How JustAnswer Works:

  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.

Ask Dr. R. Bora Your Own Question

Dr. R. Bora
Dr. R. Bora, Doctor
Category: Health
Satisfied Customers: 5227
Experience:  14 years experience in the emergency room.
Type Your Health Question Here...
Dr. R. Bora is online now
A new question is answered every 9 seconds

My 89 y r. old Mother lives with my Twin and I, we are both

Resolved Question:

My 89 y r. old Mother lives with my Twin and I, we are both R.N.'s She has had a foley catheter for 1 yr. 2 months. Changed q6 weeks with HHNurse who comes only for change and lab work ...she is alert, has CHF, COPD, Diabetes and Kidney failure. She has a 16 foley cath 30 cc bag....We start getting leakage after 2 weeks of foley cath change. She gets much sediment, we irrigate as needed, but seems to be necessary daily after the 2 weaks. Pressure from b.m. makes it worse. What can be causing this...Spasms intermittedly, but leakage starts after 2 weeks in, Should we request Ditropan? She is stable with her meds....But this is getting frustrating...we change bags weekly due to sediment strands, etc. Any suggestions most helpful. thank you
Submitted: 1 year ago.
Category: Health
Expert:  Dr. R. Bora replied 1 year ago.
Hello and welcome, I am happy to help you today.

Does she leak urine by the catheter sides?

Is the urine sediment colorless?

Have you done a urine culture?
Customer: replied 1 year ago.


Coming from the Urethra, insertion site. Again doesn't start til about 2 weeks after it has been changed


 


she has had sediment on and off since insertion. It is thick, stringy, which makes us needing to irrigate, thinking this is causing blockage. Urine odor strong, When she was running low grade fever in past did UA, culture and round of antibiotics. But fever now, so not done. Doctor is reluctant to order antibiotics due to "resistance", developing due to long term. We can request tho...


our biggest concern is the leakage after 2 weeks in, and seems to have more more sediment causing us to irrigate. The bags have to be changed weekly...

Expert:  Dr. R. Bora replied 1 year ago.
Alright. The urine leakage could be due to overactive urinary bladder, detrusor overactivity or there could be chronic cystitis. So, you should talk to the urologist and get a "urodynamic study" to know the exact reason for the urine leakage. This will tell you if the bladder is overactive or there is overactive sphincters.

It is also important to exclude badder cancer which can rarely be seen with chronic catheterization. Get an ultrasound if the KUB and a cystoscopy of the urinary bladder done.
The urine sediment and odor is very likely due to infection of the kidneys or the urinary bladder. It can also be due to albuminuria due to kidney failure itself.

So, I believe she needs a urine analysis and culture asap.



I hope my answer has helped you.



Please remember to choose accept or to rate me excellent service ( 5 or 4 positive rating)to give credit for my answer and time.Bonuses are warmly appreciated.
Customer: replied 1 year ago.


We cannot take her in for any studies. She is basically Palliative Care so work directly with the Doctor. No need to do ultrasound or KUB, Yes her albumin is high.....we just need some tips on palliative care, control of the leakage? She can certainly have chronic cystitis we have given her azogantrisin otc, would Diprovan be helpful?

Expert:  Dr. R. Bora replied 1 year ago.
I believe the ditropan would be helpful and will take care of the leakage too. Secondly, the catheter could also get encrusted with the sediment which may be causing the leakage. So, irrigating the catheter is of utmost importance.



I hope my answer has helped you.



Please remember to choose accept or to rate me excellent service ( 5 or 4 positive rating)to give credit for my answer and time.Bonuses are warmly appreciated.
Dr. R. Bora, Doctor
Category: Health
Satisfied Customers: 5227
Experience: 14 years experience in the emergency room.
Dr. R. Bora and 4 other Health Specialists are ready to help you
Expert:  Nurse Milli, RN replied 1 year ago.

