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    Clogged SP tube

    So, after waiting 2 months, and untold cost due to irrigating at least twice/day and changing catheter at least twice/week, Jim's cysto was today. Only the doctor wouldn't do it. First his little aide took blood pressure and was going to procure a urine sample after clamping his S/P. Because she didn't wash her hands beforehand, I said I'd be glad to do it for her, washed my hands and got the sample. She didn't say anything but had an attitude. When the (new to us) doctor came in he was also brusque and stated that even doctors never wash their hands before a procedure, just after a procedure. He was very defensive, mentioned that he worked at RIC and wrote articles about SCI. His article, by the way has the use of vinegar, not a bleach solution, to cleaning equipment. Then he said the UA showed bacteria so he wouldn't be doing the cysto after all. No treatment except urging Jim to get on an anticholenergic to prevent UTI"s. Jim is c5, complete and totally flaccid.
    Obviously I'm upset. We have managed to keep Jim out of hospitals since initial injury. In the first 8 years he had only 4 UTI's, usually after cysto's. But the last year he has had non-symtematic bug of some kind that fills his catheters with a thick white discharge that occludes the catheter in days, despite irrigating. His nurses say they don't prescribe Renicedin for flush. I am at my wits end.
    So 2 questions:
    !. Has it been shown that anticholenergics decrease the incidence of UTI's?
    2. if SCI with a S/P tube is always colonized, why wouldn't he do the cysto to check for stones?

    With the rampant outbreaks in MARSA and other pathogens in hospitals everyone is warned to make sure that workers wash their dam hands, what they don't say is how you get treated if you do.

    #2
    Originally posted by lilsister View Post
    When the (new to us) doctor came in he was also brusque and stated that even doctors never wash their hands before a procedure, just after a procedure.
    This is unforgivable!

    Based on that and his other statements, I say this guy is a quack.

    Comment


      #3
      But, Scorp, this guy "wrote the book" at RIC, so he says. I'm getting madder by the minute. Essentially I feel this guy wrote us off since there's always colonization and he won't do the cysto because "he's infected", and it is at least 2 months til Jim could even get another date for a cysto and no antibiotics- what is the course of action? I did suggest a ultrasound to look for stones and then I think we will be looking for another Urologist. So, in the end, there's going to be another lenghty wait for services. Jim is "lucky" that he has WC because I can't imagine many could afford the expenditure for supplies-2 catheters, insertion kits, irrigation kits, sodium chloride or the time it takes to keep that in order. The pharmacist at Walgreens has made it clear that they don't like dealing with bottles of sodium chloride, "it's a hassle". I'm sorry, I know I'm venting, I'm just sorely frustrated. we should have moved back to Boulder, Madison has been a bust for SCI issues!! Deb

      Comment


        #4
        Originally posted by lilsister View Post
        So, after waiting 2 months, and untold cost due to irrigating at least twice/day and changing catheter at least twice/week, Jim's cysto was today. Only the doctor wouldn't do it. First his little aide took blood pressure and was going to procure a urine sample after clamping his S/P. Because she didn't wash her hands beforehand, I said I'd be glad to do it for her, washed my hands and got the sample. She didn't say anything but had an attitude. When the (new to us) doctor came in he was also brusque and stated that even doctors never wash their hands before a procedure, just after a procedure. He was very defensive, mentioned that he worked at RIC and wrote articles about SCI. His article, by the way has the use of vinegar, not a bleach solution, to cleaning equipment. Then he said the UA showed bacteria so he wouldn't be doing the cysto after all. No treatment except urging Jim to get on an anticholenergic to prevent UTI"s. Jim is c5, complete and totally flaccid.
        Obviously I'm upset. We have managed to keep Jim out of hospitals since initial injury. In the first 8 years he had only 4 UTI's, usually after cysto's. But the last year he has had non-symtematic bug of some kind that fills his catheters with a thick white discharge that occludes the catheter in days, despite irrigating. His nurses say they don't prescribe Renicedin for flush. I am at my wits end.
        So 2 questions:
        !. Has it been shown that anticholenergics decrease the incidence of UTI's?
        2. if SCI with a S/P tube is always colonized, why wouldn't he do the cysto to check for stones?

