How to do Self Cath
Why do I write blogs that those outside the world of mesh injuries may find distasteful? The answer is simple. I have been there, felt the fear and shed the tears. I did not know what to do or how I was going to get through it and my Internet search revealed little than was useable. So I had to learn much of it on my own and struggle through feeling quite alone.
When we are around those whom we feel comfortable with, we say sentences that describe what we are feeling and what we need to do. We are human beings who have to take in food for sustenance and whatever our body does not need, we have to expel it. It is a normal part of who we are and yet when it is taken away from us, we are in shock. We don’t know how to handle it and our lives are turned upside down. We no longer say things like “I’ve got to go for a pee” or “I need to go”, instead we are thinking “I wish I could go”. We envy those who do this in a normal manner and when we struggle through it alone, we often feel quite depressed. So that is why I am writing this blog.
During the past three days I have helped two women understand what products they need and how to get through the fear of doing self cath. Regardless of what the world of doctors think, mesh slings cause many, many complications and removing them is major surgery. The hard part is, doctors are often flippant about what is does to us, medically, emotionally and psychologically. We don’t want to go through all this and yet, we have no choice. We would rather be normal and be just like the way we used to be and yet we have to go through so much hell and fear, and have to struggle through all this often on our own. That is the truth about what mesh slings can do to a woman.
I have heard doctors say “Women can do self cath easily. They can just lift up a leg and do it over the toilet and it is so easy. My question to these doctors, is this. “How often have you done self cath yourself? Are you a male saying this and if so, do you understand the real learning curve of doing it? I doubt if any have ever done it in their lives and no male can understand this from a female point of view.
I will say one thing that was good about the female surgeon who first put the sling into me. After a second surgery nine weeks after she put it in me, she finally realized I had serious problems along with infections that would not go away, so she had someone spend time with me to show me how to do self cath and what I needed to do it. She handed me some self caths and other things I needed so I had a starting base. The rest was from my own fearful learning curve and the help of other women who were also doing the same thing.
First let me say to you, the woman reader who has just gone through major surgery and is now wondering how to cope. I completely understand all your fears and I am going to try to help you get through it. This past week I took photos of the things I used so that they could see what they are, not just guess. By writing this blog, it will save me time later and everything will be here for any woman who finds herself put in the same situation. The biggest issue you will face is facing your fear and conquering that fear. It won’t happen in the first day and it will take you perhaps a few weeks to get used to it. But with luck it won’t be forever.
Why do some women need to self cath where as others don’t? It depends on your removal or reconstruction surgery what you may have to go through, but the good news is, most of it is caused by swelling. As you heal, in time you will probably be able to go by yourself again, so don’t give up hope. Do everything you can to help yourself and be independent so that you can continue on with your life.
I have gone through doing this twice since the sling was put into me almost four years ago. The first time was immediately after the sling was put into me and I was quite shocked. I did not expect this to happen and I panicked. I was afraid I would never be able to go on my own again and I did not know where to turn. At that time I did not know other women who had gone through this and I felt so alone. The second time was after the fascia sling was put into me six months after all the mesh was removed. Although I did not expect this to happen, I was much better prepared for it because of my first time. However, once again it was a learning curve because since the first time, my leg injury was far worse and I was quite a bit older.
I can happily report to you that after about four months I never had to do it again, but I did a lot of work to know when I no longer needed to do it. You must be careful and plan to go the distance to get through it and learn how your bladder works.
At first Dr. Kim gave me instructions to do self cath every 2/3 hours during the day and night. I can tell you that was so hard and yet I now know how necessary it was. If we don’t we will retain urine and retention can significantly increase your chances of infection. Infections can get serious in a hurry and infections mean antibiotics. Antibiotics mean yeast infections and an increased risk of becoming used to them and therefore they will not work after a few weeks, plus they too have side effects. So avoiding them if at all possible is the best thing you can do for yourself. Before I left UCLA that last time I saw Dr. Kim and she told me she did not want me taking any antibiotics, unless absolutely necessary. I smiled and told her I have my own way of making sure I wouldn’t need them and told her about marshmallow root. She looked at me and said whatever I needed to do to avoid them was good.
I can truthfully report to you swhat I did was so good that I never had an infection at all during the months I self cathed and not since. So if you want to do the work, you can get through it without antibiotics.
There is something very important. At all costs avoid anything with caffeine. Caffeine will irritate a bladder that is already inflamed and swollen. It doesn’t matter what else you drink, water, juice, cranberry, or green tea, but avoid sodas and coffee. If you don’t you stand a good chance of your bladder becoming so irritated that it will cause you the unbearable pain of bladder spasms. They are so agonizing, that I did everything to calm my bladder and although I enjoy a good cup of coffee, I did not touch any for six months after my last surgery. My main choice of drink even now is light, hot green tea and I enjoy it too. Now here are some tips that could help you through this awful time.
Types of self caths.
There are many out there and your doctor will give you a prescription for the first lot and you can call around to any company on the Internet and ask for free samples. Dr. Kim gave me a prescription when I first needed to do this and in the end, I preferred the ones she gave me, even though I tried others. They are called Magic caths. This is the link. https://www.liberatormedical.com/catheters/lp/catheters-rochester.php?keyword=%2Bmagic%20%2Bcatheter&utm_source=google&utm_medium=CPC&mkwid=saqkBuVsn_dc|pcrid|33338599981&publisher=google&campaign=Urology+-+Urology+Brands&group=Rochester+Catheters+-+Broad&match=b&mm_campaign=&gclid=COme98OnnLwCFYNQ7Aod8mIAfw
I found them very flexible and that made it easier for me to use them. Others look like lipsticks and you can pop them into your purse if you are a working woman. It is all about preference. So call around and get those samples and then choose which you are most comfortable with.