Hi there and thank you for the question. I am also a Registered Nurse and will be happy to help you today. I felt the need to chime in on this one regarding the leakage. 99% of the time, the cause of leakage is due to the extended use of a catheter and the urethra loses tone because of this (and also her age). First intervention would be to remove the foley she has now and reinsert a larger Fr catheter. Also, limit the irrigation as this continues to reintroduce bacteria into her bladder (which is otherwise a sterile organ). Threads, mucus and sediment are most likely due to bacteria that is currently in her bladder (urinary tract) and I would certainly push for antibiotics to clear this up asap. But most of all, increase your foley size and make sure the balloon is properly inflated. The '2 week' point could mean that gravity is letting the saline leak from the balloon over time combined with the foley size being too small. Hold off on requesting the Ditropan until all of the other issues have been resolved (improper cath size and infection). Don't forget to check your balloon prior to insertion (to make sure there are no leaks prior to insertion) and also advance the catheter in enough so that the balloon is not on the sphincter...and make sure the tubing is never kinked and causing it to leak. If all else fails, I would have a Urologist take a look at her anatomy to make sure she doesn't have a fistula so that she is able to urinate from both her vagina and urethra (urine leaks from her urethra into her vagina).

JustAnswer in the News:

 
 
 
Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... Justanswer.com.
JustAnswer.com...has seen a spike since October in legal questions from readers about layoffs, unemployment and severance.
Web sites like justanswer.com/legal
...leave nothing to chance.
Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent.
Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.
 
 
 

What Customers are Saying:

 
 
 
  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
< Last | Next >
  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
  • I thank-you so much! It really helped to have this information and confirmation. We will watch her carefully and get her in for the examination and US right away if things do not improve. God bless you as well! Claudia Albuquerque, NM
  • Outstanding response time less than 6 minutes. Answered the question professionally and with a great deal of compassion. Kevin Beaverton, OR
  • Suggested diagnosis was what I hoped and will take this info to my doctor's appointment next week.
    I feel better already! Thank you.
    Elanor Tracy, CA
  • Thank you to the Physician who answered my question today. The answer was far more informative than what I got from the Physicians I saw in person for my problem. Julie Lockesburg, AR
  • You have been more help than you know. I seriously don't know what my sisters situation would be today if you had not gone above and beyond just answering my questions. John and Stefanie Tucson, AZ
  • I have been dealing with an extremely serious health crisis for over three years, and one your physicians asked me more questions, gave me more answers and encouragement than a dozen different doctors who have been treating me!! Janet V Phoenix, AZ
 
 
 

Meet The Experts:

 
 
 
  • Nurse Milli, RN

    Nurse (RN)

    Satisfied Customers:

    4043
    20 years experience in many areas of Nursing. Both Hospital and Private Practice experience.
< Last | Next >
  • http://ww2.justanswer.com/uploads/NU/nursescare4u/2013-3-31_03429_JApic.64x64.jpg Nurse Milli, RN's Avatar

    Nurse Milli, RN

    Nurse (RN)

    Satisfied Customers:

    4043
    20 years experience in many areas of Nursing. Both Hospital and Private Practice experience.
  • http://ww2.justanswer.com/uploads/agketch/2008-7-14_184046_drketchresized.jpg Dr. Ketch's Avatar

    Dr. Ketch

    Doctor

    Satisfied Customers:

    102
    Medical Degree, Former Assistant Professor at School of Medicine at Yale University
  • http://ww2.justanswer.com/uploads/FA/FamilyPhysician/2013-8-31_191624_JA550x500Photo.64x64.jpg Family Physician's Avatar

    Family Physician

    Doctor (MD)

    Satisfied Customers:

    5622
    Emergency Medicine and Family Practice for over 26 years
  • http://ww2.justanswer.com/uploads/drphophalia/2007-08-23_095626_dr._arun_phophalia.jpg Dr. Arun Phophalia's Avatar

    Dr. Arun Phophalia

    Doctor (MD)

    Satisfied Customers:

    17025
    MBBS, MS (General Surgery), Fellowship in Sports Medicine
  • http://ww2.justanswer.com/uploads/VA/VANP/2012-6-6_235535_Skye2.64x64.jpg A. Schuyler, NP's Avatar

    A. Schuyler, NP

    Nurse Practitioner

    Satisfied Customers:

    12170
    Board Certified NP, MS, RN. Private practice & hospitalist
  • http://ww2.justanswer.com/uploads/TA/tazechip/2012-6-7_135230_drpic.64x64.png Dr. Chip's Avatar

    Dr. Chip

    Doctor (MD)

    Satisfied Customers:

    10029
    Over 20 yrs of Family Practice
  • http://ww2.justanswer.com/uploads/neurosurg/2009-10-06_120923_profile.jpg Dr. Mark's Avatar

    Dr. Mark

    Doctor (MD)

    Satisfied Customers:

    6234
    U.S. Physician/Surgeon in Neurosurgery