Living with an Indwelling Catheter: Lifestyle Adaptations and Self-Care

There are many conditions that can render your bladder unable to empty itself, making catheterization a necessity. But even though it’s a necessity, we do understand if you feel upset, stressed, or even hopeless.

“It practically felt like a death sentence to me,” shares Joel Thomas, recalling his first catheterization experience.

Joel Thomas, aged 43, was in a terrible road accident in 2011, and has required a catheter ever since. However, after living with an indwelling urine catheter for over 12 years, he began to appreciate the benefits it brings.

“To be honest, having this plastic thing hanging down is still very ugly. But after being so near death, a catheter is a very small price to pay. Once you’ve learnt all the tricks to the catheters, it doesn’t really affect your previous lifestyle or anything. And I’m still here, living – and this catheter is helping me live – and that’s the main thing to me.”

Let’s explore various aspects of life with an indwelling catheter, accompanied by real-life testimonies from many individuals, such as Joel. It’s not all bleak and hopeless with catheters. With the proper understanding of the device, indwelling catheter care, and hygiene, you can undoubtedly return to your new normal life, just like thousands of others who live a happy and fulfilling life with indwelling catheters.

Understanding Indwelling Catheters

An indwelling catheter, also known as a Foley catheter, is a thin flexible tube inserted through the urethra (the organ that carries urine out of the body) and into the bladder (the hollow organ that stores urine) to help drain urine because the bladder can’t do it on its own.

Once inside the bladder, these catheters have a balloon at the tip that is inflated with sterile water to keep them in place. Then, a drainage bag is connected with a valve in the catheter to collect and store urine until it can be emptied.

Catheter Care and Hygiene

Since a catheter goes from the outside world into your body, it’s important to maintain a good standard of hygiene when dealing with catheters.

“One thing my doctor has nailed into my head is that there’s always a risk of infections when it comes to catheters. But she also nailed into my head that following the basic catheter maintenance guidelines can decrease your risk of infections greatly.” shares Binduja Santosh, a homemaker, who has been using indwelling catheters for 9 years.

Here’s a step-by-step guide to cleaning an indwelling catheter:

1. Begin by washing your hands with soap and warm water.
2. Hold the visible part of the catheter where it enters your body to avoid tugging or pulling.
3. With your other hand, use a washcloth dipped in soapy water to clean the catheter. Start from where it enters your body and wipe down toward the drainage bag (away from your body). Avoid wiping in the opposite direction to prevent any bacteria from entering your body.
4. When cleaning around the catheter entry point, men should start from the top of the penis and wipe backward, ensuring cleanliness underneath the foreskin. Likewise, women should also start at the catheter entry point and wipe backward.
5. Rinse off any soap and pat the catheter and surrounding area dry with a clean towel.
6. Finally, put the towel and washcloth in the laundry, and wash your hands again.

Avoid using perfume, talcum powder, creams, lotions, or scented soaps when cleaning the catheter or the surrounding area.

Changing the Catheter Drainage Bag

Taking care of the drainage bags is as important as caring for the indwelling urine catheter itself. Here's a step-by-step guide on changing your catheter drainage bag:

1. Begin by washing your hands thoroughly with soap and warm water.
2. Empty your catheter drainage bag into the toilet.
3. Pinch the catheter tube close with your finger and detach the drainage bag.
4. Wipe the end of the catheter and the tip of the new drainage bag with an antiseptic disinfectant.
5. Connect the new bag and release the pinch.
6. Ensure there are no bends or kinks in the catheter tube and wash your hands again.

These steps are applicable to both types of catheter bags: the regular (large bag) drainage bag and the small leg bag.

Cleaning the Catheter Drainage Bag

Now, for cleaning your used drainage bag, follow these steps:

1. Begin by washing your hands thoroughly with soap and warm water.
2. Empty your catheter drainage bag into the toilet.
3. Pinch the catheter tube close with your finger and detach the drainage bag.
4. Wipe the end of the catheter and the tip of the new drainage bag with an antiseptic disinfectant.
5. Connect the new bag and release the pinch.
6. Ensure there are no bends or kinks in the catheter tube and wash your hands again.

Preventing Infections and Complications

You may already be aware that catheter-related infections are quite common. However, there are things you can do to minimize these risks. First and foremost, it's essential to keep yourself well-hydrated. It might seem like we’re asking for a lot; we might even come across as ignorant or senseless to some. But we understand.

“The design of a catheter… it’s so from the stone age, man! Having a bag of urine strapped to your leg is really not a pleasant idea. And I have to admit I’m very self-conscious when I’m out. In my home, I drink plenty and make sure I keep my bladder flushed. When I go out, I tend to not drink very much, I don’t want people noticing my leg bag bulge under my pants. I end up getting infections as a result, but I DO NOT want people noticing my leg bag, not at any cost!” confesses Selvan Chellappa, an ex-serviceman aged 69 who has been on catheters for 4 years.

