Tuesday, 26 March 2019

SO! A Catheter was required next!

Indwelling urinary catheter

What are Catheters and how could they affect my life?

As I said in my last post, before my Chemotherapy Treatment Started, due to the treatment delay while the Stoma operation took place, the "Bowel Cancer" spread to my Liver (Still "Bowel Cancer" not Liver Cancer) and my "Lymph Glands" were also affected by the Bowel Cancer and, as a result I've had a catheter inserted (to ensure the urine is removed) because the swollen "Lymph Glands" had prevented urination.

"A urinary catheter is basically a flexible tube used to empty an individuals bladder and collect urine in a drainage bag."

Once the Catheter was put in place, my Chemotherapy would be able to start.

As expected my Urinary Catheter was inserted by a Doctor and has been replaced, every 12 weeks, by a District Nurse.

My urethral catheter was inserted through the tube that carries urine out of the bladder (urethra); there is another type called a Suprapubic Catheter which I'm informed is inserted via a small opening made in an individuals lower tummy.

Both types of catheter usually remain in the bladder, allowing urine to flow through it and into a drainage bag.

"I've given my drainage bag the nickname - Weasel and, I forgot to tell you that the nickname for my Stoma bag was/is - Donald."
They, both Weasel & Donald, occupy quite a lot of attention! 

When are urinary catheters likely to be used?

Usually used when individuals have difficulty urinating naturally. 

In my particular case it was to allow urine to drain as the swollen Lymph Glands, possible prostate enlargement and the Bowel Cancer Tumour (a swelling, generally without inflammation, caused by an abnormal growth of tissue, whether benign or malignant) were causing an obstruction in the urethra.

They can also be used to empty the bladder before or after surgery and to help perform certain tests.

Depending on the type of catheter you may have and why it's being used, the catheter may be removed after a few minutes, hours or days, or it may be needed for the long term.

As I've already said, mine is changed every 12 weeks.

Types of urinary catheter

Apparently there are several different types of urinary catheter, which are inserted and used in different ways.

NOTE: Again from my experience of having my Catheter inserted/re-newed, it is a painful experience.

Those who have done the changes have all said the pain was probably due to the Bowel Cancer Tumour and/or a swollen Prostate Gland (Prostate enlargement is a very common condition associated with ageing. More than 1 in 3 of all men over 50 will have some symptoms of prostate enlargement.)

Again, from the information I've had, it's not known why the prostate gets bigger as you get older, but it is not caused by cancer and does not increase your risk of developing prostate cancer.

An enlarged prostate can put pressure on the urethra, which can affect how you urinate.

Signs of an enlarged prostate can include:

  • difficulty starting or stopping urinating
  • a weak flow of urine
  • straining when peeing
  • feeling like you're not able to fully empty your bladder
  • prolonged dribbling after you've finished peeing
  • needing to pee more frequently or more suddenly
  • waking up frequently during the night to pee 

So, back to the Types of Urinary catheter...

1: Intermittent urinary catheters - inserted several times a day, for just long enough to drain your bladder, and then removed.

2: Indwelling urinary catheters - inserted in the same way as an intermittent catheter, but the catheter is left in place.

"This is the one I have!"

The catheter is held in the bladder by a water-filled balloon, which prevents it falling out. These types of catheters are often known as "Foley catheters".

Urine is drained through a tube connected to a collection bag, which can either be strapped to the inside of your leg or attached to a stand on the floor.

My Indwelling catheter is fitted with a valve. 

The valve can be opened to allow urine to be drained into a toilet, and closed to allow the bladder to fill with urine until drainage is convenient.

NOTE: Individuals should empty the bag before it's completely full (around half to three-quarters full). Valves should be used to drain urine at regular intervals throughout the day to prevent urine building up in the bladder. 

"I also have to change my Leg bags and valves every seven days (Thursdays)."

The bag itself can be attached to either your right or left leg, depending on which side is most comfortable for you. I find it varies so swap when appropriate.

At night, I need to attach a larger bag. 

It can be attached to your leg bag or to the catheter valve and placed on a stand next to your bed (mine is), near the floor, to collect urine as you sleep.

Depending on the type of night bag you have, it may need to be thrown away, as mine is, in the morning or it may be emptied, cleaned and reused for up to a week.

The catheter itself needs to be removed and replaced at least every three months (as I've said mine is every 12 weeks). 

Mine is done by a District Nurse.

3: Suprapubic catheters - used when the urethra is damaged or blocked, or when someone is unable to use an intermittent catheter

Rather than being inserted through your urethra, the catheter is inserted through a hole in your abdomen and then directly into your bladder. This procedure can be carried out under general anaesthetic, epidural anaesthetic or local anaesthetic.

This type of catheter is usually changed every six to eight weeks.

Looking After your Catheter...

Take it from me, it’s possible to live a relatively normal life with a long-term urinary catheter, but it took some getting used to at first.

Our District Nurse gave me detailed advice about looking after my catheter, albeit some time after it was inserted.

More recently my District Nurse...

..."realised the Catheter used initially, was oversized and the likely the main reason why I find the change of My Catheter so painful."

"LOOKS LIKE THEY USED WHAT THEY HAD rather than what was appropriate.

Next change, 11 weeks time, she will reduce the Catheter Size - PHEW!

I was provided with a supply of catheter equipment when I left Hospital, and also told where to get supplies from. 

In my particular case, Bullens - https://www.bullens.com/ - dedicated home delivery service provides all of my Stoma and urology products and prescription medication in one delivery, efficiently and discreetly to my door.

Preventing infections and other complications

Having a long-term urinary catheter increases the risk of developing urinary tract infections (UTIs), and can also lead to other problems, such as blockages.

To minimise these risks you should...

  • wash the skin in the area where the catheter enters your body with mild soap and water at least twice a day
  • wash your hands with warm water and soap before and after touching your catheter equipment
  • make sure you stay well hydrated – you should aim to drink enough fluids so that your urine stays pale
  • avoid constipation – staying hydrated can help with this, as can eating high-fibre foods, such as fruit and vegetables and wholegrain foods
  • avoid having kinks in the catheter and make sure any urine collection bags are kept below the level of your bladder at all times

My regular activities...

Having a urinary catheter shouldn’t stop you from doing most of your normal activities. 

"The Indwelling catheters, like mine, can be more problematic"

Risks and potential problems...

The main problems caused by urinary catheters are infections in the urethra, bladder or, less commonly, the kidneys. 

These types of infection are known as urinary tract infections (UTIs) and usually need to be treated with antibiotics.

You can get a UTI from either short- or long-term catheter use, however, the longer a catheter is used, the greater the risk of infection. 

This is why it's important that catheters are inserted correctly, maintained properly, and only used for as long as necessary.

Catheters can also sometimes lead to other problems, such as...

  • bladder spasms (similar to stomach cramps), leakages, blockages, and damage to the urethra.

Hopefully, with this post, along with the previous ones posted, I've raised your awareness of what individuals may experience if, like me, they get "Bowel Cancer", have a Stoma Operation and an Indwelling urinary catheter inserted.

"Please feel free to provide feedback on my post."

If you have any questions, feel free to ask, I'll do my best to provide honest answers.

Thank you! 

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