When do you know when you need to do self cath or when you can stop? The first part is easy. Your bladder will be screaming at you with bladder spasms that no one can understand the pain, unless you have been through it. I’ve been there and if you go to the E.R they will put a Foley catheter back in you so that things will settle down. But then you are stuck with a catheter that is painful over a long period and can cause many infections and injury to your bladder during continuous use. So you don’t have a choice but to face learning how to self cath. So how do you learn if you are thousands of miles away from the surgeon who did your surgery? Not simple I know. The first thing you may try is to find a YouTube video to help you understand. Of course this is such an difficult theme, you will find diagrams that look nothing like your body because of course they cannot show this on a human body. These diagrams make it look SO easy. Until you try to do it yourself, while you are shaking with fear of injuring yourself and stiff as a board with that fear. It is easy to say you need to relax, unless you try it yourself.
This is just one video and you will understand what I mean when you watch it. http://www.youtube.com/watch?v=apoS5TE85Ts
So to find out when you need to do self cath is easy. Your bladder will be full and it will let you know. But what about when, how often and when you no longer need to? I was told to keep records of everything I did myself and then what I removed doing self cath. If you are lucky you can find or be given something called a toilet hat. It will have measurements in CC’s and this is what they use at the urologist office. It sits in your toilet and when you go, you can write down time of day or night and what you did. Then if you need to self cath, you will then do that and write down what you removed from yourself. That is how you will define when you can finally stop doing it, but be aware it won’t happen overnight. Without a toilet hat (I did not have one this last time) you can use a plastic jug with CC measurements on it. Hold it underneath you when you try to go and then record what you did if any. Then do self cath.
Your urologist should suggest how often you need to do it at first and then as time goes along you can view the amount you are doing or taking from your body and ask questions then. I am not a doctor, but I have been there and asked. I was told that under 75 cc’s you can stop. Now saying that, I don’t mean you did self cath an hour ago and then did it again. Don’t self cath too often as you may cause infection. Every 2/3 hours at first is enough and as things improve you have to become a judge according to the records you keep. I was told this last time by Dr. Kim to begin doing it every 2/3 hours day and night. This is because my bladder was having major spasms because it no longer knew how to work. It had been stopped from normal activity for several weeks and it was very confused to say the least. So I faced facts and began doing it that often until I was able to do more on my own and lessoned over a long period of how often I had to do it, by viewing my own records and listening to my body. No one can tell you how it will work for you as we are all individuals and our bodies work differently. So begin keeping records and learn how your body works so that you can make changes as needed. This will be another way you will stand a better chance at not getting infections.
Where to do it?
I don’t know any woman who knows this part of her body so well that she can just do it. We know we have two areas, but we don’t normally study them, so the best way to begin is to start out doing it in bed. You will need really good lighting to see. Then you can study yourself and get used to the idea. If you don’t have other injuries, then you can try going over the toilet once you have discovered where to put the cath. It will take time for you to stop worrying and begin relaxing and the latter will help you get through this.
Products you need.
You really need a good mirror with a heavy base that won’t tip over easily if you do this in bed. One woman told me that once she got used to it, she used a hand mirror on top of the toilet and worked out the easiest way for her. I have a leg injury and this was never an option for me, so everyone has to work this out for themselves.
Iodine. When I was first showed how to self cath, I was shown how to clean myself with iodine but because I did not want infections I added another step first. I will give you that info in a moment.
On the way home my daughter stopped at Target and picked mine up. A little will go a long way.
I will explain what else you need, but organization will be the key, plus we are women and doing something like this will help us get through this. We like to do things in a pretty way, even when it is something like this. Also in this basket I have a throw away plastic container with lid and I used it to drain the urine into it and then put the lid on to move it through to my bathroom to measure and put into the toilet.
Other things you need. You need something to put the iodine on your body and it can be cotton balls or I found the best way was disposable make-up pads which I bought at my local dollar store. I have a container in there where I kept them at easy reach free from dust. There is also a bottle of hand sanitizer I used even after washing my hands, before I began to self cath. Lastly I had a pretty container with baby wipes and you can see a nice small trash can with a liner inside. Alos some clean inexpensive towels and a throw away bed liner to avoid any mistake messes until you get you to it.
I did forget one thing. It is a spray called Puricyn that will really help you not get infections when you self cath. Read this blog. http://meshangels.com/2013/06/those-really-difficult-infections
I would first clean myself with a baby wipe and then wipe the area where the cath will go in with iodine, in one swoop. Don’t go back and forth. They will always use iodine at the urologist office or ER before they put the catheter in you and this is to remove and germs that can be pushed inside you urethra. Then I used the Puricin spray which I wrote about on the blog link I gave above, and sprayed the urethra area. You can use this spray many times a day and it will not sting or cause you any issues.
Then I would do the self cath and remove the fluid by watching what I did in the mirror.
Then I would get out of bed and go and measure it in a jug and write down what I had taken. Then flush it in the toilet and wash everything.
I know this seems a lot to do especially when you are very tired at night. But doing this will show you how things progress and will help you make decisions when you need to cut it back. Then you will be so happy you did all this.
During the time I did this and still to this day I do take marshmallow root. http://meshangels.com/2013/05/mesh-my-triple-three
I did write about other things during the time I went through this and some of it may help you. http://meshangels.com/2013/07/understanding-your-bladder-part-one and http://meshangels.com/2013/07/understanding-your-bladder-part-two
Give yourself some time for healing after your surgery and then you may consider adding this. http://meshangels.com/2013/11/surgeries-scar-tissue
I just want you to know that there is always light at the end of the tunnel. One day when all the swelling has healed you can say”I’ve got to go and pee”. That is why doing all this will be worth it.