Peristeen Anal Irrigation System

[metronycguy]

how does the peristeen compare to the PIE system ? has anything new come along

[SCI-Nurse]

Peristeen is more like a traditional enema. It does not require a big machine to administer, nor is the water "pulsed", and you must use it on a toilet so that the stool and water evacuates into the toilet. The PIEE evacuates through the catheter into a bag you have to empty, and has to be administered in bed, and by an attendant. The Peristeen can be self administered for those with sufficient hand function. Disposable parts for the PIEE run $40 or so per use, while Peristeen is less expensive, and many people reused the speculum (which is supposed to be disposable) very successfully.

(KLD)

[forestranger52]

I contacted the Spinal Cord Clinic at VAMC Pittsburgh, which is located at the H.J. Heinz Campus in Aspinwall PA. I requested the director Dr. Murty, to see if she could possibly write a prescription for the Peristeen System. For 10 years my experienced caregivers trained the new workers how to do the digital stimulation method and it worked almost perfectly, until the state changed the regulations which in August of 2014, required that dig-stim be performed by skilled nursing only.

Although I gave all of the 14 different nurses who were assigned to help me The PVA Bowel Management Booklet to read and showed them the VA produced/copy protected Accidents Stink VHS Video, not a single one was able to open the internal anal sphincter. This has resulted in 3 years of incomplete bowel movements, which has me in a constant state of maximum inflation that can only be resolved by drinking a couple of bottles of Magnesium Citrate about every 6 weeks or so. And probably left me with a Megacolon. I've also lost 40 pounds, since I can only eat once a day because I don't want even more BM left behind the internal sphincter, which quickly hardens into golf size balls. Even with taking stool softeners, lactulose every day and milk of magnesia 3 times per week.

Dr. Murty in turn, contacted the Regional Spinal Cord Clinic at the Cleveland VA Medical Center, who told her they have no clue what a Peristeen system even was. No surprise here.
So I recommended that she possibly contact our esteemed, Hall of Famer Ms. Kathleen Dunn at the San Diego VA but of course Dr. Murty said, ''oh I couldn't do that.''

So I'm again left with a failed bowel program and potentially a megacolin, when I've been begging the VA for help for over 3 years. I should at the least, be permitted to have my nurses trained to use the Peristeen. You would think they'd be at least a little concerned, when I explain that almost every evening when I am put in bed, I'm dysreflexic for about one half hour when I attempt to lower my head and the same problem in the morning, for a shorter period. No luck there either.

[gjnl]

I contacted the Spinal Cord Clinic at VAMC Pittsburgh, which is located at the H.J. Heinz Campus in Aspinwall PA. I requested the director Dr. Murty, to see if she could possibly write a prescription for the Peristeen System. For 10 years my experienced caregivers trained the new workers how to do the digital stimulation method and it worked almost perfectly, until the state changed the regulations which in August of 2014, required that dig-stim be performed by skilled nursing only.

Although I gave all of the 14 different nurses who were assigned to help me The PVA Bowel Management Booklet to read and showed them the VA produced/copy protected Accidents Stink VHS Video, not a single one was able to open the internal anal sphincter. This has resulted in 3 years of incomplete bowel movements, which has me in a constant state of maximum inflation that can only be resolved by drinking a couple of bottles of Magnesium Citrate about every 6 weeks or so. And probably left me with a Megacolon. I've also lost 40 pounds, since I can only eat once a day because I don't want even more BM left behind the internal sphincter, which quickly hardens into golf size balls. Even with taking stool softeners, lactulose every day and milk of magnesia 3 times per week.

Dr. Murty in turn, contacted the Regional Spinal Cord Clinic at the Cleveland VA Medical Center, who told her they have no clue what a Peristeen system even was. No surprise here.
So I recommended that she possibly contact our esteemed, Hall of Famer Ms. Kathleen Dunn at the San Diego VA but of course Dr. Murty said, ''oh I couldn't do that.''

So I'm again left with a failed bowel program and potentially a megacolin, when I've been begging the VA for help for over 3 years. I should at the least, be permitted to have my nurses trained to use the Peristeen. You would think they'd be at least a little concerned, when I explain that almost every evening when I am put in bed, I'm dysreflexic for about one half hour when I attempt to lower my head and the same problem in the morning, for a shorter period. No luck there either.

It is hardly any easier to get the Peristeen system when you are using traditional insurance. The Peristeen system is a product made and distributed by Coloplast. Before Coloplast will release a unit to a patient, you have to be trained by a Colorplast certified nurse. There are few of these trained individuals around. What's more, Coloplast is not very responsive to patients who are inquiring about the system.