        With the rampant outbreaks in MARSA and other pathogens in hospitals everyone is warned to make sure that workers wash their dam hands, what they don't say is how you get treated if you do.
        If your at RIC in Chicago try to see Doctor Daniel Dolton (Double D I call him) if he is still practicing there at Northwestern. he is a great uro doc and placed my sp tube some 20 years ago with no problems ever.
        ^^(A)^^

        Comment


          #5
          Originally posted by Scorpion View Post
          This is unforgivable!

          Based on that and his other statements, I say this guy is a quack.
          quack is right. quite a few of his statements are just "wrong".

          vinegar instead of bleach, no Renicedin for flush, total disregard for handwashing, wtf?

          dr,s and nurses who are so arrogant that their way is the only way and they're higher up on the totem pole than GOD irks me to no end.

          pardon my french but...i don't care how many damn books he's written, HE'S WRONG. just my opinion but i'd fire his ass and make sure he found out why, lol.

          Comment


            #6
            Thank you so much for the response, often I feel very lonely in these issues. Just to update you, I did get an order for an ultrasound and afterwards took Jim back to the Urology Clinic and asked to speak to the administrative Head in a nice, calm voice. They had us in a room within 10 minutes and I explained what had happened and our concerns about the handwashing policies and how we thought they should be aware of the deficits we came across. Head honcho winced, stated it wasn't policy to not use proper technique and they were glad to be told. Come to find out his assistant is not a nurse or aide, she's an X-ray tech and will be taught policy. As for the doc not much was said, just a pained expression and would Jim like to get in to see him sooner. We declined and asked for a different Urologist and that appt will be on the 19th of July. I shudder to think of others that maybe have a TBI or passive personality that get wronged. Jim has a TBI and would have never questioned a doctor's ways, opinion or methods.

            Comment


              #7
              Dear lilsister you'd think these irrogant professionals or quacks would have better manners and cleansing procedures . I hope they wash their hands after handling someones privates then going out for lunch lol it sounds gross and makes me sick thinking of negligence and gross tableside manners .

              I irrigate my SP tube from time to time and sometimes i've noticed floaties or little whitish cloudy stuff floating around in the bag or clear connector hose especially after I have a severe bladder spasm episode but I drink alot of pure water and flush out my system literally 24/7

              I wish you both the best
              maybe go lpok into using a different urologist ...

              Good luck
              Sincerely;
              Gypsylady

              Comment


                #8
                Originally posted by lilsister View Post
                Thank you so much for the response, often I feel very lonely in these issues. Just to update you, I did get an order for an ultrasound and afterwards took Jim back to the Urology Clinic and asked to speak to the administrative Head in a nice, calm voice. They had us in a room within 10 minutes and I explained what had happened and our concerns about the handwashing policies and how we thought they should be aware of the deficits we came across. Head honcho winced, stated it wasn't policy to not use proper technique and they were glad to be told. Come to find out his assistant is not a nurse or aide, she's an X-ray tech and will be taught policy. As for the doc not much was said, just a pained expression and would Jim like to get in to see him sooner. We declined and asked for a different Urologist and that appt will be on the 19th of July. I shudder to think of others that maybe have a TBI or passive personality that get wronged. Jim has a TBI and would have never questioned a doctor's ways, opinion or methods.
                good for you, lilsister.

