Hello All,
I have had a call from the continence nurse who wants to do a home visit at the end of the month to start me on ISC.
My Neuro has requested it because of the number of times per night I have to get up.
I was wondering if anyone can give me an idea of what to expect from the visit.
Thanks,
MS2017
Hello
What I would expect is first that the nurse would want to check that the reason youâre getting up so frequently is that your bladder is not fully emptying when you wee naturally. They can do this by means of an ultra sound scanner - which comes in a portable form so could be done at your home. What they do is scan your bladder when itâs full and then after youâve been to the loo to see how much residue is left in your bladder. (They may not do this, she (I assume itâs a female, equally Iâm assuming you are!) may just work on the assumption that you are retaining urine.)
Then assuming itâs decided that youâre going ahead with ISC, she will talk you through the process. Essentially what happens when you self catheterise is that you pass a hand held small catheter into your urethra and to the bladder. You can do this either sitting on the loo or directly into a collection bag (through tubing that attaches to the end of the catheter. The process is done in a âcleanâ but not âsterileâ way. The catheters themselves are sterile, and you should wash your hands before starting, but you canât expect to do it in a completely sterile way. You just use a wet wipe to make she the exterior of the urethra is clean and thatâs it.
The nurse will talk about the different makes of catheter and generally will have a stock of samples to show you. The best kind of catheters are those which are made of hydrophilic plastic. This means they become lubricated with a small amount of water (which is contained within the package), and are much more frictionless so easier to slide in. The nurse I saw asked which one I wanted to try. Being a complete novice I just said âanyone will doâ! I would suggest that when you are first learning to do ISC, opting for a catheter which is fairly rigid but also hydrophilic is a good idea. A good make is Coloplasts Speedicath. There are several different variants, you can get one with an attached bag, which is a good idea to start with. They also do a very neat little one called Speedicath Eve (very discreet packaging). But there are many more to choose from.
What I would try to avoid is a catheter thatâs too flexible. If you imagine trying to thread a piece of cooked spaghetti into a straw with a blindfold on and keeping the spaghetti from touching anything but the straw, youâll see why a more rigid catheter is a good idea, especially at first.
Often people learn to do it while looking in a mirror. It definitely helps to have had a look yourself before the nurse comes. We are frequently woefully unfamiliar with our own anatomy âdownstairsâ so to speak. So have a look so you know what the urethra opening looks like and where it is found is helpful.
I started doing ISC sitting on the bed with my legs up and a mirror positioned so I could see what I was doing, and with a connecting tube going to a bag lower down. (At that time I could manage to manoeuvre myself into such a position!) Some people manage to do it on the loo with a mirror right from the start.
The nurse needs to see that you are capable of doing it for yourself so will have to be quite up close and personal. I used to be very reserved and shy about doing things like having someone watch while I tried to poke a tube up my urethra. But pretended I wasnât! These days Iâll show almost anyone anything if they want to see. But then Iâve been doing ISC for about 7 ish years now.
After a few months of doing ISC twice per day, I decided just to try and do it sitting on the loo without being able to see what I was doing. To my great surprise I managed it first time and have done it that way ever since. My bladder is a bit of a drama queen and after Iâd had a huge relapse some years ago, it stopped being able to wee ânormallyâ at all, so I use a catheter every time I go.
This whole process might be done over two or three visits, or just in one go, it depends on how itâs managed in your area.
Once youâve got started with ISC, youâll be set up with a delivery company who will deliver your catheter supplies, usually monthly. It should all run fairly smoothly, if you later want to change to a different type or make of catheter, you can request samples to try out to se which you like best.
Good luck with it, there are lots of us on here who use ISC, so if you have more questions just ask.
Sue
Hello Sue,
Thanks for your very detailed response, very much appreciated.
Just to let you know the nurse is female and I am male but as the significant other said âshe will have seen lots of male anatomy and they are all the same just different sizesâ (can you tell she used to work as a community carer so will have seen quite a lot of anatomy herself) haha.
I have seen the nurses in clinics so have had the scans done. First couple of times there was about 100ml left about 15 mins after a toilet visit but the last time there was around 245ml. They are referring me to urology for possible botox but since the last appointment I saw the Neuro and, because of the times I was getting up at night, she wanted the ISC to start to hopefully help with sleep/fatigue.
When I spoke with the nurse on the phone we arranged for the appointment on a Friday afternoon but she doesnât want me to start until the Sunday incase I end up with an infection so that I can get to my Dr for antibiotics.
Thank you again for all the information.
MS2017
Hi, I have been ISC since June last year, the nurse will talk you through the process. It took time to get use to doing the whole sterile thing and finding the urethra, but laying on the bed propped up helps me, with a mirror. I found it a bit strange for a while but now Iâm ok with it. It does not hurt ( I thought it would). We tried different catheterâs. I like the one with the bag (braun brand) I find very handy and you can monitor how much you are emptying. Ask any questions you may be unsure or nervous about. All the best. Lina
Quick update on my ISC experience.
The continence nurse came round on Friday and was there for about an hour. Quite a lot of questions in both directions and a rough demonstration of how everything should be done.
Significant other was there as well as she may have to help/do the ISC in the future so it was a help for her to know what to do.
Didnât have to have a go whilst the nurse was there but she did say that if I needed she would come back and help.
So last night was the first attempt, the continence nurse didnât want me to start on the Friday incase I got a UTI as the Drs would be closed for the weekend.
Sat on the edge of the bed with a jug to empty into and significant other was there with me for moral support and to help if or when needed (she had to point out where to open the packaging and to hold the jug for me haha).
Everything seemed to go OK on the first attempt, which I was quite surprised about but very pleased, so second go tonight.
Hopefully this will be as successful.
Continence nurse is due to phone me on Wednesday to see how I got on.
MS2017
Hi
Glad it went well. It should all be plain sailing from here.
The key to staying UTI free is keeping all equipment / hands / etc as clean as possible. And donât be worried about the number of catheters you go through, especially in the early days. If you touch the business end, or it touches something it shouldnât (your leg for eg), chuck it in the bin and get another one out.
If you maintain a âcleanâ technique, it should be possible to avoid UTIs. (Itâs a bit different for girls - some idiot designed our bodies very poorly!)
Sue