“Catheter and ALS” Chapter 132

“I have to pee.”

“Quick, get the urine bottle before it gets everywhere!”

Does this sound familiar? When I started down this road, I could no longer walk safely and get to the bathroom on time. As a result I would stay in my chair and pee in a urine bottle. I figured it was no different than a long car ride. 

When I eventually couldn’t use my arms, I would call for help and hope I wouldn't pee on myself, which happened a lot. There had to be another way, we thought. After discussing it with the ALS team, we decided on using the condoms. These solved the problem of needing a quick reactionary force, and most of the time they keep me from making a mess.

Anyone who ever had to change the diaper of a baby boy knows to be ready for geysers. Well, I’m even more prone to geysers now as a grown man who has lost all control over my bladder.  If anyone finds the bladder control button, please let me know. The condom helps a lot unless something is wrong and causes it to burst. It’s a condom connected to a collection bag and various issues can cause a problem. Got a kink in the hose POP! Hose being pulled, POP! The bag not lowered, or even if it's too cold (Think about it) POP, POP, POP!

I can’t help but laugh at the reactions of my caregivers when they are “baby boy-ed.” I get “OMG!” or “Oh shit!” and people come running to get something to clean it up. After two years it hasn’t gotten old yet. Yes, it’s nasty, never done on purpose, but still funny. The other day I was being moved from my bed to my chair with the condom bag up.  My new nurse was standing in front of me when POP! The geyser went off again. As the condom started to fill I had no way to let anyone know. When the condom hit maximum capacity it burst like a water balloon all over my nurse. His reaction was priceless. Don’t get me wrong I don’t want that to happen, but it was funny and I will take the laughs when I get them. 

We have had a lot of geysers and blow outs over the years and it took time to find a solution, but we did. I wrote some possible solutions that might help you prevent some spills and yes get a few laughs.

Types of Urinary Catheters -

There are several types of urinary catheters, each suited for specific clinical needs:

1. Indwelling (Foley) catheters: These are inserted through the urethra into the bladder and remain in place for an extended period. They have a balloon near the tip that is inflated to keep the catheter in place.

2. Intermittent (straight) catheters: Used for periodic emptying of the bladder and then removed after each use. This is common in self-catheterization for individuals with spinal cord injuries or certain neurological conditions.

3. Suprapubic catheters: Inserted directly into the bladder through the abdominal wall, usually in cases where urethral catheterization is not possible or advisable.

4. External (condom) catheters: Used primarily in male patients with urinary incontinence, they fit over the penis like a condom and connect to a drainage bag.

   
   

Each catheter type has advantages and disadvantages depending on the patient's condition, duration of catheterization needed, and risk of infection

Complications of Catheter Use -

Although urinary catheters are beneficial, their use is not without risks. Complications include:

1. Urinary tract infections (UTIs): The most common complication, often due to poor insertion technique, prolonged catheterization, or contamination.

2. Catheter-associated urinary tract infections (CAUTIs): A significant concern in hospitals, leading to increased morbidity, length of stay, and healthcare costs.

3. Bladder spasms and discomfort: Especially with long-term catheterization.

4. Urethral trauma: From improper insertion, especially in male patients or those with urethral strictures.

5. Blocked catheters: Due to encrustation or blood clots, particularly in long-term use.

6. Bladder stones: Can develop over time with chronic catheter use.

7. Leaks and spills: They leak and you will spill.

Minimizing these risks requires diligent care and regular assessment of catheter necessity.

Best Practices and Catheter Care -

To ensure safe and effective catheter use, healthcare providers should follow evidence-based guidelines:

1. Use catheters only when medically necessary: Avoid unnecessary catheterization and remove catheters as soon as possible to reduce infection risk.

2. Maintain a closed drainage system: Ensures sterility and prevents backflow of urine, which can lead to infections.

3. Regular hygiene and maintenance: Daily cleaning of the catheter and surrounding area with mild soap and water is essential. The drainage bag should be emptied regularly and kept below the level of the bladder to prevent backflow.

4. Monitor for signs of infection: Such as fever, cloudy or foul-smelling urine, and discomfort. Prompt action is needed if infection is suspected.

5. Education and training: Both healthcare providers and patients who self-catheterize should receive proper instruction on technique, hygiene, and when to seek help.

   
   

I have the information is helpful and you get a laugh.

Love and Blessings 

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