We understand that many of you may share this sentiment. But we need you to understand that an indwelling catheter is held in place by a balloon, and this balloon prevents the bladder from emptying completely. As a result, there will always be residual urine in the bladder, which can easily become infected by bacteria. The only way to prevent bacterial growth is by frequently flushing out the bladder, and to do that, you need to ensure you always stay well-hydrated.
Other than that, just maintain hand hygiene when dealing with catheters and follow the instruction to handle the catheter and the drainage bag closely. As a general rule, change your drainage bag once every two weeks, and your indwelling catheter once every two months.

Coping with Emotional and Social Challenges

We'll allow Fatima Sheikh, a 38-year-old teacher and tailor who has been using indwelling catheters for 5 years, to take the lead in this discussion. This part of the blog is about picking yourself up and finding support in your struggles, and hearing from someone who shares your experience can really help a lot:
“I believe indwelling catheters isn’t that big of a deal. It’s only as big a deal as you make it out to be. Just, just don’t let it rule your life.

Now, I can’t speak for everyone. I can empty my drainage bag on my own, and I know many people can’t even do that without the help of a caregiver. Everybody’s struggle is unique.

But, I believe if you’re just going to sit at home and sulk about it all day, without doing anything, it’s going to feel 10 times worse. If you just learn to get on with your life and accept that a catheter is a necessity now, you’ll realize your life isn’t as half as bad as you make it out to be.

And one thing I literally preach to many catheter users like me is the importance of realizing that they can and should seek help when needed. Even after 5 years, I still can’t change my drainage bags alone; my husband has to help me. Barakallahu feek, he’s always there for me. It’s very easy to isolate yourself, but your unique struggle doesn't have to define the rest of your life. Find the strength to carry on with your life! As-salamu alaykum wa rahmatullahi wa barakatuh. (Peace, mercy, and blessings of Allah be upon you.)”

It's important to remember that there are many people like Fatima who have picked themselves up and are living fulfilling lives. If they can do it, so can you.

Understanding Potential Catheter Removal

Now depending on your condition, there may come a time when your doctor considers catheter removal. Now during that time, keep these points in mind:

1. A thorough assessment will be done

2. It’s a gradual adjustment

Catheter removal doesn't always mean an immediate return to normal urination. Depending on your condition and how long you've had the catheter, there may be an adjustment period.

In some cases, your doctor might recommend a trial without the catheter. During this trial period, you'll be closely monitored for any signs of urinary retention or other issues. It’s very important to communicate any discomfort or difficult you face during this period.

3. There will be follow-up care

After catheter removal, your healthcare journey isn't over. Your doctor will schedule regular follow-up appointments to monitor your progress. In some cases, medications may be prescribed to manage underlying conditions that contributed to the need for a catheter.
 
We’ve finally reached the end of the blog. Living with an indwelling urine catheter requires some adjustments, but with the right knowledge and self-care practices, you can maintain a good quality of life. Remember to prioritize hygiene, stay vigilant for signs of infection, and seek emotional support when needed. And most importantly, keep a positive outlook towards life. See you in another blog.

FAQs:

How does one prepare for the placement of an indwelling catheter?

Preparing for the indwelling catheter insertion typically involves the following steps:

• Your healthcare provider will assess your medical condition and determine if an indwelling catheter is necessary.
• You'll be informed about the procedure and asked to provide consent. You must clear all your doubts and concerns in this stage.
• During catheter insertion, you will be asked to shower or clean the genital area before the procedure to reduce the risk of infection.
• You'll be positioned comfortably on an examination table or bed with your legs apart for the catheter insertion.
• In some cases, a local anaesthetic gel may be applied to numb the urethral area.

Then the healthcare provider will insert the catheter into the bladder.

How can one ensure comfort and mobility while using an indwelling catheter?

To ensure comfort and mobility with an indwelling catheter:

• Ensure the catheter is secured properly to prevent tugging or pulling.
• Wear loose-fitting clothing that won't put pressure on the catheter or catheter tubes.
• Avoid prolonged sitting or lying in the same position. Change your position regularly to prevent discomfort and pressure sores.
• Stay well hydrated to prevent catheter-related discomfort and reduce the risk of urinary tract infections.

Can individuals with an indwelling catheter engage in regular physical activities and outings?

Yes, it’s certainly possible! Just be sure to consult with your doctor before engaging in strenuous physical activities to ensure it's safe for your specific condition. If you’ll be away from home for a while, plan for urinary catheter care and bring extra supplies.

Are there specific clothing adaptations or considerations for individuals with an indwelling catheter?

While clothing choices largely depend on personal preferences, here are some considerations:

• Opt for loose fitting clothing with easy access to the catheter and drainage bag. This might include pants with side zippers or adaptive clothing designed for individuals with catheters.
• Choose soft, breathable fabrics to reduce irritation and enhance comfort.
• Ensure that clothing doesn't put pressure on the catheter or tubing, which could cause discomfort or dislodgment.

Can living with an indwelling catheter affect one's emotional well-being, and are there coping strategies for this?

Yes, and here are some potential coping strategies:

• Accept that your feelings are valid responses to a challenging situation.
• Talk to friends, family, or a therapist about your feelings.
• Consider joining support groups or online communities where you can connect with others facing similar challenges.
• Engage in activities and hobbies you enjoy to boost your mood.