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My son has a suprapubic catheter - does anyone have any tips?(6 Posts)
My son is three and since birth has has been diagnosed with grade 5 hydrophonosis and reflux. In October last year he began having more frequent urine infections and then began withholding urine. Until march he was in and out of hospital for antibiotics and spent periods from one week to one month with an in dwelling urethral catheter, but kept being discharged as one of those things and it won't happen again. In April he was readmitted with over a litre of urine withheld.
Then we finally got to see a urology consultant who put in the suprapubic cath. He has had an MRI to rule out spina bifida, and numerous ultrasound scans - but still no diagnosis other than "we will wait and see for a few years"
I am finding this approach hard to accept, things seem easier when you know the reasons why.
He is currently on clamp and release for three hourly periods during the day, and free flows at night.
The insertion site is constantly red and weepy and is painful for him. He has had many occurances of infection at the site because it doesn't seem to be healing. Also at three I can't take the hospitals advice of make him take it easy.
I feel quite alone in dealing with this, I've not met another child with a permanent cath bag, and the hospital and community nurse seem clueless. Everytime he has so much as a sniffle we get sent to a&e because the gp doesn't know how to deal with his issues - which again seems crazy.
After all this waffle I suppose I am just wanting to connect with someone who understands what is going on and might be able to give me some ideas on the best way to manage it instead of a shrug and advice that is definitely not geared towards an active three year old
I'm a practice nurse, used to be a district nurse and see lots of S/P catheters. Unfortunately it is a general rule that most people do get quite sore weepy sites as the body doesn't like the tube being there and it obviously irritates the skin.
Has he ever had a little foam dressing put on? With a cut in it so it sits nicely around the tube .. Helps to stop it rubbing and anchors it so it doesn't move so much.
If the site is over granulating, so if there's a raised red area of tissue we often use silver nitrate to cauterise it which also helps stop it rubbing and stops the site tissue growing too much which can be uncomfortable
This might not have helped at all and you've probably already been told it by the community nurses but thought I'd try!
Your community team need to liaise with paeds to have a better system in place for any complications, such as fast track to the ward where his team can review him. A and E just isn't the place, ask at your next opd if something can be arranged.
Agree with pp the foam pads prevent rubbing, the catheter should be looped and taped to prevent any traction and if he is constantly sore make sure you are using a barrier film like cavilon or similar to protect the skin.
If the community team are clueless they need to look at getting someone trained up to assist, it's exasperating when there is no provision. We have a family member with very specialised needs and it is an ongoing nightmare so to you.
Ask your community nurses to try a statlock, a small securement device that sticks, a bit like a plaster, close to the insertion site & secures the catheter, which may reduce some of the movement & irritation.
Thanks for all the tips, our Internet was off for a few days so I'm late checking back in.
He has had the silver nitrate a few times, some applications work better than others. Last week's attempt has made no difference but I will ask now about the foam pads. His tube is looped I think I place it above the belly button, tape and then tape again on his groin and thigh.
I am going to suggest to the community nurses that they ask for more training with the hospital. Now I know that's an option and not just being cheeky, it's hard when they are asking me to take the lead in his care and I am Internet trained lol.
I will also ask if he can be admitted straight to the ward with any problems. I've tried phoning ahead and saying we are on our way and can a surgeon be called, as now a&e Dr's won't look at him either. But unless the surgeon whose taken him on as a "pet" case is working we tend to get left in the waiting room for hours before admission.
Thank you all so much for replying. I hate to ask as I know every case is different but what are the reasons behind needing a supra public catheter long term. Everything I have read is due to spinal abnormalities or dexterity problems which he doesn't have
Thank for the info on the statlock. Just looked it up and it seems ideal. Are the zofft wipes the type required to remove it?
We have finally gotten a prescription for meditate which I am hoping will be less harsh on his skin than the plaster type tape. He is also very afraid of changing the tape so I am hoping this will be a better option.
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