                Comment


                  #9
                  Originally posted by lilsister View Post
                  Thank you so much for the response, often I feel very lonely in these issues. Just to update you, I did get an order for an ultrasound and afterwards took Jim back to the Urology Clinic and asked to speak to the administrative Head in a nice, calm voice. They had us in a room within 10 minutes and I explained what had happened and our concerns about the handwashing policies and how we thought they should be aware of the deficits we came across. Head honcho winced, stated it wasn't policy to not use proper technique and they were glad to be told. Come to find out his assistant is not a nurse or aide, she's an X-ray tech and will be taught policy. As for the doc not much was said, just a pained expression and would Jim like to get in to see him sooner. We declined and asked for a different Urologist and that appt will be on the 19th of July. I shudder to think of others that maybe have a TBI or passive personality that get wronged. Jim has a TBI and would have never questioned a doctor's ways, opinion or methods.
                  good for you, lilsister.

                  we get soooo much help from this lil old site called carecure.

                  Comment


                    #10
                    That's great you were there! Even so not only hand washing but gloves are appropriate for catching specimens from any medical staff. It may be different for family as you're right to wash your hand but anyone else needs to wear gloves on this procedure. Good for your to talk with the Admin. I encourage others while in hospital and any problem with any staff to speak with the Nurse Manager but in your case at the office to talk with Admin. Also anyone doing anyone's care should give their name and if they're a Nurse or tech. Good for you. My best and hope this problem clears up . My best.
                    ________________________________________

                    Comment


                      #11
                      I make my own sterile saline as per directions of SCI Nurse recommended here. Just use 1/2 dozen of the containers for storage/reuse. I also use the same syringe ($1/ea) for 1 week, rinsing and air drying after each use.

                      I have a bladder augment for 7 years and produce a lot of thick mucous. I irrigate 2x/day. I am always colonized, like your son with an SP tube. "Clean" technique may be appropriate and less costly.

                      Comment


                        #12
                        Well, we finally got in to a different Urologist today and found out the probable cause for the S/P getting clogged so frequently---he has a large stone in his bladder. At first the doc thought it was just because he's had an S/P tube for 10 years and suggested removing the bladder altogether. I said maybe just a cysto would be good to rule out stones, even though the ultrasound didn't show any. So surgery for stone removal will be Aug 5th, with bladder biopsies while in there.
                        I'm glad we stuck to our guns and pushed for a cysto, I hadn't known that ultrasounds weren't that reliable. Or that you should clamp the catheter for a while before the ultrasound to get a better reading. We continue to hope to avoid anticholenergics with their side effects, all the extra urological supplies and especially all the irrigations. Deb

                        Comment


                          #13
                          glad to hear you found the issue.

                          do you still use a sp if the bladder is removed? that sounds a little extreme!

                          Comment


                            #14
                            No, a urinary ostomy (either continent or incontinent) would be needed if the bladder must be removed. We rarely do this except for bladder cancer.

                            (KLD)
                            The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

                            Comment


                              #15
                              Oy!

                              Well, Jim has continued to have a problem with a ~2 day build-up to complete clogging of his S/P catheter. Because he is diabetic, type 1, and his blood sugar goes up above 300 when this is happening it is urgent that a solution is found. The clogging of the tube is of a slimey, white, mucus type material, that at times is unable to be dislodged by irrigation. He is c5 complete, TBI and has had the S/P tube x10 years. First 8 years he had only 4 UTI's, usually after having a cysto. Last symptomatic UTI was 2 weeks ago with C&S indicating >100,000 Proteus Mirabilis, which was treated with antibiotic x10 days and 1 week later the mucus starts to clog the catheter again. We just got back from his Internist who took the sample of mucus I took in and is having it tested-none of the Urologists ever would take a sample. Although since we had to wait 3 days I'm not confident the specimen isn't compromised, I did put it in a sterile spec container with sterile water and refridgerated it. It is the length of a catheter, diameter of a Bic pen and looks, frankly, like a long, albino worm! Yuch.
                              The policy at UW is to NOT use Renacedin and to just keep irrigating. But I don't think this is a long term solution, or cost effective. And the high blood sugars caused by this are dangerous long term also.
                              Has anyone else had this kind of symptomology? Treated it with Renacedin with success? I had thought the renacedin was used for a gritty type of discharge. Any ideas? Deb

                              Comment

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