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    #16
    I find 5 pumps burst the balloon of the foley once you start pumping water in. With a new catheter(I reuse them) 4 good pumps seems to be the limit. If you reuse them, they stretch a little and you can get away with 5 pumps.

    I would be interested to hear how much water folks are using.

    My procedure has evolved to, pump in just over half the bag of water around (500CC), wait 20 minutes, do a quick digistim. Pump in the other half the bag (500CC) wait 20 minutes.. Digistim to check nothing is left. I'm doing this every other day.

    Thoughts ?

    Comment


      #17
      Like NW-Will in the previous message, I used 5 pumps for the balloon this morning and everything seemed to be fine until I began pumping the water in. The balloon popped when I had only about 400cc of water in. The catheter was properly inserted and I was holding onto it when it popped.

      When I use 4 or fewer pumps I have serious leaks.

      I am new to the Peristeen device (this is my first week). Why would the water cause the balloon to burst?

      I see my OT tomorrow and she may be able to help.

      Comment


        #18
        The balloon bursts when you add water, because you're adding pressure inside your bowel.
        You've fully inflated the balloon and then crushing it. the ballon has no elasticity left to flex so it just bursts.

        Once you inflate the ballon a couple of times it has more elasticity. I haven't tried this yet, but I wonder if you inflate it with 5 or six pumps before you insert it to stretch it out, whether it would then allow 5 pumps and then the insertion of water.

        I'll try and remember to try it out






        Originally posted by John Davis View Post
        Like NW-Will in the previous message, I used 5 pumps for the balloon this morning and everything seemed to be fine until I began pumping the water in. The balloon popped when I had only about 400cc of water in. The catheter was properly inserted and I was holding onto it when it popped.

        When I use 4 or fewer pumps I have serious leaks.

        I am new to the Peristeen device (this is my first week). Why would the water cause the balloon to burst?

        I see my OT tomorrow and she may be able to help.

        Comment


          #19
          I would contact Coloplast. They have Care advisors. Here is the contact information.
          Also-Did you enroll with them? Can do online.
          from website-Learn more about Care for Peristeen users and enroll today!
          Care Advisor Contact Information For Users
          Care Advisor Hours
          • Monday-Friday 7:00am-7:00pm Central Time (Continence Care and Ostomy Care only); 8:00 am-7:00pm Central Time (Bowel Care)
          • Saturday 9:00am-1:00pm Central Time (Continence Care and Ostomy Care only)
          Contact Information
          • Bowel Care: 1-855-605-7594 or email peristeen@coloplast.com

          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


            #20
            Thank you SCI-Nurse! I will do that.

            Also, yesterday I met for the first time with my SCI-rehab's Peristeen trainer. She was excellent and helped a lot.

            I noted for her that I have had to use more than the recommended number of pumps for the inflator but that I have a very flaccid sphincter. She told me that my problem is fairly common and that some of her patients also require extra pumps.

            She approved everything I had been doing, except that I have been pumping air into the inflator too quickly and also pumping the water much too quickly. I need to slow way down on both.

            NW-Will, she said almost exactly what you said about the extra water adding more pressure and that being a factor in the balloon bursting.

            I did everything much more slowly this morning and all went much better. The system worked as intended.

            I used 5 pumps for the inflator. I still leaked water but not nearly so much as previously. After half the bag was empty, I pumped the inflator one more time and that helped to reduce leakage This time I did not pop the balloon.

            Despite my minor difficulties I think the Peristeen system will work for me very effectively. I just need to become more accustomed to it and "fine tune" my technique.

            Thanks NW-Will and SCI nurse.

            Comment


              #21
              Good to hear. We very seldom used the Peristeen because original company had to supply trainer and just weren't enough but they required it. Coloplast has improved a lot and improvement with the website.
              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


                #22
                I'm jealous you got to speak with a professional!

                Curious,
                How much water do you end up putting in?
                How much extra digitial stimulation do you do?
                How long does the whole process take you.. from getting on the pot to leaving the bathroom etc.

