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    #61
    The SCI nurses on this board recommend that anyone who has a suprapubic or long term indwelling urethral catheter take anticholinergic medications long term to help maintain bladder size.

    All the best,
    GJ

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      #62
      How do the medications help maintain bladder size?

      I'll be using a valve not a leg bag so that will maintain my bladder size.
      Board Member of Assistance Dog Advocacy Project working in Education. Feel free to ask me any service dog questions!

      I am not paralyzed. I have a genetic connective tissue disorder with neuro complications and a movement disorder.

      Comment


        #63
        Statlock-Put the part of the catheter with the Y -the part not connected to bag- the port for balloon inflation and not the long tube. You can close it easier and it will hold and not crimp the catheter. You can also put statlock or tape next to the Sptube to stabilize- it doesn't have to be on your thigh unless you want it. the idea is not to pull the Sptube out but it does have a balloon inflated so some don't really use anything.
        Can try skin prep or its equivalent over skin- if you aren't allergic to that - and use generously and this might keep the skin from coming in contact with adheseive.
        CWO
        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.

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          #64
          I've been having problems with a lot of sediment, does Vetericyn help dissolve sediment?
          Last edited by JamesMcM; 13 Sep 2014, 3:39 PM.

          Comment


            #65
            Originally posted by wheelman21 View Post
            Little late to the topic;
            I've had my supra pubic for about 13 years. Was started with a 22fr and it's what I still use today. The site around the tube(stoma) is cleaned morning and night with an alcohol wipe with a little neosporin on it. This works for me and my Urologist has always said my sp looks better than any he's ever seen. I drink plenty of water. In the time I've had my sp, I've never had a UTI. *KNOCKS ON WOOD*
            Alcohol applied to clean the stoma can be pretty caustic to sensitive skin. I couldn't use it, although I do clean the catheter tubing and my leg bag with alcohol.

            All the best,
            GJ

            Comment


              #66
              The anticholinergics relax the bladder. with an indwelling tube ( foley or SP) and constant drainage , the bladder does not expand and can shrink in size and lose its filling capability- i.e. becomes stiff with collagen around it. this can cause spasms and leakage. The current recommendations are to 1). rule out UTI 2).use low dose anticholinerics such as Oxbytynin, Detrol etc..
              CWO
              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


                #67
                Yes, but as I mentioned before I won't be keeping a bag attached 24/7, I'll be using a valve to maintain the size of my bladder. So why would I need to continue on the drugs after my body has healed and my bladder has adapted to the indwelling being in it? For the 2 months worth of medications my Dr prescribed. I don't understand how usage after that would make a difference in the size of my bladder.

                I also have GI issues with severe constipation secondary to gastroparesis motility issues which anticholinergics are contra-indicated for. I take about 15 prescriptions for different things (pain/muscles, GI, heart, asthma, hypothyroidism and more) so I'm always wary of introducing a new med that may not be required. And especially in this case, because with the contraindications it might end up with even more meds to battle the side effects, which is something I really dislike doing. The dry mouth is also a concern because of tooth damage I have between dehydration and eroding from stomach acid with my GI issues.

                Also, if the problem with the bladder becoming stiff with collagen, well that wouldn't be an issue for me at all anyway lol. I have a collagen defect, (Ehlers Danlos) so my collagen is too weak and elastic.
                Board Member of Assistance Dog Advocacy Project working in Education. Feel free to ask me any service dog questions!

                I am not paralyzed. I have a genetic connective tissue disorder with neuro complications and a movement disorder.

                Comment


                  #68
                  Did the leakage stop for a while after it was irrigated? If bladder spasms not causing then ? Did you have urodynamics fill pull flow before SPtube insertion to insertion you did not have a low leak point or leaking through sphincter? this is usually done to ensure it wouldn't leak through urethra.
                  CWO
                  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


                    #69
                    Lin, as long as your bladder has a tube in it you will most likely have spasticity issues. The ones with the lesast side effects are the extended release drugs. Regular oxybutynin chloride begins work almost immediately but it causes dry mouth and constipation. When its brand name extended came out, Ditroopan XL, I was thrilled! No more dry mouth and I had to find a new drug for my IBS (diarhhea dominant). Oh, even the dandruff that showed up in rehab disappeared. Then I picked up my prescription one day and my insurance had switched me to the extended generic, Oxybutynin Chloride ER. Took that for a few weeks and was tested 3 times for utis because of leakage. Then my memory turned to cheese. Googled it and a paper came up about the new generic and memory loss in normal control subjects. I was able to switch back to the brand name and my pharmacist and I both reported this to the FDA for after marketing reporting. Everyone gets different side effects so give each 2 to 3 weeks before trying another. The longer acting ones have fewer side effects because they maintain a constant but lower concentration of the active ingredient in your system. The slower motility issues of Ehlor Danos also effects most with SCIs. For some of us it means taking a once a day long acting twice a day. I do this and it hasn't had anywhere near the effects that the immediate release form of the drug has. But using a floride rinse like ACT before bed after brushing can help if you dry out at night.
                    Courage doesn't always roar. Sometimes courage is the quiet voice at the end of the day saying, "I will try again tomorrow."

                    Disclaimer: Answers, suggestions, and/or comments do not constitute medical advice expressed or implied and are based solely on my experiences as a SCI patient. Please consult your attending physician for medical advise and treatment. In the event of a medical emergency please call 911.

