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REQUEST: Anti-UTI tips (for a person new to self-catheterization), please

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    REQUEST: Anti-UTI tips (for a person new to self-catheterization), please

    Hello friends,

    I had to start self-catheterization (aka clean intermittent catheterization or CIC) last week after I saw a Urologist for incontinence and she discovered hydronephrosis (urine backing up into a kidney) on ultrasound.

    I've been coping with mixed incontinence for a few years but was scared to see a Urologist...so I took a med my Neuro prescribed and spent a fortune on Poise. I was upset by the idea of CIC at first, but after sleeping through the night for the first time in years I was all on board. For the first couple of days things were great. I hadn't realized how uncomfortable I was until I wasn't anymore.

    Unfortunately within the first 3-4 days of starting, I developed a UTI. I cannot remember ever having a UTI before this and I didn't know what it would be like. Plus, I didn't know what to expect from the CIC having just started, so I chalked up dysuria and frequency to urerthal irritation from the catheters. Ultimately the smell that tipped me off (yikes!).

    After than I started having such bad pain in my abdomen that I was worried I had somehow poked a hole in my bladder with the catheter and developed peritonitis. The urine culture confirmed UTI and I got started on antibiotics, so I'm hoping to start feeling better soon.

    In terms of technique, I was taught to urinate normally first then wash my hands and prep supplies. Mostly I've been using single use simple catheters along with sterile lubricant single packs and wipes--either BZK or baby wipes. For cleansing the area around the urethral meatus, the training RN said I could do it with a washcloth (!) so I figured it that's true then baby wipes would probably be okay, too.

    When cathing, I try to handle only the far portion of the catheter so that the area my fingers have been on stays outside the urethra, but that limits my control of the catheter so it doesn't seem like it is always possible. I'm wondering if this might be part of the problem... or maybe the wipes?

    Many thanks for any ideas, strategies, or tips you can share. I'm very new to CIC, so no tip is too basic. I'd like to hear anything you could think of which might help prevent this from happening again because it has been miserable

    It's been a while since I've been active on MSWorld, but it has always been good to know that you are here if needed. Much love and thanks again,


    Jennie

    #2
    I use the BZK wipes. I don't think the cleansing agent in baby wipes would be strong enough. When I get everything ready, I clean my fingers with a separate wipe before I start. Ideally the wipe should be wet, not just damp. Dynarex wipes are really inconsistent, some completely dry or just damp. I've had better luck with Hygea brand,

    Some lubricants are bacteriostatic, which helps inhibit the introduction of bacteria into the bladder. I think McKesson is sterile but not bacteriostatic. Just check the label.

    I take a 100 mg trimethoprim antibiotic daily, and take cranberry extract pills.

    In spite of all this I still get a UTI four or five times a year. I keep the test strips on hand and test my urine if it looks cloudy. That way I can call the urologist and get in to see him before it gets bad. The test strips are ridiculously expensive in drugstores, but reasonable on Amazon.

    Good luck with this. Self cathing is a lot easier than being at the mercy of a neurogenic bladder.

    Comment


      #3
      Originally posted by GoodJennie View Post
      For cleansing the area around the urethral meatus, the training RN said I could do it with a washcloth (!) so I figured it that's true then baby wipes would probably be okay, too.
      I agree with you that the baby wipes might be part of the problem. Baby wipes aren't sterile, and they have chemicals in them that shouldn't be introduced into your bladder, either. You might try eliminating the baby wipes (or a washcloth) and see what happens. I hope it helps.

      It's a bit disturbing that your training nurse would tell you to use BZK then undo everything with an unsterile washcloth. It would be interesting to hear what your urologist thinks about use of a washcloth in what's supposed to be a sterile environment.

      Comment


        #4
        Originally posted by jreagan70 View Post
        It's a bit disturbing that your training nurse would tell you to use BZK then undo everything with an unsterile washcloth. It would be interesting to hear what your urologist thinks about use of a washcloth in what's supposed to be a sterile environment.
        Thank you both for your replies.

