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Cancer: Prostate board


part II:

What type of care is required for the catheter, bag(s), and patient during the time the catheter is worn?

He came home with 2 cath bags--a big one for most of the time and overnight, and a leg bag, for getting dressed. The bag is supposed to be kept below the bladder. My husband just carried the big one around with him and then hooked it on to whatever was near him when he sat down. At night, he hooked it to the mattress frame.

He only put on the leg bag when he got up to take his daily walk. He ended up having an allergic reaction to the latex leg bands and it raised welts on his thigh. We used a lot of powder after he showered each day.

We were concerned about spilling the urine when changing the bags, so he would shower with the big bag on, then would change it out to the small leg bag, while still in the shower. That way, any spillage could be rinsed away. I always helped with the changing of the small bag back to the big bag, when he came home. He has big, clumsy fingers, and it was easier for me.

I figured out a better way of dealing with the catheter bag than pinning it to my pants and having its weight pulling my pants down. I took two belts and attached them to make a big loop. I looped the catheter bag handle through the belts and wore it like a bandolier. They teased me about my macho looking bandito ammo belt running diagonally across my chest. The belt loop sat on my left shoulder and ran down into my right pants leg where it held the bag. It was way more comfy this and more discreet than pinning it to my pants leg.

You should also have Vaseline and some sterile swabs, like big q-tips for him to apply the Vaseline to the head of the penis and the catheter tube after washing both with soapy water every night. Keeps down the chance of infection and keeps the tube moving smoothly in the top of the penis.

Some people are more comfortable wearing medical-style gloves when working with the cath bags. I never had a problem with spilling or getting it on me.

Silk/nylon/rayon boxer shorts for the period you have the catheter.

For the first several nights, my wife got up once during the night to check on how full the bag was. She would empty it into a bucket and dump and rinse it in the bathroom so I wouldn't have to get out of bed to do it. She was afraid that I would be even less stable on my feet at night and might have a fall or something trying to get to the john.

BED UNDERPADS 30" X 36". DURING THE DAY HE CAN HAVE A LEG BAG FOR HIS CATHETER. AT NIGHT A BAG FOR THE FLOOR, WITH A UNDERPADS 30" X 36" UNDER IT.

I used very loose fitting boxer shorts, so there would be room for pads. I didn't leak badly enough (around the catheter) to use diapers.

Catheter bags – wash/rinse with vinegar. They smell less - just swish it around. Hang to dry.
A five-gallon plastic bucket is very useful at night as a receptacle for the large night bag. The bucket may become your constant companion around the house. Get a square one if you don't already have something else.

Purchase a Velcro catheter strap (available at most medical supply stores about $6.00). The hospital tapes the catheter to your thigh. When he gets home replace the tape with the strap... it’s a lot more comfortable and repositionable. Easily removed during a shower and needless to say will not pull any leg hairs out as tape does,

Your husband will need Bacitracin (topical antibiotic ointment) or similar for twice daily cleaning of the catheter tube where it enters the penis to prevent infections. Basically, as he moves around an inch or so of the plastic tubing slides in and out of the penis, this area and the tip of the penis itself should be washed and the Bacitracin applied a couple of times a day while wearing the catheter.

Use a plastic coat hanger to support the catheter bag when he's sleeping - slip it in between the mattress and box spring. Get a small plastic adhesive hook to install at knee level in the shower to hang the bag on while showering.

You will need something to hang the catheter bag on. I used a chair with a bathrobe belt on it.

Use a plastic coat hanger stuck between the mattress and box spring to hang the bag from or just place it in the bucket on the floor.

You should have a spare night bag and a leg bag for your catheter, 4x4 gauze sponges, adhesive tape, safety pins, adhesive supports for the catheter tube, a small measuring cup, and disposable gloves.

A small shopping bag, for him to hand carry his urine bag, for those times when he wants to walk around the house or hospital without the urine bag strapped to his leg.

Take a plastic clothes hanger and wedge it between the mattress and box spring with only the hook extended. This makes a perfect place to hang the night bag.

I also found the larger bags drained better than the leg bags so I kept the larger one on most of the time at home. You'll probably need some small alcohol pads to clean the connections when you change them.

Don't waste time using the small bag they give you. They fill up too fast because they want you drinking lots of liquids.

I used a small amount of K-Y jelly where the tube entered the penis to keep things sliding.

A soft bathrobe belt makes a shoulder strap to suspend the big bag if you prefer it to the "walking" bag.

At night fasten the bag to the top edge of your mattress.(I just used a big safety pin) This allows the total length of the cath tube for movement, turning over, etc while in bed.

I was able to sleep on my side and/or back with the catheter. He will probably have a clip for it tapped to his thigh. I hope then shave the hair before they put it on, alcohol helps take it off later.

Antibiotic ointment/lubricant (Polysporin, for example) for where catheter exits (some had this supplied by their hospital). Some recommend a water-based lubricant such as KY Jelly but that tends to dry out quickly. Get gauze 4X4 pads to apply ointment. There has been some debate about the best fluid to use. You want something slick, long lasting and certain not to damage the tube. It would be nice if it were also antibacterial. I used Polysporin and Erythromycin with no problem.

Alcohol swabs to clean the catheter at the tip of the penis (single use wipes designed for cleaning the skin before an injection).

I never liked that little leg bag I was given. The only times I used it was to come home from the hospital and to go back and have the catheter removed. The rest of the time, I used the large "night" bag and just carried it around - even on my mile walks.

Velcro Foley straps - the walking bag can slip down your leg and pull on the tube.

Some of the little plastic, stick-on hooks to put in the shower etc., for a place to hang the bag or simply the pail, placed outside the tub.

