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    Peristeen New User with Concerns

    I'm starting a new thread on Peristeen to address my concerns. I know that there are many threads and that's the issue. Most are really dated and I simply don't have the time to read through them all to see if my concerns were previously addressed.

    I'm just shy of 30 years post SCI with a T6 complete due to GSW. For almost the entire time of my SCI life I have used Magic Bullet with fair success. Early on, I could wrap things up in about an hour and change but most recently... When I go in the bathroom, you can expect not to see me for two to three hours.

    I recently received my Peristeen kit and have been using it for about two weeks with less success than I had anticipated. I thought things would be great like the person in the animated video from the company. My results have been less than that and I'm concerned. Maybe this is just not for me. I almost always wind up with an "incomplete" feeling. And based off of whatever I had to eat previous and the amount of water I pumped in during the process... The results were just not "done". I would have to use a magic bullet after all to finish.

    In the last couple of days I decided to go off script and try something. I would start with checking the "chamber" to make sure there was no ammo present and insert the magic bullet. Instead of waiting the 15 to 30 minutes for it to activate, I gave it about 10-12 minutes and then I introduced the Peristeen. Within less than a minute to about 2 minutes I found the most success thus far. Almost completely empty. I would then follow up with some digital to clean out any stragglers.

    I know this is not what was prescribed, but that other way simply wasn't working. Maybe I just need to let me body acclimate to the Peristeen method. But I'm getting frustrated. Also I recently read where @SCI-Nurse stated that the system was not recommended for SCI persons because the stretching of the bowl walls could result in incontinence. I'm fortunate enough to not have had any problems with that in almost 30 years and I shudder to think that I could inadvertantly cause it at this stage in my life.

    If anyone has any advise or thoughts on this, I would love to hear from you. Thank you for reading.
    Last edited by mikeinbmore; 6 Jan 2020, 4:01 AM.
    Standing up for our rights, one offender at a time!
    http://www.youtube.com/watch?v=KH59mpTo5x8

    Follow me on instagram: mikeinbmore

    #2
    I think your current method sounds just fine. I can't think of any downside.

    My Dad is a para L3 and after many trials with Peristeen (and using a lot more water volume than they recommend), he never had good results from it. So he gave up on it. Suppositories don't work for him either, unfortunately.

    Comment


      #3
      It certainly was not from this SCI-Nurse that you got information that the Peristeen system is not appropriate for people with SCI. It was developed for, and has been used for many years by people in Europe with SCI, and I have never seen any research indicating that it increases either bowel accidents or "overstretching" of the colon.

      Your method of using a Magic Bullet to bring stool down into the lower intestine before evacuating it with the Peristeen sounds like a good plan to me. Keep us informed about how you progress with longer use of this program.

      (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


        #4
        Originally posted by SCI-Nurse View Post
        It certainly was not from this SCI-Nurse that you got information that the Peristeen system is not appropriate for people with SCI. It was developed for, and has been used for many years by people in Europe with SCI, and I have never seen any research indicating that it increases either bowel accidents or "overstretching" of the colon.

        Your method of using a Magic Bullet to bring stool down into the lower intestine before evacuating it with the Peristeen sounds like a good plan to me. Keep us informed about how you progress with longer use of this program.

        (KLD)
        After finding an re-reading the comment, I stand corrected. It was said that there was concern that using the Peristeen was like using an enema which was not recommended for individuals who have a neurogenic bowel.

        http:///forum/showthread.php?250582-...=1#post1774159
        Standing up for our rights, one offender at a time!
        http://www.youtube.com/watch?v=KH59mpTo5x8