        To be fair to the nurse, she said it was okay to use either bzk wipes OR a washcloth. She and my Urologist both made the distinction between "clean" and "sterile"--it is supposed to be a clean procedure to minimize bacteria, but sterility is not expected.

        They had only given me about a dozen wipes which gave me the impression they didn't feel that strongly about it. After this, though, I sent away for several 100-count boxes and am going to try to be more diligent about it.

        What has worked for people in terms of hand washing? It feels weird to wash my hands before I go into a stall but weirder to come out of a stall to wash them then go back in... I like the idea of using a wipe for your hands but you must go through them fast. Anyone do something different?

        I was also wondering if I might be causing microtrauma by adjusting or twisting the catheter after insertion. I find I can often get more urine with a slight twist or other minor adjustment but sometimes I can feel it sting when I do that. Anyone have thoughts on that?


        Peace,
        Jennie

        Comment


          #5
          Hi Jennie,

          Sorry to hear about your infection. I also put off going to a urologist, so your definitely not alone! Would've made my life so much easier (not to mention cheaper without all the Depends and Poise pads) if I'd gone earlier. Turned out I had both urgency and retention at the same time (still retained urine even after I urinated) No wonder I had to pee so often! Retention is also the reason I started having frequent UTIs. A battle with sepsis, stemming from a UTI, is what finally got me into the urologist.

          I also use a BZK wipe on my hands. My insurance approves more than enough BZK wipes with each shipment of catheters, so at least for me, running out has never been a problem.

          After my Urodynamics test, my urologist told me my urethra was smaller than average. Self cathing was initially very uncomfortable for me, too. This is all new to your body, so of course it can get irritated. Ask your your urologist to prescribe a numbing lubricant. It really helped me, and eventually things stretched out and I didn't need it anymore. Catheters also come in different diameters, so it's always.possible a smaller one might be better.

          I also take cranberry supplements. I've never used it, D-Mannose has also been mentioned on these boards. Unfortunately, introducing a catheter into your bladder carries the risk of UTIs, but I hope that is kept at minimum.

          Good luck
          Last edited by Kimba22; 09-27-2016, 01:54 AM.
          Kimba

          “When you change the way you look at things, the things you look at change.” ― Max Planck

          Comment


            #6
            In a public bathroom, I feel like all my hand washing is useless the minute I touch something. The stall door handle, grab bar, etc are never cleaned in most of them.

            BZK wipes are inexpensive, so I've always got a few in my pocket. And I do go through a lot of them. Medicare doesn't pay for them at all, so I just order them myself. A box of 100 is less than $5.00.

            As to the irritation with twisting the catheter, try a smaller size. Average is Fr 14, so you could go down to Fr 12. SpeediCath prelubricated catheters are a lot slipperier than a plain catheter plus lubricant but they cost more, about $2 each.

            Comment


              #7
              Almost one year later...

              It was difficult getting started with "CIC," as my Urologist calls it (aka clean intermittent catheterization), but I feel like self-cathing has given me back some control which I had not had in many years. In mixed company I call it my new super-power (Holy continence, Batman!). I was able to complete a 6 hour drive and only stopped once, which I had not been able to do for about 10 years!

              I wanted to post an update with some of the tips I've picked up in the past year in case anyone stumbles across this thread while seeking practical tips.


              1. BZK wipes can be bought over the internet. There are numerous brands and what works for one person might not work for the next. Try ordering a small number of your top 3 or 5 choices so you can compare them side-by-side.

              2. You can use a wipe to clean your hands and then another to clean your urethral meatus. Alternatively, you can use hand sanitizer (which probably isn't, but to me feels cleaner).

              3. Always carry your supplies with you. Self-explanatory but I have left the house more than once without them and it was pretty uncomfortable once you get used to being able to empty your bladder.

