Latest / Numotion Ally Program Podcast / The CathCast With Leah: No Tricks, Just Tips For Overcoming Intermittent Catheterization Fears
Transcript
- Leah Holderbaum: Hey friends, it's Leo with the Catcast. And with Halloween right around the corner, getting into spooky season, I wanted to take some time to discuss some of the scary ideas surrounding intermittent catheterization. That being said, I want you all to know that you are not alone if you have these fears or concerns. I guarantee there is someone out there who has had the same thought, and your fears and concerns are valid. And I really want to normalize the conversation and hopefully give you all some tools to have some educated clinical discussions with your health. Healthcare providers and team. So, with that being said, what I did is reach out to a few of my friends to ask them some of the scariest ideas that they were thinking about before starting intermittent catheterization or as they were beginning this process. So, first on the list, will it hurt? I usually like to say that cathing should not be painful. If it is, we really need to look at the technique as well as the product that the individual is using. The individual performing intermittent catheterization is going to be inserting and removing a catheter multiple times a day. This could be four times, five times, six times, or more. And if that is going to be painful for them every time, they're not going to want to do it, they're not going to be compliant. And they could be at risk for bladder issues or other health complications. So, that being said, let's look at their technique as well as the product. For example, are they using an uncoated product with gel lubricant? Maybe consider transitioning to a hydrophilic pre-lubricated catheter. Or if they are utilizing a catheter that's made of materials that are more rigid in nature, consider trialing something that is. Less rigid and that could be more comfortable for the individual. But again, I want to reiterate that cathing should not be painful, and there are solutions and options out there. The second question: will the catheter go through my bladder? No. It should not. Catheters are designed to accommodate and navigate around some of the different features of your body as well as once they get within the bladder. They are designed to be flexible enough so that they aren't going to go straight through the bladder. That being said, if at any point you are cathing and you feel resistance, do not force the catheter. Or if that catheter is inserted all the way but urine isn't coming out. Don't force the catheter in any further, just remove it, wait a little bit, and try again. But again, it's really important to not force the catheter. That being said, the catheter should not perforate your bladder, but you really want to make sure that you're using proper technique, you're using the best product solution for your body, and you want to make sure that you are going at a rate or a speed that is comfortable for you, and that you're not rushing. the process whatsoever. The third question What if I see blood? This is also very, very, very common fear for individuals. And what I typically tell my friends, especially when they are beginning intermittent catheterization, it's not necessarily abnormal to see a little bit of blood, especially if you have had an indwelling catheter in place for a certain amount of time. Once that catheter is removed, that balloon is deflated, that catheter is pulled out. There could potentially be some urethral trauma within that urinary tract. So once you are inserting something that is a little bit rigid into the body and removing it numerous times a day, there is a possibility that there could be some residual blood due to some trauma after that indwelling catheter has been removed. It's important to note that that should not be long term. It should not be a lot of blood, and it should not be enough to completely tinge your urine a different color. If you are noticing blood that is persistent, that's not getting any better. If you have other symptoms such as fever, headache, increased spasticity, if you have a spinal cord injury at T6 above and you're having increased episodes of autonomic dysriflexia. It's really important that if you do see blood and have any of those other complications that you follow up with your medical provider just to ensure that you don't have a urinary tract infection or some other issue. That being said, blood is not necessarily abnormal, but it's also not necessarily normal. So it's really important that you're paying attention to your body, your urine outputs, your volumes, and making sure that the quality of your urine is consistent for what is optimal for your health. The next question is: what if the catheter gets stuck? Another fantastic question. The idea with intermittent catheterization is that it should stay lubricated throughout insertion, advancement, throughout urine drainage, and then with removal as well. That being said, we all have different bodies. We all have a different pH. And some individuals' bodies might react differently to certain lubricants or certain coatings that are on catheters. So that being said, if you're noticing that a catheter is getting stuck specifically upon removal, consider trying a product that has a different lubricant. For example, if you're using a hydrophilic product. That is getting stuck. Trial a different hydrophilic product from a different manufacturer, or you could potentially trial a gel product. But again, the idea is that the catheter should not stick, it should be very smooth and very slippery from insertion through advancement, drainage, and removal. Will I get a UTI? Unfortunately, urinary tract infections are also a very common fear, and this is another one of those things they aren't necessarily abnormal, but they're also not necessarily normal. Most of my friends, when they are first learning or first beginning the process for intermittent catheterization, many of them have unfortunately gotten a urinary tract infection. As I previously mentioned, these individuals have had a fole in their body for a certain amount of time. They've had it removed, and that could result in some urethral trauma. And now they are inserting a foreign object into their body four, five or more times a day. And so we're looking at insertion and removal so there can be very tiny micro tears or trauma throughout that urethral tract and if someone isn't maintaining their proper technique their clean technique ensuring that their hands are optimally clean and ensuring that the area around that the genitals which you know they're going to be cathing making sure that that's you know optimally clean if they aren't carrying that out there's a higher likelihood that bacteria can get into that urinary tract Cause a urinary tract infection. Of course, there are things that we can do to prevent UTIs, urinary tract infections, such as ensuring that we are staying hydrated because that can flush a lot of the bad bacteria of our body. We also want to make sure that we are eating a proper diet, maintaining exercise. Also, there is a direct correlation between bowel and bladder management. So individuals, if they are at risk of incontinence or constipation, it's really important to make sure that they are staying hydrated and also performing their bowel regimen properly to ensure that they aren't getting these urinary tract infections. Lastly, if you do suspect a urinary tract infection, signs and symptoms could be urine discoloration, it could be foul foul smelling urine, it could be increased spasms, it could be increased incontinence or increased accidents, it could be you just don't feel well, you have a fever or headache. If you have any of those, along with you know, the the thought that might have a urinary tract infection, you really want to make