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    I need advice from the sci nurse!

    I was discharged last friday treating a bladder infection "serratia" i had disreflexia pretty bad up to that point. They did ultra sound kidneys/bladder plus an mri to rule out cycsts. now that i'm home i'm still getting AD although not as sever but persistent mainly in the mornings when i start my routeing. once i'm up it goes away. i'm on my second pill of Pryidium hoping i just really tramatized my bladder but i never have had it so long "3 weeks" I just started workinmg with a good dr "suzy Kim" who is a para as well. I saw her on monday and she was a bit puzzeled. She asked that i call her friday for an update but i left her a msg today...Anything to rule out would be great..


    Ken

    #2
    Do you cath yourself as soon as you get up??
    Wha i s your blood pressure during this time??
    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


      #3
      i have a foley. i'll take my bp tonight, it was ok at the hospital. i went in it was low 90/70 then in bed it was 99/75 or abouts. while up 120/90 highest was 143/?

      Comment


        #4
        Since you have a foley, double-check that it is draining properly and not blocked or anything when you're having AD. I think they say that's the first thing to check for, a full bladder. And if you have an infection you might have extra "stuff" coming out that might be clogging it up and actually causing your AD problems.

        Comment


          #5
          Does it need to be irrigated??? Maybe the balloon is inflated too much. You could get a syringe as aspirate the soution out then make sure it isn't oo much- don't let the catheter fall out with the baloon deflated- then re inflate with a tleast 5cc.

          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


            #6
            its not the foley. the whole area seems overly sensitive to the touch. even during my bowel routine.

            Comment


              #7
              Ken, I see you've been having this AD problem for quite awhile. You mentioned a rash on your butt from runny stool, and maybe yeast infection. Either of these makes me have symptoms of AD, especially if you are sitting on that rash (might put you at risk for a sore).

              If you haven't yet, check out the sticky threads at the top of the Care forum home page. The clinical practice guides are especially helpful. Use the CareCure search engine at the top of the page to find previous posts that might relate.

              Oh, and welcome to CareCure, I hope you get relief soon.

              Matt
              get busy living or get busy dying

              Comment


                #8
                Any irritation can cause AD. Look for another cause.

                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


                  #9
                  Ken, check out this thread talking about a similar situation. They suggest the urethral sphincter may be irritated requiring excessive bladder pressures to void, causing not only AD, but also possible kidney damage, and incomplete voiding which results in more persistent and aggressive UTI's. Shew, that was a mouthful. They say to use a Foley catheter and have a urodynamics study done ASAP to determine bladder pressures.

                  9 Month Long UTI and AD

                  Give it a read, I hope it helps. Use the CareCure search function at the top of the page for related discussions, it's great!
                  .
                  get busy living or get busy dying

                  Comment


                    #10
                    Oxybutynin can help decrease bladder pressures and the foley, or indwelling catheter, will decrease the pressures. But tif used for a long eriod of time, he indwelling catheter will make your bladder capacity small and the size of the bladder wil shrink.


                    CWO



                    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


                      #11
                      Agreed, CWO. Here are the posts I was reading in that other thread regarding using a indwelling catheter in this situation. I found it realistic concept, even though the the person they're talking about is dealing with kidney stones.

                      #3:

                      /forum/showpost.php?p=715601&postcount=3

                      Originally posted by SCI-Nurse
                      I suspect his nearly constant AD is because he is voiding with excessively high bladder pressures, which can cause recurrent UTIs, AD, and, long term, kidney damage. If so, intermittent cath or even an indwelling catheter would possibly be safer methods of bladder management than reflex voiding with a condom catheter.
                      (KLD)
                      #26:

                      /forum/showpost.php?p=742554&postcount=26

                      Originally posted by Cory-M
                      I think this has been mentioned before but I didn't see a direct answer from you. The AD he is experiencing is most likely from high bladder pressure, because his bladder is not emptying completely with the method he is using. Even though this method worked in the past, things may have changed and the infection he has may be causing extra bladder spasms and pressure.

                      I would seriously consider an indwelling catheter or Intermittent Cathing, atleast try it or discuss with the Dr., maybe until he gets the infection cleared up.

