I had passed a lot of blood during the day Monday but my water was clear in the evening and Tuesday morning. I'd not had much exercise these last two or three weeks so I walked into the village to do a bit of shopping and back again - about a two mile round trip. It was after this that when I opened the "flip flow" valve on the catheter that no real fluid was passed and what did do contained clotty blood. This happened twice. So I changed the "flip flow" valve for a leg bag so that my bladder could drain all the time even if the flow was nearly non existent. Added to this twice urine blood mixture was forced pass the catheter. So I called the urology nurse who advised me to go to see my GP (who would only be able to tell me how full my bladder was) or go to A&E.
So I spent a couple of hours of late afternoon / early evening in A&E. My catheter seemed to be blocked and there was plenty of blood in what had come through earlier. After taking blood samples and doing the usual blood pressure and temperature checks A doctor from the urology department came to see me. Wouldn't you just know it, the catheter bag had filled! We decided that, rather than replace the catheter, the one already in would be flushed. A clot of blood came out on the first flush but nothing more on the next two. All seems to be OK now - no more blood and bag filling nicely. I hope it stays that way.
Many thanks to my mate and his wife from down the road who drove me to and from the hospital and waited around with me whilst I was there.
Still OK today (Wednesday).
I think I know what caused the problem. I had strapped the catheter pipe to my thigh to keep it tidy but I think the walking pushed the pipe in and out a little. Probably just a couple of millimetres but enough to irritate my penis (walking was uncomfortable) and cause the catheter balloon to chaff my bladder. Needless to say the pipe is no longer strapped although it would probably be OK to do so provided that enough flexibility was allowed above it.
23 September, 2009
19 September, 2009
A Disappointment
Yesterday, Friday, I went to the hospital to have the catheter removed. This was done with no problem and I just had to hang around and make sure I could pee before going home. So I was plied with tea and water to encourage the process. The first couple of attempts just produced a dribble with some blood. The next was a bit more encouraging - enough to slosh around in the measuring bottle - but still pretty pathetic. After lunch of a salad sandwich, more tea and water, the next attempts at peeing were more productive and were clear of blood but it was clear that I was taking in more liquid than I was passing out. The nurse said she'd give my bladder a scan after my next attempt to see how much fluid was being retained in my bladder. The scan showed that there was about 300ml still there.
It was decided to give it a bit longer before deciding what to do next. I had another cup of tea and went for a walk out of on hospital entrance around the block and back to the other entrance. The next pee was still less than 100ml.
Decision time. I could go home and hope it improves. The down side to this option was that if it didn't improve and I began to get discomfort due to the build up of urine in my bladder I'd have to go to A&E to get it sorted because the day case ward would be closed. So far there had been no discomfort despite more liquid intake that output. The second choice was intermittent self catheterisation. This would allow me to go home with some catheters and to use one maybe twice a day to stop my bladder getting over full. The third option was a permanent catheter like the one that had been removed that morning although I could have a "flip flow" valve (like a tap) instead of a leg bag.
I was very tempted just to go home and hope for the best but decided to give self catheterisation a try. The nurse explained what was involved gave me a catheter and left me to give it a go. Holding the tube (a normal sized one) in the proper way there was no way I could manage to even get it started. I discussed my failed attempt with the nurse. She told me that it would be all right to hold the tube near to the end to be inserted if that would help. She got me a smaller (narrower) sized catheter and offered to be around whilst I tried to insert it. This time I got it started and it was well in before it hit some sort of obstruction and refused to go further. The same thing had happened last week when two nurses failed to insert a catheter.
Now it was only the third option left. The nurse went off to get a normal catheter which she managed to insert with no trouble. A bag was attached initially so that my bladder could be drained then a "flip flow" valve was put in its place. The nurse had also brought along a bag containing some reusable night bags, a spare "flip flow" valve, a couple of leg bags, and a leg strap to keep the leg bag tube close to my thigh. She also contacted the company that supplies these items. They will contact my GP for a prescription, deliver extra spares on Tuesday and when ever I contact them for more (the one prescription is enough no repeats needed). She also put in a request for an urgent appointment with my Urology Consultant so that something can be done about the problem.
So, rather than being rid of the catheter as I had hoped, I'm lumbered with it indefinitely. There being no point in going along to the hospital each week, having the catheter removed, trying to pee, failing, and going home with another catheter. Especially if the problem has been brought on by various tools and tubes being poked into my bladder and something in the pipes, possibly the prostate, swelling up in protest and restricting the flow. I'm not inclined to allow any further internal investigations though. I'd rather stick to using the catheter for a couple of months whilst any potential inflammation settles down. I don't want any more prodding about causing more inflammation.