        Follow me on instagram: mikeinbmore

        Comment


          #5
          Originally posted by mikeinbmore View Post
          Aft
          Originally posted by mikeinbmore View Post
          After finding
          i have not been around for awhile but i may be of some help here
          i use these https://store.independenceaustralia....erile-25000295 $10 in aus
          have done for 15 yrs, 50 yr old c5 quad, we dont much around, i use a microlax enema 1st(5ml) bit like a bullet i guess, over the loo, wait 10 min (if im lucky) do a check & remove whats there if possible, then hit it with about 500-750 ml just warm water.
          hose up about 3 inches, use 3 quarters of the water, then digitally release the water straight away, & hopefully you'll get a niagra falls type effect, whoosh" & its all gone, do another check to be sure (im anal about it) & make sure waters out, use the remaining water or more if necessary, once you get it down pat, its a 10 min job, admittedly, i have carers & they do it, but it sure beats waiting 30 mins, really you dont even need enemas or bullets, you can just do this. i do it everyday, just in case, some days i miss for up to 4 days, but i dont panic about it.
          survivor of beijing oeg transplant

          Comment


            #6
            Originally posted by philquad36 View Post
            (im anal about it)
            Standing up for our rights, one offender at a time!
            http://www.youtube.com/watch?v=KH59mpTo5x8

            Follow me on instagram: mikeinbmore

            Comment


              #7
              Originally posted by SCI-Nurse View Post
              It certainly was not from this SCI-Nurse that you got information that the Peristeen system is not appropriate for people with SCI. It was developed for, and has been used for many years by people in Europe with SCI, and I have never seen any research indicating that it increases either bowel accidents or "overstretching" of the colon.

              Your method of using a Magic Bullet to bring stool down into the lower intestine before evacuating it with the Peristeen sounds like a good plan to me. Keep us informed about how you progress with longer use of this program.

              (KLD)

              Hi KLD, thanks for your perspective here. Like Mike, I was a little wary of Peristeen based on ckf's suggestion in 2015 that it might have an enema-like long term stretching impact on the walls of the intestine. Sounds like the evidence from the last 5 years hasn't supported that reason for concern, which is good news.

              Mike - any news on how Peristeen is working out?
              C5/6 complete (maybe) circa June 2018

              Comment


                #8
                Hi Guys,

                I’m a relatively new user of the Peristeen system. It didn't work that well initially. I was advised to mix a 'Toilax' (like a Microlax mini enema) into the full Peristeen water bag. Then use Peristeen as normal. I use 650ml of water. It works well but I'd like to just get to a stage where I just use water only.

                Does anyone else do the above?

                Could there be long term issues using the (diluted) Toliax in the Peristeen water that reaches my upper intestines?

                Comment


                  #9
                  It doesn’t reach the upper (small) intestines. I thought the whole purpose of it was water only but we very seldom order it as our patients don’t choose it as an option. Hopefully users can help you. Does company have a customer assistance/questions contact? 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


                    #10
                    Originally posted by SCI-Nurse View Post
                    It doesn’t reach the upper (small) intestines. I thought the whole purpose of it was water only but we very seldom order it as our patients don’t choose it as an option. Hopefully users can help you. Does company have a customer assistance/questions contact? CWO
                    The Peristeen Cololoplast nurse advised me that I could try this as she knew people who do it... but she said Coloplast wouldn't officially recommend it... (no reason given)

                    Comment


                      #11

                      Not sure what Microlax is but Enemeez (Docusol) is a natural (docusate sodium) mini enema of 5 mls. It is not a chemical irritant Bisacodyl/Dulcolax ( AKA Magic bullet suppositories ) but it should be used before Peristeen to empty out or move stool down to lower colon. Once you get on a regular schedule with Peristeen you should be able to stop it unless bowel is very dry and/or large. www.enemeez.com is the website. You might also want to consider a stool softener or Miralax laxative to get things moving the first time.
                      Coloplast bought Peristeen-which is great because lack of training and educational resources were almost nonexistant before Coloplast purchased Peristeen.
                      The only possible complication is if someone had a bowel obstruction and peristeen used and the bowel ruptured. So best to use when no abdominal distention and on a regular basis to ensure no obstruction. So that is probably why don't officially recommend it.
                      Also, bowel program should be done every other day or every day. I know there are those that do it every 3 (or more) days and I would think Peristeen recommends the routine schedule.
                      Recommendations for the consistency of the stool is important also. Should not be rock hard! Prefer semisolid or Type 4 of Bristol Stool. Like a Milky way or minimally a few lumps like an Almond Joy. That should be your goal with diet , intake of fluids and stool softeners.
                      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


                        #12
                        Hello, i’m John and this is my first time to post in this forum. I have incomplete SCI trauma from an old accident. I am being seen by an SCI rehab center in Raleigh NC for neurogenic bowel. They prescribed the Peristeen Irrigation system and it recently was approved by my insurance.