You might try directing your doctor to these sites and/or printing out some articles to give to him/her. Have your doctor contact Coloplast :

Article in New Mobility Magazine: http://www.newmobility.com/2014/04/p...el-management/

Article from National Library of Medicine: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3896552/

Coloplast website information: https://www.coloplast.us/peristeen-a...tem-en-us.aspx

Video about trans anal irrigation: https://vimeo.com/105538505

[Davey]

If you have the funds you could purchase it yourself: https://www.owlmedical.com/products/...rigation-29121, https://www.owlmedical.com/products/...rigation-29122. Around $500 should last you around a year.

[gjnl]

Or you could try this:

Flowmaster. http://www.optimalhealthnetwork.com/...master-3qt.htm

It is working very well for me.

[forestranger52]

I did purchase the Peristeen Sytem but the nurse whom the VA pays to do my bowel program, will not use it untl she receives the training. We did try to use it before I was forced to move but the catheter balloon kept breaking on my caregiver. Glad they designed a new one that hopefully performes much better, if I ever get the chance to use them.

[gjnl]

I did purchase the Peristeen Sytem but the nurse whom the VA pays to do my bowel program, will not use it untl she receives the training. We did try to use it before I was forced to move but the catheter balloon kept breaking on my caregiver. Glad they designed a new one that hopefully performes much better, if I ever get the chance to use them.

What is the new Peristeen catheter design?

There are a few online tutorials about the Peristeen system and the Peristeen system is not really very complicated. Here are some on line video references. They may be repetitive:

https://www.youtube.com/watch?v=l6sWaD6d2Sk

https://www.youtube.com/watch?v=M89WHE3TAZA

https://www.youtube.com/watch?v=qVsMgER-HU0

https://www.youtube.com/watch?v=RPM7Zqc8k08

https://www.youtube.com/watch?v=DiqSHa9AuG8

[forestranger52]

We have once again contacted the regional spinal cord center at the Cleveland VA and they still say that they know nothing about the Peristeen System. And it's been over 2 years that it's been on the VA Contract. Just how many regional SC centers does the VA actually have, 8 or possibly 10? It should not have required this long to make this available to all our Vets.

I also had an appointment with a highly respected Physiatrist regarding my failed bowel program and he also never heard about Peristeen. We are so far behind every other developed country who have almost universally adopted this system, that it's ridiculous.

[SCI-Nurse]

We were working with the company about getting Peristeen available to our SCI Veterans in San Diego (one of 24 VA SCI Centers) when I retired in early 2017. Not sure if they have it now. The company's requirement (from the FDA) to have certified nurse trainers at any facility prescribing this was an issue, as the VA would not support the training costs, and the company would not provide it for free without having a bunch of SCI Veterans available as inpatients during the training period. Sort of a Catch 22.

We were actually referring SCI Veterans to a local private sector clinic which did have such trained staff, using the "Veterans' Choice" program. You might want to look into that. It only requires that a VA provider validate that a procedure (the assessment and training) was not available within the VA facility. Once the Veteran received this at the private sector clinic, and they sent a recommendation back to the VA provider, we were able to order the supplies needed for that Veteran.

(KLD)

[metronycguy]

many years ago one of the guys on here showed me how he had made a home made PIE type device. HE was a engineer and didn't leave anything to chance. I ended up getting a pie machine via my insurance , but I almost killed myself trying to do it to myself. THe home made PIE could work just as well, The builder of the homemade kit even did things the regular pie neglected, such as keep the salinity of the water the same as the bodies to prevent the osmosic of water via the intestines through the potassium levels of the body off. think it was .6% or something. I was able to do the PIE with no training too. Persiteen is simple looking, I do think it would work so much better if the person could lie on their left side though.

[Davey]

The requirement to "have certified nurse trainers" for Peristeen is one of the dumbest things that we have to deal with. Successfully using Peristeen requires a one page instruction manual, not a one-on-one visit with a healthcare professional to watch us poop.

[SCI-Nurse]

The requirement to "have certified nurse trainers" for Peristeen is one of the dumbest things that we have to deal with. Successfully using Peristeen requires a one page instruction manual, not a one-on-one visit with a healthcare professional to watch us poop.

This was not set up by the company. It was a condition of FDA approval for sales & prescriptions in the USA.

(KLD)

[Davey]

This was not set up by the company. It was a condition of FDA approval for sales & prescriptions in the USA.

(KLD)

Yeah, I'm aware of that. Doesn't make the requirement any less onerous. I didn't intend to imply that it was Coloplast. The people at ColoPlast that I've talked too thinks it's a crazy requirement also, but can't really do anything about it.

[forestranger52]

Thanks for the information KLD, I really appreciate your help. The VA actually pays for a skilled nursing company (PA Reg., caregivers previously) to do my bowel program and the LPN they send refuses to use the Peristeen system until she's trained. I purchased the system years ago and recently a bag with a supply of the new catheters. The physiatrist I saw is the top doc at the clinic which deals with spinal cord injuries at The University of Pittsburgh Medical Center (UPMC). They have 6 or 7 hospitals in and close to Pittsburgh and the Doc told me he'd check into the PS months ago but when I called about it last week, there were still no answers.