Pouch Pointers- Tips on how to use catheters 




In the early stages, learning how to catheterize with ease can be quite challenging. It is important to be as relaxed as possible when catheterizing.  Learn how to block out distractions. Take your time.  It is good to focus on some deep breathing before getting started. This process is not something to rush and you don't want to injure the stoma or be unable to fully empty the bladder.  Learn how to accept and love your stoma. I named mine "Rosebud" because she looks like a small bud on a rosebush.  It doesn't matter if you call yours a"Ernie", Suzy, Herman, etc....just pick a name that will help you endear yourself to this new appendage that will  support your new life.

The stoma should always be gently patted clean and lubricant used prior to insertion of the catheter into the stoma. If your bladder is very full, you may not have time for the lube and that is OK.  In that case, you will likely have enough moisture created by the stoma which will allow the catheter to go in. In the beginning, while training the bladder, due to frequent catheterization, the stoma and channel that leads to the pouch may have some swelling. The swelling makes it more difficult to catheterize. This is normal and as time goes on, this problem should go away. On occasion, you may also see some specks of blood in the urine and this too is typical. You may also see small amounts of blood on the stoma or on the dressing you use to cover the stoma.  I use a tiny amount of an antibiotic ointment around the outside of the stoma at times for such irritations and also an anti fungal cream when the skin surrounding the stoma becomes itchy or overly dry.

When you go to catheterize and you don't see the volume expected, change positions, bending slightly forward or sitting down if necessary.  I empty from a standing position and pee similar to how most guys do but some prefer to sit...over time you will discover what works best for you.  Again,  relax and take some deep breaths to help loosen things up. Give yourself some positive self talk.  Before removing the catheter, it is good to slowly pull the catheter out two to three inches and then push it back in slowly to sweep the pouch to draw out any residual urine. Repeat the sweeping motion two or three times. After your abdomen is no longer tender, you will find that pressing gently on various parts of the abdomen will help to locate and release hidden [pockets of urine.  I recommend you always catheterize before you leave to go anywhere for a long walk or travel in a vehicle....and always carry supplies with you.  Most of the silicone supplies listed below are like what you see me using in my video, and if used carefully, can be reused by changing up the gauze pads.  My thanks to my warrior friend, Barry, who provided me with the info. below.  He tells me prices  shown are as available on Amazon as of Feb. 2018.....key words used for search is  "silicone adhesive" to locate hypoallergenic adhesives.  Some of us warriors struggle with skin irritation due to the adhesive found on  ordinary bandages, so you may need the list below.  Often, If you call the medical supply companies you can get a few samples to try out.  Sadly, I have learned that although I could get the best of supplies while I was employed and had good insurance, since going on Medicare, the quality and quantities of supplies provided are reduced so if you are employed at a job that you enjoy had presently have good insurance, you may want to continue working to receive the best benefits...you can expect it to be challenging when working with Medicare and medical insurers and medical supply companies.

 

Stoma Coverings


BRAND                            SIZE                            PRICE                    QUANITY           NOTES_____        
3 M                                   4x4                              $1.39                            60                Light tack

Dealmed                           4x4                                  .40                        25 for $10     (single use only)

McKesson                         3x3                                2.00                            10              Silicone adhesive

Mepilex                             3x3                                3.58                              5               Silicone adhesive

Areza                                4x4                                2.63                            10               Silicone adhesive

Mepilex                             4x4                                4.75                              5               Silicone adhesive

Hollister/Triact                   4x4                                5.12                            10               Silicone adhesive

​Austin Medical Products    3x3(and others)            0.85 - $1.69                50             (single use only)

​(Ampatch stoma bandages

Believe it or not, the sterile water requires a prescription from the doctor but is usually covered by insurance. If not, I understand, warriors sometimes make it themselves using 1 tablespoon saline to 1 quart of water. Boil water, add salt and store in the refrigerator, discarding after 48 hours.  I have even heard of a few who have used distilled water.  I have only used the prescription water myself.  The point is we are trying to thin out the mucus within the pouch so we have a better flow of urine and that makes for a healthier operating system. The more mucus you see, the more irrigating is needed to maintain the flow.  Also, after the sterile water has been opened, I try to use the bottle within the same week.

Finally, it is so important to be relaxed. If things aren’t working for you, change positions, and if still struggling, don’t be afraid to ask God to help. He truly understands our frustration and anxiety. If still no urine, take a break and come back to it in 15 or 20 minutes.