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    Foley catheter

    Help! Lately I've been waking up in the middle of the night needing to cath. I try to regulate what I drink, getting all of my liquids in before 6 PM, but I still hold my fluids until the middle of the night. It's driving my wife and I crazy because we can't get the sleep we need. Would it be advisable to put a Foley catheter in at night and remove in the morning thus avoiding having to Cath in the middle of the night?

    #2
    Mattc - I would not recommend a foley at night. Have you tried to cath just before you turn the lights out for the night? This may reduce the need to catheterize a little later. You might also try to cut your fluid intake by 5 PM and see if that helps. CRF
    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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      #3
      I have that problem too. When I was in the hospital I asked my doctor about it and she said your kidneys process better lying down so I would always have that. My Mom gets up at 2 every night to cath me.

      Marie
      Unbroken by the grace of God
      Marie
      Unbroken by the grace of God

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        #4
        I always cath before lights out, and I've tried stopping drinking earlier but I still have the same problem. I used to be able to sleep through the night without being cathed, but now I seem to be able to hold less in my bladder. I'm taking more Ditropan because my last urodynamics showed that my bladder pressures were too high. Plus, I'm drinking less because I worried about my bladder overfilling. What kind of risks am I taking by wearing a Foley at night? My wife has a full-time job and she can't continue to be up at night cathing me.

        I feel for you Marie, it's such an aggravation. Everything seems to work against you, a body just tends to dump urine when you're lying down, you would think it would slow down when your metabolism slows.

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          #5
          MattC - How long has it been since you had your urodynamic studies done? Was the problem you are now experiencing present then? Have you discussed management options with your urologist? If not, I would urge you to do so.

          Decreasing your fluid intake is not necessarily going to help the problem of high pressures in your bladder. That is a function of the neurological deficits, from your SCI, that affect your bladder. An overactive bladder (spasticity) will contract when partly full; the sphincter does not relax as the bladder contracts and thus the bladder cannot empty. This creates dysserngia and there is an increase in pressure within the bladder. I would encourage you to keep your fluids at about 8 8oz glasses daily, to help reduce the risk of UTIs and promote good bowel function.

          The problem with using a Foley is that you do increase your risk of UTIs and your bladder will alternately be continuously drained while the Foley is in place and then emptied intermittently during the day. I would encourage you to discuss, with your doctor, the best management approach for you, your needs and the impact this is having on your lifestyle needs. CRF
          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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            #6
            Ask your physician to check your daytime (2PM) and nighttime (2AM) ADH blood levels and urine osmolality. Some people with SCI, esp. with higher injuries, have less ADH levels at night, which is the opposit of what is normal. If this is the case, you may be a candidate for use of DDAVP at bedtime.

            (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


              #7
              I too couldn't go the night without cathing and hated bothering my wife. I now insert a red catheter, tape it to my penis and connect it to a night bag. That way I can drink a glass of water before bed and rehydrate myself without worrying.
              "Never argue with an idiot; they'll drag you down to their level and other people may not be able to tell the difference."

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                #8
                KLD, I got lost in your lingo -what are ADH blood levels (hormones from the adrenal glands?), how would I get a 2 AM ADH blood level, and what is DDAVP?

                Also, what do you think of 24/7's solution? I would love to not have to wake my wife up every night...

                CRF, I had my urodynamics done about three weeks ago and I had to up my Ditropan another 10 mg. It has helped, I can retain more urine now.

                [This message was edited by mattc on 11-14-04 at 07:52 PM.]

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                  #9
                  Mattc - glad to hear that the increased ditropan has helped.

                  Re: KLD's post...ADH is antidiuretic hormone and I am not sure about DDAVP. KLD is away until Nov 21; she is periodically checking her emails. Hopefully she will pick up on this post at some time to further explain her suggestions. CRF
                  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
                    mattc - I was able to contact KLD; here is her reply:

                    "Some people with SCI, esp. quads have reverse levels of ADH (antidiuretic hormone) excretion at night for some reason, resulting in high urine output in spite of fluid restriction in the evening. We did a published study on this in the early 1990s (Szollar, Dunn, et al). The treatment is the use of DDAVP, which is usually given as a nasal spray at bedtime. Normally it is used as the drug treatment for diabetes insipidis.KLD"

                    I would show this information to your urologist and discuss the options for obtaining a 2 AM blood sample. I would imagine this would either entail a short overnight hospital stay for this....i.e. in a bedtime, out in the morning or to investigate the possibility of blood being drawn by a home health person at 2 AM.

                    Hope this helps. CRF
                    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


                      #11
                      I also have trouble with my bladder and staying dry in the night,and cath in the day but at night i wear a coveen sheath,last week saw top doc at sheffeild and he was talking about a op to make my bladder bigger,once the word op came up everything went over my head then,can you give me some details,have just started oxbutnin at night but not working,or anybody who as had it done if its thumbs up or thumbs down,dave.
                      pxssycat

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                        #12
                        Dave1234, do a search here using the term "augmentation" and you should find a lot of information about this surgical procedure. It still would not be safe to maintain more than 450-500 cc. in your bladder at one time though. The technique of inserting a catheter every night is also discouraged as it provides a easy route for bacteria into your bladder.

                        (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


                          #13
                          My husband (C5-C6 Quad)had the same problem. Nothing during the day, then huge output at night (over 2000 cc's). Since I worked full-time, I could not continue to do intermittent cathing in the middle of the night. So we came upon our own management system based upon his bodily needs. I insert a foley when I get home from work at around 7 pm with a night drainage bag hooked to the hospital bed. This makes us worry-free til morning. It is removed the next morning before bowel program, and the cath is rinsed in hot water with just a little tiny bit of anti-bacterial soap in it and rinse thoroughly. It then air dries for re-use later that night. We change them every two weeks, and use a silicone foley with antibacterial tip.

                          We have been doing this for 2 years and he has NEVER had a UTI.
                          A month ago he had a mild fever and the HHC nurses swored he had a UTI, but the test came back negative.

                          I am not saying this would work for everyone, and you have to be religious about cleaning the cath, but for us it has worked great. He has a very large bladder and actually goes all day without being cathed. When I put it in, only 200 or 300 cc's comes out, and he does not restrict his fluids during the day.
                          We simply worked with his body's rythms and did what made sense. If he goes out for a long period of time during the day, we leave the foley in and attach a leg bag.

                          What I have learned is that you do what makes sense, and pay attention to what happens. Good luck.

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                            #14
                            I have been having problem with large volumes at night(I was doubling my volumes at night), and leakage. With this problem is the end result of little sleep, and many wet nights.After having a urodynamic study, my urologist put me on 0.2 mg of DDAVP (desmoressin) at bedtime, which has been great. I can sleep through the night and not worry about large volumes and leakage. My volumes at night are half of what they are during the day (vs. 2x the daily volume)

                            I would recommend this to any folks who have similiar problems.

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