              4. Consider making a "cathing kit" to keep your supplies organized. I used a spare make-up bag at first, but I recently realized pencil cases work even better. (It's long enough to fit my 6.5" female catheters without bending.) My kit contains several catheters, packets of lube to match the number of catheters plus one, ~2 times as many wipes as catheters, baby wipes, a couple of extra liners, and a travel size (2 oz) hand-sanitizer. Sometimes but not always there is an extra pair of underwear in there as well.

              5. For my bathroom at home, I have a white plastic storage container (about the size of a shoe-box) with my catheters in it next to the toilet. When I cath, the lid pulls double-duty as a work surface or tray on my lap to get things ready. I keep a small (approximately 6 inch cube) container with 3 drawers on the back of the toilet. This is where I keep my hand sanitizer, BZK wipes, and lube.

              6. I got a pedal-operated trash can for next to the toilet, and I *love* it. Is serves several purposes. I don't like looking at the supplies after I have used them, so now they are out of sight. If I don't take the trash out as often as perhaps I ought to do, it keeps the smell down (I soak a cotton ball in essential oil and put that in the bottom of the trash bag which helps with smell also). I can operate the pedal with my heel while using both hands to cath then pitch the used catheter directly in the bin.


              Does anyone else want to add helpful tricks or tips for cathing?


              Best,
              Jennie

              Comment


                #8
                Those are great tips. I'd like to add a few:

                Pre-lubricated compact catheters are easier for me to deal with away from home. It's one less step to juggle. Several versions are available.

                When I remove the catheter, I take a look at the drops of urine left in it to check for cloudiness, often the first sign of a UTI.

                I keep a box of drugstore UTI test strips in my home supplies. If urine is cloudy or has an odor, the test strip will tell you right away if there's a problem. Some urologists frown on this but mine is fine with it. I don't generally get burning or urgency due to MS numbness. It's better to catch UTI's early.

                Comment


                  #9
                  I just began CIC 4 days ago and I've been all over the internet looking for tips. This thread was incredibly helpful and I can't thank you enough for starting it! I've already been on Amazon and ordered some BZK wipes.

                  My urologist gave me some catheters to get started with, and there were 2 different kinds. 1 is not lubricated, and is long, red and flexible. The other is short, white, stiff and lubricated. That second one seems more manageable.

                  I have a lot of trouble inserting and a few times I finally gave up. I'm pretty sore because it's only been a few days, but I can't tell if my urethra is irritated or if I'm getting a UTI. The nurse who trained me said it was going to be impossible for me to realistically do a sterile CIC, and just to be sure to wash hands really well and clean myself good using wipes or a wash cloth.

                  She also said that when you begin doing CIC regularly, you introduce bacteria and from then on you are "colonized" and will always test positive on a culture. She said their approach is to treat symptomatic UTIs (fever, pain, etc.). I'm not accepting that as 100% fact, though, and I did get a box of test strips from Amazon as well.

                  I've only been cathing at home so far and think I'll probably freak out the first time I have to do it in a public bathroom. I feel like I can't get clean enough at home. Public bathrooms creep me out.

                  Have you all noticed an increase in UTIs/bladder infections since beginning CIC?
                  ~*~ Jeri ~*~

                  Comment


                    #10
                    The long red flexible catheters are difficult for me to use because of the floppy feel. Coloplast (among others) makes clear silicone catheters that are firmer and easier to guide. The non-lubricated ones will need to be lubricated before insertion. You can buy lubricant in tubes or individual packets.

                    Coloplast makes a catheter called a Speedicath that I use for public restrooms. It’s prelubricated, small, and you aren’t trying to lay out supplies and apply lubricant in that environment.

                    You can buy these online from medical supply companies. Coloplast offers free samples on their web site, other manufacturers may also.

                    Comment


                      #11
                      Thanks for the info, kmallory1! I just ordered a sample Speedicath to try. FYI for others who want to order, you'll need your doctor's name plus clinic name and phone so they can verify your Rx.
                      ~*~ Jeri ~*~

                      Comment

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