sure that you're following up with your professional. To get further testing. Another question How do I catch in public restrooms? This is a significant fear, and I will be the first to admit that unfortunately I did a huge disservice to so many of my previous patients and friends because I did not take them into a public restroom to learn how to perform intermittent cathing. And as an occupational therapist from inpatient rehab, I took for granted the accessibility that is within the hospital setting. And so I really encouraged my friends to go. Out on outings or go out in the community and navigate through problem solving and troubleshooting the storage of supplies, the setup of your supplies, making sure that you're not cross-contaminating things as you're going throughout the entire cathing process. So, how do you cath in a public restroom? There are so many caveats and so many strategies and components of adaptive equipment and Techniques that you can implement. It is not one size fits all. I would encourage you to trial a bunch of different strategies. talk to some of your peers, check out the Ally sub forum, see if there's any ideas there that could help you. But it is very, very possible. A few tips that I always want to point out and bring attention to are really making sure that you're keeping the entire process from start to finish hygienically clean. If you are in a wheelchair, think about You are going into the restroom, so you might be pushing open the door, or you might push a button. You want to make sure that your hands are clean so you would go to the sink and wash them. But then once you need to get into the stall to manage your bladder, you'll need to touch your wheels. So that could be potential cross-contamination. If that is the case, you want to make sure that you also have some sort of hand sanitizer, antibacterial nearby, so that you can also sanitize. Your hands once again because you're also probably going to have to lock that stall door. So, again, that is additional contamination. You want to make sure that you're staying as clean and hygienically optimal as possible. Next, thinking about where are you going to be storing your supplies? How are you going to be utilizing them and managing them? And so many of my friends, you know, they might utilize. their their vanity their sink in their bathroom at home but in a public restroom you may not necessarily have that sink in that in that stall space so you want to make sure that you have a pouch with all your supplies nearby or are you able to utilize your leg what's going to be the best strategy for you Next, clothing management and positioning. Again, this is trial and error. It is not one size fits all. Thinking about my friends with female anatomy, considering is she going to pull one leg out of her pants, both legs out of her pants? Does she put one leg on the commode, both legs on the commode? Does she drape them behind the casters of her wheelchair? There are so many different things to think about. That being said, it is very, very possible to cath in a public restroom. Keep in mind though, you may not get it perfectly right the very first time, but that's why you practice trial and error, work through some strategies, talk to your peers, and continue checking out our different resources and the Ally Community subforum for additional resources. The next question I want to address, ooh, this is a very, very scary one that comes up very often. What do I do if I run out of supplies? With it, you know, we just finished the summer season, now we're approaching the holiday season. This is unfortunately a great concern. What to do if I run out of supplies? I often encourage my friends to, when they are first getting their supplies, try to get a little bit more on your prescription and have that medical justification that that justifies the need for those additional supplies because you never know what could happen. What if you drop a catheter? You can't reuse that. What if you have a urinary tract infection and you need to cath a bit more frequently? What if you are going out with your friends for a bachelor party weekend and you drink a little bit too much and need to cath a little bit more frequently? You're going to require a higher frequency of catheters. For my friends with female anatomy, what if you accidentally insert the catheter into the vagina instead of the urethral opening? It happens more often than what many people even realize. So, for those reasons, I always like to encourage folks try to build a surplus of supplies kind of in the background things. That way you can ensure you never run out of supplies. If you do run out of supplies, make sure you have your medical supply providers. Phone number as well as your healthcare provider's phone number on hand saved in your phone. That way you can ensure that you have quick access and a potential quick solution to ensure that you are not going to run out of supplies. Also, it's very important that you do take responsibility and inventory of how many supplies you have and be mindful of when your next shipment is due to process. That way you can ensure that you aren't going to run low. If you do run low or run out of supplies, make sure that you reach out to New Motion Medical Supplies. You can speak with one of our product specialists, and we can ensure that you have an emergency sample of supplies shipped. That way you can maintain your bladder health and overall quality of life. The final question that I want to address is: what if the catheter won't go all the way in? This is another great question, a very common fear. And as I previously stated, I want to circle back. You want to make sure that you do not force a catheter in. If there is any sort of resistance, make sure that you do not push, you do not want to cause any sort of trauma to the body. This resistance could be due to a number of things. For friends with male anatomy, if the prostate is enlarged, that could be. The reason for some of that resistance. If an individual is nervous and they are potentially holding their breath throughout catheterization, that can tighten those sphincter muscles and that will prevent that catheter from advancing. So it's really important that you are kind of breathing or talking to allow for those muscles to relax for that catheter to pass. This stricture could also be potentially due to scar tissue that's buildup, or it could be. due to any sort of urethral narrowing. There really isn't a rhyme or a reason as to why someone may have potential resistance, but know that there are solutions if you do feel that resistance. First and foremost, do not force the catheter. Second, you wanna wait a little bit until you kind of you know let your body resolve, let some of that trauma resolve. You can try a little bit later, maybe 30 minutes to an hour. If you continue to experience that resistance, you wanna make sure that you're following up with your healthcare provider. The solutions that can be offered, it could come down to just trialing a product that has a different lubricant or a different rigidity, or there are catheters that have specialty tips called CUDA tips. And those specialty tips go past any sort of anatomical stricture or barrier. This could be an enlarged prostate, it could be urethral narrowing, it could be scar tissue due to surgery or trauma, but there are options that are available for you. With that, I hope I have helped to alleviate some of the fears and concerns around intermittent catheterization. If you do have any additional questions, please continue posting those in the community sub forums. I am happy to answer those. I love being able to respond and connect with you all. Continue checking out all of the additional resources that Alley has to offer. And with that, I am looking forward to seeing you all next time. Have a fantastic day. You all take care.