Prep for bladder instill therapy

[Braedley]

I was doing my instills at a clinic an hour away, and was fortunate to be able to get them transferred to a local one last week - The first two were done at the long distance clinic, and they were amazing; I had ABSOLUTELY no pain, discomfort, nothing from the entire process. The third one was done at this local clinic and they do things a little differently - They get you to cleanse yourself and asked me to use antibacterial foaming hand soap (that all hospitals supply in washrooms), which of course irritated my 'area'. Then I had an application of iodine to the area prior to catheterization (and the cath insertion and removal was not nearly as smooth/painless as the prior nurse was able to do).
I ended up having very uncomfortable uretheral area that entire day/evening, and have been itching like a yeast infection since that one.
Is it possible that iodine is too irritating for me to use, given how I've been feeling since, OR could it be a combination of the irritants used?
What is protocol for some of your experiences, what is used, etc?
I definitely can't deal with this discomfort, when I previously was feeling so good before/during/after my first two sessions with the other nurse

[ltapilot]

Re: Prep for bladder instill therapy

Washing with antibacterial hand soap seems odd, and likely to irritate the urethral opening. Perhaps next time you can politely decline, it just use plain water and fib about it.

The Betadine solutions that I've had used does not irritate me. My doctor simple swabs the area three times with Betadine, squirts lidocaine gel in, gives it a couple of minutes to work, then puts in the catheter.

Some nurses are better than others at placing catheters. Any chance you can start self cathing? You know best what hurts you and what doesn't.

[ICNDonna]

Re: Prep for bladder instill therapy

I suggest you contact the hour away clinic and ask them about the prep --- then talk with the local folks about doing it the same. It could be that you have a problem with iodine --- you could do a skin test to see if you're allergic to that. You can do the test by putting a little bit of iodine on a spot on your upper arm (or most any place easy to reach on your body), then put a small piece of Saran wrap over it and taping it down. If the spot itches or turns red, that's a pretty strong signal that you shouldn't use it.

Donna

[Braedley]

Re: Prep for bladder instill therapy

Apparently she said I misunderstood her, she didn't want me to use the soap, just water (although when I asked, that is what she said!). I have used iodine in the past for both my c-sections, and no problems that I can remember, but the genital area is much different tissue, and SO sensitive, I think that's the difference, so she used another type of 'wash' yesterday and it is prone to stinging, BUT it's short lived and I was over it within a few hours, VS days of itching and burning with the iodine.
She was better cathing me the last two times as well, which helps - they don't use lidocaine gel or anything here, but they do use a VERY small catheter, and it's minimally intrusive for me, I'll take it.

[L. Thomas]

Re: Prep for bladder instill therapy

I have a link in my signature that explains how I do instillations. Maybe it will give you some ideas that you can try.

[Braedley]

Re: Prep for bladder instill therapy

Thank you We are not allowed to do at home instills here, they're administered by a nurse or uro/gyn only. Our nurses aren't even allowed to use the heparin/lidocaine/sodium bicarb cocktail, just the heparin saline one, because of regulations. It's very different in Canada

[L. Thomas]

Re: Prep for bladder instill therapy

Thank you We are not allowed to do at home instills here, they're administered by a nurse or uro/gyn only. Our nurses aren't even allowed to use the heparin/lidocaine/sodium bicarb cocktail, just the heparin saline one, because of regulations. It's very different in Canada

There are many MD's in the USA that will not do the rescue installation. Dr.Dell will do the instills in his office or will teach you how to do the instills at home. When I started treatment with rescue instillations 12 years ago no MD in my home town would do them even in their office. Dr.Dell's office is 100 miles from where I live. I am so happy he taught me how to instills. It was just the right thing for me.

Dr. Dell also uses oral Elmiron for IC treatment. I am not sure if you have talked with your MD about Elmiron. It is FDA approved in the US. Since the IC is so well controlled for me with instills I don't use Elmiron. The lidocaine in the instill more or less numbs the bladder lining for a short time. I don't think it would be necessary to have in the instill but it does calm the bladder. Dr. Dell experimented with the instills and found the sodium bicarbonate did not make the treatment more effective so he stopped adding it to the instill. During a heparin shortage several years ago. Dr. Dell substituted Elmiron for heparin in the instill. You had to open the capsule and add it to the instill. It was very effective for many. The heparin is the ingredient in the instill that helps the bladder lining.