                        I just received my Peristeen supplies this week. As I have been “irrigating” for years (with old-fashioned hanging bag enemas), my doc told me to go ahead and try the Peristeen.

                        My initial efforts have been successful and I consider the system to be “effective.”

                        However, I have questions about the number of squeezes to inflate the catheter balloon. Previously, I saw an older discussion of this somewhere in this forum but cannot now locate it.

                        It was necessary for me to use quite a few squeezes to inflate the balloon enough for it to remain in place after the water was pumped in. I tried four squeezes and that was not sufficient. I think I ended up with five squeezes or a bit more. While I definitely could sense the balloon, it was not uncomfortable (I have some limited sensing in the rectum).

                        How many squeezes are “typical” (I won’t say “normal”). At what point is it unsafe?

                        Thanks,

                        —John

                        Comment


                          #13
                          Originally posted by John

                          Hello, i’m John and this is my first time to post in this forum. I have incomplete SCI trauma from an old accident. I am being seen by an SCI rehab center in Raleigh NC for neurogenic bowel. They prescribed the Peristeen Irrigation system and it recently was approved by my insurance.

                          I just received my Peristeen supplies this week. As I have been “irrigating” for years (with old-fashioned hanging bag enemas), my doc told me to go ahead and try the Peristeen.

                          My initial efforts have been successful and I consider the system to be “effective.”

                          However, I have questions about the number of squeezes to inflate the catheter balloon. Previously, I saw an older discussion of this somewhere in this forum but cannot now locate it.

                          It was necessary for me to use quite a few squeezes to inflate the balloon enough for it to remain in place after the water was pumped in. I tried four squeezes and that was not sufficient. I think I ended up with five squeezes or a bit more. While I definitely could sense the balloon, it was not uncomfortable (I have some limited sensing in the rectum).

                          How many squeezes are “typical” (I won’t say “normal”). At what point is it unsafe?

                          Thanks,

                          —John
                          Hi John,
                          GJ researched the Peristeen system extensively. I looked back at some of his notes and found these that are relevant to your question.

                          https://www.albamedical.ca/Coloplast...tion=show_all:
                          The required number of pumps will vary between individuals; typically 3 pumps is sufficient for the standard catheter (maximum 4 pumps) and 1-2 pumps for the small catheter (maximum 2 pumps)

                          https://www.coloplastcare.com/siteas...bystep_a4.pdf:
                          Recommended amount of pumps by your HCP (Health Care Professional or Personnel): (maximum 4 pumps or 2 if you are using a small catheter).

                          http://www.stmarksnhshospital.org.uk...essionals.pdf:
                          If the balloon is deflated: check for a burst balloon. Practice inflation technique with a catheter outside the body to ensure the balloon symbol is used and enough air is instilled. Check that you are not accidentally turning to the air symbol when intending to use the water symbol after inflating the balloon.

                          If the balloon is expelled immediately after inflation, the balloon is stimulating rectal contractions. Try inflating the balloon more slowly or inflate it a little less. If the balloon is expelled once you have begun to pump, check that the water is not too hot or cold, or try pumping more slowly. Expelling the balloon may be more likely to happen if you irrigate after a meal: try other times.


                          Did you get training from a Coloplast certified nurse?

                          NL

                          Comment


                            #14
                            NL, thank you very much for your help. I may have inflated the balloon too quickly. No, I didn't to receive training from a Coloplast nurse, but I have read all of the Coloplast brochures and viewed all of the Peristeen videos. I will see an OT next week.

                            --John

                            Comment


                              #15
                              I typically use two pumps. Make sure you get the catheter all the way up in there, and hold it, before inflating. Good luck.

                              Comment

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