                      Normally a UTI itself does not cause AD, but a full bladder/high bladder pressure is a primary cause.
                      #32:

                      /forum/showpost.php?p=760890&postcount=32

                      Originally posted by ouch
                      I'm a c6-7 quad. I wore a leg bag and condom cath for ten years and had a TON of utis. I was on meds every other week.

                      I finally asked to have a bladder pressure test done.. was too high.

                      I nows straight cath every 4 hours..sleep thru the night, and most importantly.. GET NO UTIS.

                      I would bet the quad in question has a residual amount in the bladder that is acting as a breeding ground for those nasty bugs.

                      Dump the condom cath.
                      get busy living or get busy dying

                      Comment


                        #12
                        I was agreeing with you. But each person is a little different.
                        A UTI is a not common cause of AD, but any irritation below the level of injury can cause AD. I had a pt who we tie dhis sheostrings to tight & he had AD. And a UTI can be irritating.
                        A while ago I had a pt. having AD, he had a bladder infection but the volume obtained was small, on fluoro he had an outpouching of the bladder, a diverticuli, or we call it a tic.-that was holding about 65 cc of very funky thick urine. He had the AD until I crede' d his bladder tic and emptied it- ony 65 ccs but it was some thick foul urine. And the AD was gone. The AD did not return when his bladder was filled over 500cc with sterile water.
                        Also there are many causes of high pressures. One cause is the high pressure of the bladder filling and trying to empty- the bladder contracts & tries to empty. At this time, the sphincter should relax and let the bladder empty-but it doesn't so the bladder pressure gets higher & higher trying to empty. & force th esphincter open -sometimes this works. This is called detrusor sphincter dysnergy- DSD.
                        Due to the SCI, the bladder is a little "confused" and tries to empty with low volumes in it or due to irritation, as with a UTI.
                        You can only tell this from Urodyanmic Studies-cystometrogram with EMG and fluor is helpful. And these realy need to be done and are the only way to tell exactly what is going on.
                        But the treatment for high pressures is catheterization when volumes are below 400cc, usualy at least eveyr 4 hours, and Oxybutynin(an dother meds) can help. An indwelling catheter will keep the bladder from fillling but it has its disadvangtages. Botox is another possibility.




                        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


                          #13
                          Originally posted by SCI-Nurse
                          I was agreeing with you. But each person is a little different.
                          A UTI is a not common cause of AD, but any irritation below the level of injury can cause AD. I had a pt who we tie dhis sheostrings to tight & he had AD. And a UTI can be irritating.
                          A while ago I had a pt. having AD, he had a bladder infection but the volume obtained was small, on fluoro he had an outpouching of the bladder, a diverticuli, or we call it a tic.-that was holding about 65 cc of very funky thick urine. He had the AD until I crede' d his bladder tic and emptied it- ony 65 ccs but it was some thick foul urine. And the AD was gone. The AD did not return when his bladder was filled over 500cc with sterile water.
                          Also there are many causes of high pressures. One cause is the high pressure of the bladder filling and trying to empty- the bladder contracts & tries to empty. At this time, the sphincter should relax and let the bladder empty-but it doesn't so the bladder pressure gets higher & higher trying to empty. & force th esphincter open -sometimes this works. This is called detrusor sphincter dysnergy- DSD.
                          Due to the SCI, the bladder is a little "confused" and tries to empty with low volumes in it or due to irritation, as with a UTI.
                          You can only tell this from Urodyanmic Studies-cystometrogram with EMG and fluor is helpful. And these realy need to be done and are the only way to tell exactly what is going on.
                          But the treatment for high pressures is catheterization when volumes are below 400cc, usualy at least eveyr 4 hours, and Oxybutynin(an dother meds) can help. An indwelling catheter will keep the bladder from fillling but it has its disadvangtages. Botox is another possibility.




                          CWO
                          CWO, I surely didn't mean to disagree with you, sorry. I hope frwheel16 reads this and takes your advice to request urodynamics study. I only pointed out those posts to save him some searching, that other thread is so long.

                          Would be interested what you do with Botox? Thanks.
                          get busy living or get busy dying

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