14fr and 12fr. I felt a pinch while inserting the cath and the supplier said he hasn't heard of that, but I have IC and have always been sensitive to caths. So, last week, the nurse gave me urojet and that was a big help.