Once the catheter is out, what types of incontinence undergarments are most comfortable, absorbent and unnoticeable?

I used the Depends disposable underwear for a few weeks.

Start with some fairly thick pads but don't buy very many of them. I found that I graduated to smaller pads quickly and was using only panty liners after about 4 weeks.

One pack of ‘Tena Men's Regular Absorbency Pads’ are fine to begin. If you can't find the men's, the unisex work fine (or even sanitary pads in a pinch). You may not even need them – he was pretty much dry when the catheter came out. These are expensive - don't buy what you may not need. You can always buy more if he needs them.

I had no leaking. I would have small discharges during the day so wore a Depends for Men pad that was adequate to get me through the day and a clean one at night. Later, a much smaller pad and about 5 - 6 weeks out - nothing. Occasional small discharges still happen but not enough to count.

As for incontinence stuff after the catheter is removed, I always used women's pads. They are cheaper than men's and worked just as well. My prostate cancer urologist recommended using a jock strap. I was told to stick the pad to the inside of the jock and lay my penis up against my belly. The tightness of the jock puts pressure on the underside of the penis where the urethra is. It provides a bit of mechanical advantage while trying to regain control.

After the catheter comes out I used the Depends Guards for men, also a smaller pad from "Serenity" I think.

A few woman's (not a few women's- get them from one woman) menstrual pads - don't be shy, the big ones, they're smaller, cheaper than incontinence pads and can be added to the diaper and changed more often.

We knew that he would need to wear a pad to the doctor's office, when the cath was removed. But, when he very first strained with a bowel movement, there was some leakage around the catheter. So I had to run to the store right then, to get pads.

When he got the cath out, he was worried about leaking during his sleep, so I put a rubberized sheet under his sheet on his side of the bed. But it was evident after 2 nights he was not going to need it.

There is a shelf full. I used ‘Tena Serenity for Men.’

After catheter removal you may want to consider a waterproof mattress pad - he had one "accident" at night but it was minor.

After the catheter was removed, (after about 10 days) I was continent enough to not leak while sleeping and during the daytime, I replaced the pads with 3-4 Bounty paper towels, folded into 1/4's that were held in place with my shorts, and replaced them as needed. After a couple of weeks, I only needed to replace them a couple times a day. After about 6 weeks, I was totally dry, except for times of stress, like coughing, or sometimes just standing up after sitting for a while.

I used the Serenity pads. They were triangular in shape and fit in my underwear. I didn't have much incontinence problem even in the first few days. I was changing the pads a few times a day in the first week because I am fussy about hygiene issues. I preferred underwear that gave me a narrow waist band that wasn't tight on my incision.

I bought diapers for the first night’s use. They gave me solace, but made me crazy. They were too hot and awful itchy. The diaper thing lasted one day. After that, ‘Poise’ pads. Warning - cheap ones leak.
I worked at the office after cath out – I used TIGHT jockey shorts with a ‘Poise’ pad and carried an extra in my back pocket and a 3rd in my front pocket. Then, I doubled the underwear – I wore a second pair of tight briefs over the first. After a while I went to one pair of bvd's and a ‘Poise’ pad. The leaky ones with the loose bvd's would leak down the leg.
You may need something to cover the bed. I got one from the hospital in case of leakage after catheter comes out.

A plastic sheet to go under the bed sheets and protect the mattress once the catheter comes out. A large plastic garbage bag might work in a pinch.

What items do you feel it is important to have on hand for recovery once you arrive at home?

When you arrive home from the prostate cancer surgery, it helps to have the room ready. You will want a table or stand of some sort within reach of the bed to put water, food, etc. on.

Having a TV would be nice to help pass the time during the first few days when you don't really want to get out of bed.

Have lots of bland and easy to fix foods ready. I ate a lot of soup. Spicy is not good for the first few days.

If you have allergies, you want to avoid anything that will make you sneeze. A sneeze is really going to hurt for the first month.

You should start on a stool softener as soon as you start solid food. Don't wait until you get constipated. It will really hurt.

You may have seepage at the wound site - you'll need some sterile absorbent dressings and tape. This is normal and doesn't last.

Most of the items needed were provided by the hospital. You may want to get the medication before hand than waiting to be discharged especially if you have your own pharmacy.

I had bought a small table to put beside his side of the bed--to hold his medication, water and meals. I think he only had meals in bed 1-1 1/2 days. But he did continue to keep the meds and water bedside.

Foods for the first few days should be soft and easily digestible - this isn't the time for gas or constipation problems. I stocked up on soups, juice, some canned fruit, and oatmeal. Limit dry stuff like bread and nuts. Puddings and Jell-o are good treats. Drink lots of water.

I had two pairs of the support stocking so I could wash out a pair each night and put on a fresh pair while they dried. That felt good to change them nightly.

I used a little Neosporin to rub on any redness around the incision.

CELL PHONE IF YOU ARE OUT, BOTH OF YOU.

Ointment and the plastic bucket for hanging the bag

"Invalid" cushion (looks like an inner tube)

A pair of slippers or sandals or loafers

Over-the-counter stool softener

Another thing I was told by my doctor, and it worked great for me, was to take a spoonful of mineral oil daily for 30 days or so after the surgery to keep the stool soft. It is not a good thing to strain during a bowel movement after any abdomen surgery.

HAVE A FEW BOTTLES OF WATER HANDY. HE NEEDS TO DRINK LOTS OF WATER.

I had lots of good books to read and lots of quiet time to myself.

I had easy food to make for lunch. We only had small containers of milk. I couldn't lift a full gallon of

milk for about 5 weeks.