                If you get the chance, ask if they have any advice for adding anything to the water for soothing etc ?


                I experimented with the balloon.. Took it out the packet and inflated it twice with 7 pumps to stretch it.
                Then inserted and pumped it up with 6 good pumps, the balloon didn't burst! hardly conclusive but seemed to work for me.

                Share any other pro tips you pick up ..

                Originally posted by John Davis View Post
                Thank you SCI-Nurse! I will do that.

                Also, yesterday I met for the first time with my SCI-rehab's Peristeen trainer. She was excellent and helped a lot.

                I noted for her that I have had to use more than the recommended number of pumps for the inflator but that I have a very flaccid sphincter. She told me that my problem is fairly common and that some of her patients also require extra pumps.

                She approved everything I had been doing, except that I have been pumping air into the inflator too quickly and also pumping the water much too quickly. I need to slow way down on both.

                NW-Will, she said almost exactly what you said about the extra water adding more pressure and that being a factor in the balloon bursting.

                I did everything much more slowly this morning and all went much better. The system worked as intended.

                I used 5 pumps for the inflator. I still leaked water but not nearly so much as previously. After half the bag was empty, I pumped the inflator one more time and that helped to reduce leakage This time I did not pop the balloon.

                Despite my minor difficulties I think the Peristeen system will work for me very effectively. I just need to become more accustomed to it and "fine tune" my technique.

                Thanks NW-Will and SCI nurse.

                Comment


                  #23
                  Just in case others who read this forum have the same problem, I should note that I have been inserting the catheter in just a little bit too far. Not much, just an extra ⅝" or so by holding the catheter at the base instead of at the ridges intended for fingers to grasp. That made a small difference in inflating the catheter in the best location for it to do its job as a plug. The small distance made a difference in my leaking. I still leak some, but less.

                  NW-Will, I am very fortunate to have found such a good Peristeen trainer.

                  I will try to answer your questions. I use the full liter of water, or as much as I can. I usually manage to use at least 700ml. Please recall that I have been using traditional hanging bag soapsuds enemas where I am accustomed to using 2 liters for the soapsuds enema and more for the rinse. I am having to adjust to using less water. I think the Peristeen's large inflated catheter balloon must stimulate peristalsis and a strong defecation urge. I say that as the Peristeen is working more effectively than I expected for the amount of water used.

                  I am still fine-tuning my use of laxatives. As they were not effective enough, my doc increased the laxative dosage (Senna, Miralax, and docusate sodium stool softeners). Now they are a little "too effective" so I need to reduce them a bit. If they are "too effective," I have a sudden bowel accident in the morning before using the Peristeen. If that happens, I skip the DigiStim. Otherwise I will do a digital rectal exam, manual removal of stool as necessary, and DigiStim twice before using the Peristeen. I do not do any DigiStim after using the Peristeen.

                  Because I have been administering traditional enemas for years (more than 5,000), I am very organized in how I arrange things before use. Once everything is set up, I can administer the Peristeen in 12 minutes (I timed it). If I include setup time, actual use, and time afterward to clean and put things out to dry, about 25 minutes. I found that I can set up, administer two Peristeen irrigations, cleanup, put things out to dry, and shower in 50 minutes. Please note that I am an incomplete SCI and can move around with a Rollator or cane.

                  I will ask for you about adding anything for soothing at my next opportunity.

                  So, I am pleased with the Peristeen system and as I am new, I realize that my learning curve will last for quite a while. The most important thing I learned this week is how small things can make such a difference.

                  Best wishes to all and thank you for sharing.

                  Comment


                    #24
                    NW-Will, you asked me to ask my Peristeen trainer "if they have any advice for adding anything to the water for soothing etc?" Upon reflection, I am not sure I understand the nature of your question enough to relay your concern accurately to my Peristeen trainer.

                    What is the nature of your problem requiring "soothing" after using Peristeen? Personally, I have generalized increased pain afterward, probably from twisting to hold the catheter in place (but much less than with my traditional enemas). Is is irritation at the anus? Cramps, Mucosal discharge? Late drainage? If it is too personal, please feel free to send me a PM.