                    Comment


                      #70
                      I'm taking the generic oxybutinyn er and it's already been awful. The dry mouth is horrible and my throat hasn't healed from the surgery yet because of it, still feels as bad as when I woke up from the anesthetic and my roommate said my voice is off. And I haven't had a bm in over a week, probably around a week and a half now. I've doubled my miralax to see if that helps. I know some here with Sci also have gastroparesis but mine has been really bad lately so it's not good timing to be doing anything that will make it worse. I have an endoscopy Tuesday (Rescheduled from when I was in the hospital for cellulitis) and new gastric emptying studies after that. I had no idea I was going to get bladder spasms or need medication for it before agreeing to the surgery. The medication has helped but not completely stopped the spasms as well so I don't know how much is the medication and how much is it just slowly improving as time goes on. The uro nurse said they would only last for up to a month after the first catheter change. I had no bladder spasm issues prior to the spc surgery. I've decided to give it 3 months (based on the nurse's one month after first change timekine) before deciding if I want it removed. I'm hoping once I start using the valve things will improve since the bladder will not always be empty and in contact with the catheter.
                      Board Member of Assistance Dog Advocacy Project working in Education. Feel free to ask me any service dog questions!

                      I am not paralyzed. I have a genetic connective tissue disorder with neuro complications and a movement disorder.

                      Comment


                        #71
                        I've had a supra-pubic catheter (22fr) for about 10+ years. Things have general gone well & so far I have not had one UTI. I basically follow the same approach as Gjnl & Darty approach toward maintainence. Placement of the catheter & extension tube along my leg as it connects to the leg bag can be an issue since I don't want the urine to stop flowing & get backed up causing a full bladder, AD, & wet pants.
                        C4/5 incomplete, 17 years since injury

                        "The trick is in what one emphasizes. We either make ourselves miserable, or we make ourselves happy. The amount of work is the same.” - Carlos Castaneda

                        "We live not alone but chained to a creature of a different kingdom: our body." - Marcel Proust

                        Comment


                          #72
                          Anytime you change something, your body needs time to get used to it. Be patient. And try one thing at a time. If the generic medication gives you problems, ask for the brand name. See if that makes a difference. And different medications act differently on each one of us.

                          In doing SCI work for over 40 years, no one I know has gone back from a spc. That doesn't mean that could be the right decision for you. I am just remembering that many of the people I worked with took a month or a little longer to get used to it.

                          I know that patience is not always easy to come by - but try.

                          CKF
                          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


                            #73
                            Originally posted by Sue Pendleton View Post
                            Lin, as long as your bladder has a tube in it you will most likely have spasticity issues. The ones with the lesast side effects are the extended release drugs. Regular oxybutynin chloride begins work almost immediately but it causes dry mouth and constipation. When its brand name extended came out, Ditroopan XL, I was thrilled! No more dry mouth and I had to find a new drug for my IBS (diarhhea dominant). Oh, even the dandruff that showed up in rehab disappeared. Then I picked up my prescription one day and my insurance had switched me to the extended generic, Oxybutynin Chloride ER. Took that for a few weeks and was tested 3 times for utis because of leakage. Then my memory turned to cheese. Googled it and a paper came up about the new generic and memory loss in normal control subjects. I was able to switch back to the brand name and my pharmacist and I both reported this to the FDA for after marketing reporting. Everyone gets different side effects so give each 2 to 3 weeks before trying another. The longer acting ones have fewer side effects because they maintain a constant but lower concentration of the active ingredient in your system. The slower motility issues of Ehlor Danos also effects most with SCIs. For some of us it means taking a once a day long acting twice a day. I do this and it hasn't had anywhere near the effects that the immediate release form of the drug has. But using a floride rinse like ACT before bed after brushing can help if you dry out at night.
                            I just started using regular oxybutynin and it seems to be helping with leaking around the sp. The bad part is the dry mouth and constipation. I'm going to talk to my urologist about Ditropan XL. I can't have no leaking around the sp but also no stool going into my colostomy bag.

                            Comment


                              #74
                              Lin,
                              You may not need as much oxybutynin as your doctor has prescribed. The SCI nurses have spoken of low doses of anticholingerics for on going use with a suprapubic catheter. I have been able to cut my dose of oxybutynin way back and dry mouth is reasonably tolerable. I don't have the gastroentrological problems you describe, but I am not having any constipating issues on a low dose. You can cut the tablets in half and experiment with a dose that almeliorates spasms, but may not cause you so much trouble otherwise.

                              A new anticholinergic has been introduced that has significantly less side effects, especially dry mouth. It is marketed as Myrbetriq.

                              All the best,
                              GJ

                              Comment


                                #75
                                I thought 10mg once a day was a rather small dose? I've read on here people who take 10mg 4x a day.

                                I've been on it since last tuesday. I still get bladder spasms when I'm moving around/active. They generally eventually taper off when I'm still. At night I'll move around causing them, fall asleep, wake up and don't feel them but once I change position they start again. At this point I really don't know if the medication is doing anything at all or they're just gradually decreasing over time, after the surgery they were nonstop causing the urge to pee to be pretty strong, I even tried to pee out my urethra a couple times wondering if the SP wasn't draining, all that did though was make them worse and cause horrible bladder pain. The dry mouth is killer for the first couple hours after I take it, but also lasts all day. Like I mentioned before my throat is still sore from the surgery, I assume the dryness isn't letting it heal. And tomorrow I'm getting an endoscopy so I'm sure thats not going to be pleasant after.

                                I love the SP other than the damn spasms. So if I didn't have sensation and wasn't feeling like I needed to pee all the time with no relief I'd be ecstatic. I finally got my supplies (there was a mistake with the first delivery and they had to be returned and new stuff shipped out) so I can start using the valve during the day. I'll wait until after the endoscopy tomorrow though, I don't want to be worrying about leakage around the site or pea size bladder while there.
                                Board Member of Assistance Dog Advocacy Project working in Education. Feel free to ask me any service dog questions!

                                I am not paralyzed. I have a genetic connective tissue disorder with neuro complications and a movement disorder.

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