A curious thing with the catheter is that even though my bladder is emptied into a bag or via the "flip flow" valve, every now and again the system tries to pee normally and manages to squeeze a small amount of fluid out past the tube. Most of the time it is just a drop or two but occasionally it is enough to be potentially embarrassing. It is easier to manage with the "flip flow" valve because using the valve upon the warning signs usually pre-empts this happening. Even so, I'm using incontinence pads in case it happens whilst I'm out and about just in case.
It was decided to give it a bit longer before deciding what to do next. I had another cup of tea and went for a walk out of on hospital entrance around the block and back to the other entrance. The next pee was still less than 100ml.
Decision time. I could go home and hope it improves. The down side to this option was that if it didn't improve and I began to get discomfort due to the build up of urine in my bladder I'd have to go to A&E to get it sorted because the day case ward would be closed. So far there had been no discomfort despite more liquid intake that output. The second choice was intermittent self catheterisation. This would allow me to go home with some catheters and to use one maybe twice a day to stop my bladder getting over full. The third option was a permanent catheter like the one that had been removed that morning although I could have a "flip flow" valve (like a tap) instead of a leg bag.
I was very tempted just to go home and hope for the best but decided to give self catheterisation a try. The nurse explained what was involved gave me a catheter and left me to give it a go. Holding the tube (a normal sized one) in the proper way there was no way I could manage to even get it started. I discussed my failed attempt with the nurse. She told me that it would be all right to hold the tube near to the end to be inserted if that would help. She got me a smaller (narrower) sized catheter and offered to be around whilst I tried to insert it. This time I got it started and it was well in before it hit some sort of obstruction and refused to go further. The same thing had happened last week when two nurses failed to insert a catheter.
Now it was only the third option left. The nurse went off to get a normal catheter which she managed to insert with no trouble. A bag was attached initially so that my bladder could be drained then a "flip flow" valve was put in its place. The nurse had also brought along a bag containing some reusable night bags, a spare "flip flow" valve, a couple of leg bags, and a leg strap to keep the leg bag tube close to my thigh. She also contacted the company that supplies these items. They will contact my GP for a prescription, deliver extra spares on Tuesday and when ever I contact them for more (the one prescription is enough no repeats needed). She also put in a request for an urgent appointment with my Urology Consultant so that something can be done about the problem.
So, rather than being rid of the catheter as I had hoped, I'm lumbered with it indefinitely. There being no point in going along to the hospital each week, having the catheter removed, trying to pee, failing, and going home with another catheter. Especially if the problem has been brought on by various tools and tubes being poked into my bladder and something in the pipes, possibly the prostate, swelling up in protest and restricting the flow. I'm not inclined to allow any further internal investigations though. I'd rather stick to using the catheter for a couple of months whilst any potential inflammation settles down. I don't want any more prodding about causing more inflammation.
A curious thing with the catheter is that even though my bladder is emptied into a bag or via the "flip flow" valve, every now and again the system tries to pee normally and manages to squeeze a small amount of fluid out past the tube. Most of the time it is just a drop or two but occasionally it is enough to be potentially embarrassing. It is easier to manage with the "flip flow" valve because using the valve upon the warning signs usually pre-empts this happening. Even so, I'm using incontinence pads in case it happens whilst I'm out and about just in case.
11 September, 2009
What a nightmare
It should have been a straightforward procedure - Rigid cystoscopy and bladder biopsy. I understood it was to be done as a day case so didn't take any overnight things to the hospital at the appointed time of noon on Wednesday. The admittance notes had me down for overnight. Anyway I was taken to the ward and an allocated bed. All the admittance procedures went smoothly enough and I changed into a hospital gown.
At about 14:20 I was led downstairs to the surgery reception and fitted out with heart monitor and blood pressure cuff. A few minutes later wheeled into the anaesthesia room where a cannular was inserted into the back of my left hand. Pretty much the next thing I knew I was in the recovery room and ready to be taken back to the ward. The good news is that the surgeon could see nothing amiss in my bladder but took four random biopsies for testing anyway.
I had told the surgeon that I was keen to get back home the same day, and accordingly he had not fitted a catheter so that if I had no trouble peeing I'd be allowed home. Unfortunately I did have trouble peeing. This was almost certainly down to the damage done to the end of my penis by the cystoscope. Apparently I have the tightest entry the surgeon had come across and the skin on the inside of my penis had been torn and probably bruised too. After two or three hours of not being able to pee a catheter was inserted to allow my bladder to drain. So an overnight stay anyway.
The next morning the catheter was removed. I still couldn't pee though. After a couple of hours a short catheter was inserted on the basis that the obstruction to the flow seemed to be in the penis rather than the bladder. This was unsuccessful. So an attempt by a couple of nurses to insert a normal catheter was made - unsuccessfully. So a call was made for one of the doctors to come and do the job. An hour or two later a reminder call was put through. After about seven hours of desperately needing to pee and failing and getting pain in my penis with each attempt I was getting pretty distressed. The nurses, bless them, saw this and, I think made it pretty clear to the doctor that he was needed urgently.