                    Best wishes!

                    Comment


                      #25
                      You use lidocaine rectal gel ? It only last about 20 minutes. If pain is from being full of water, not sure there is anything for that. 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


                        #26

                        This morning I had two perfect irrigations. I say “perfect” as there were no leaks and no balloon pops.
                        (The second irrigation was a reuse of the same catheter.)

                        Yesterday I mentioned that that small things can make a big difference in using the Peristeen System optimally.
                        - I have learned to pump both the air and water very slowly.
                        - I have learned that I had been inserting the catheter a little too deeply.

                        Re pumps of the catheter balloon, I need 5 pumps (you can joke about that part of my anatomy). Then one more when the bag is about half empty.

                        Today, to my surprise, I learned the importance of relaxing more. By this, I mean to completely relax my anal sphincter once the catheter is inserted and fully inflated.

                        It seems that, due to my fear of accidentally expelling the balloon, I was contracting my anal sphincter. This was preventing the balloon from “seating” itself in the optimal manner to serve its plugging function. Once I decided to fully relax (and risk the balloon slipping out), it slid slightly downward into its optimal position and there were no leaks at all! I was amazed.

                        Wow. Small things do make a difference with the Peristeen.

                        I see my doc tomorrow and look forward to hearing what she has to say.

                        Best wishes,

                        —John

                        Comment


                          #27
                          Good advice. Thanks. 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


                            #28
                            Thanks for all the great feed back... really appreciate it.
                            So just confirming... you're using between 700cc and 1000cc's of water... and you do this twice ?
                            How are you gauging when to stop putting more water in.. what determines whether you use 700cc's or a 1000cc's ?

                            My butt hole is just so sore and irritated from the whole digistim and plus haemarroids.. so looking for something to sooth my butt.
                            I'm trying lidocaine at the end.. as in using it on the last digistim just to make sure I'm empty as a means to try and calm things down.

                            I am hoping to find something I could add to the water that would be soothing or calming.. like say aloevera, not saying aloevera but just as an idea.

                            Oh one last thing... what kind of temperture is the water you're using? I'm using just luke warm.

                            Comment


                              #29
                              NW-Will, good questions.

                              I always aim for 1000ml of water for maximum emptying of the colon. My Peristeen trainer approved this because of my previous experience with larger enema volumes. Recently, I have been managing to get at least 700 ccs in and often 1 Liter. If I stop at less than 1000ml, it is because I am sensing strong peristalsis or strong defecation urge. If I sense strong peristalsis, there is no need to pump in more water.

                              I am experimenting with two irrigations to reduce the likelihood of a later bowel accident. I should note that my normal bowel pattern is to have 2 BMs per day. With one irrigation, I sometimes have been having later accidents. So, I am experimenting with one or two irrigations, and modifications to laxatives, to see just what I need. I have an appointment with my SCI rehab doc this afternoon and will have the opportunity to discuss this with her. I expect this trial and error to continue for some time.

                              I am fairly active in my community and chair a resident committee. So, after all this time, I continue to be very anxious about having a bowel accident in public. So far, no one even knows that I wear a diaper (insofar as I can tell). I live in a nice retirement community (yeah, I'm old enough to be the father or grandfather of some in this forum). In such a small community, rumors fly very quickly and one public bowel accident would create all sorts of gossip. Of course, eventually that is bound to happen.

                              I use water that I consider to be warm. Probably about 101 degrees F. Never hot. Be very careful with temperature. In addition to the risk of injuring sensitive rectal tissue, water that is too hot may cause the bag to fail earlier than otherwise would have been the case. I need to discuss this with my Peristeen trainer.

                              I sympathize with your sore anus but cannot advise you there. Previously, when that has happened to me, I skipped enemas for a day and used suppositories instead.

                              Please don't do anything I do without first checking with your physician or Peristeen representative.

                              Best wishes to all,
                              --John

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