Well, the doctor came, and not without some difficulty, managed to inset a catheter. What a relief - physically and emotionally. The down side was that I'd have to stay another night in the hospital, but all things being well I'd be able to go home the next day with the catheter still in place attached to a bag strapped to my leg.
I had a good night and the catheter worked well and this morning the doctor agreed that I could go home with the catheter fitted and keep it in place for a week. After the week I am to have it removed and to see if I can pee without it. Getting the OK to go and actually getting away are not the same thing. I pointed out that I had an appointment at the health centre this afternoon for my next Prostap injection and I really did not want to miss it. I think this concentrated their minds and by 14:00 the paper work was done, an appointment booked for next Friday to remove the catheter and a supply over overnight bags and a spare day bag provided with instructions on their use.
Matthew, my eldest son, picked me up from the hospital and took me home. He also agreed to drive me down to the health centre for my appointment. Just as we were about to leave I got a call from Smile about suspected fraudulent use of my credit card. We decided to sort that out on our return. I had the Prostap injection but didn't bother with the PSA test - the nurse confirmed my thoughts that all the mucking about around my prostate would produce artificially high readings. I'll get that done in a month or six weeks time.
So for the next week I'll be living with a catheter and bag. I don't think I'll go to the gym next week nor doing any cycling. Walking is OK but a bit strange at the moment. It is good to be home and more or less back to normal though.
A call back to Smile confirmed that someone had been using my card on an on-line betting site. So the card is stopped until they send me a new one. They told me not to worry about the fraudulent transactions (about £700 worth), they will be removed from my account as the fraud department handles the matter. Just an inconvenience but an unwelcome one.
Ain't life fun?
At about 14:20 I was led downstairs to the surgery reception and fitted out with heart monitor and blood pressure cuff. A few minutes later wheeled into the anaesthesia room where a cannular was inserted into the back of my left hand. Pretty much the next thing I knew I was in the recovery room and ready to be taken back to the ward. The good news is that the surgeon could see nothing amiss in my bladder but took four random biopsies for testing anyway.
I had told the surgeon that I was keen to get back home the same day, and accordingly he had not fitted a catheter so that if I had no trouble peeing I'd be allowed home. Unfortunately I did have trouble peeing. This was almost certainly down to the damage done to the end of my penis by the cystoscope. Apparently I have the tightest entry the surgeon had come across and the skin on the inside of my penis had been torn and probably bruised too. After two or three hours of not being able to pee a catheter was inserted to allow my bladder to drain. So an overnight stay anyway.
The next morning the catheter was removed. I still couldn't pee though. After a couple of hours a short catheter was inserted on the basis that the obstruction to the flow seemed to be in the penis rather than the bladder. This was unsuccessful. So an attempt by a couple of nurses to insert a normal catheter was made - unsuccessfully. So a call was made for one of the doctors to come and do the job. An hour or two later a reminder call was put through. After about seven hours of desperately needing to pee and failing and getting pain in my penis with each attempt I was getting pretty distressed. The nurses, bless them, saw this and, I think made it pretty clear to the doctor that he was needed urgently.
Well, the doctor came, and not without some difficulty, managed to inset a catheter. What a relief - physically and emotionally. The down side was that I'd have to stay another night in the hospital, but all things being well I'd be able to go home the next day with the catheter still in place attached to a bag strapped to my leg.
I had a good night and the catheter worked well and this morning the doctor agreed that I could go home with the catheter fitted and keep it in place for a week. After the week I am to have it removed and to see if I can pee without it. Getting the OK to go and actually getting away are not the same thing. I pointed out that I had an appointment at the health centre this afternoon for my next Prostap injection and I really did not want to miss it. I think this concentrated their minds and by 14:00 the paper work was done, an appointment booked for next Friday to remove the catheter and a supply over overnight bags and a spare day bag provided with instructions on their use.
Matthew, my eldest son, picked me up from the hospital and took me home. He also agreed to drive me down to the health centre for my appointment. Just as we were about to leave I got a call from Smile about suspected fraudulent use of my credit card. We decided to sort that out on our return. I had the Prostap injection but didn't bother with the PSA test - the nurse confirmed my thoughts that all the mucking about around my prostate would produce artificially high readings. I'll get that done in a month or six weeks time.
So for the next week I'll be living with a catheter and bag. I don't think I'll go to the gym next week nor doing any cycling. Walking is OK but a bit strange at the moment. It is good to be home and more or less back to normal though.
A call back to Smile confirmed that someone had been using my card on an on-line betting site. So the card is stopped until they send me a new one. They told me not to worry about the fraudulent transactions (about £700 worth), they will be removed from my account as the fraud department handles the matter. Just an inconvenience but an unwelcome one.
Ain't life fun?
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