One of the less talked about risks for folks wearing a long-term catheter is our system leaking all over our (if we’re lucky) house because we either forgot to close off our drainage bag after emptying it, or because hose popped off of either the bag or the catheter outlet.
The main concern, of course, is that we’ve compromised our closed system, allowing more bacteria in. But by far the most immediate emotion you’ll feel is embarrassment. I have now had 3 incidents. Learn from my mistakes!
The leg bag incident
Incident number one happened while my wife and I were at a friend’s house watching a movie. All of a sudden my lower right leg felt cold. The end of the tube that connects to the top of the leg bag had come detached without my knowing. Because fresh pee is warm, it didn’t make any impression on me until it soaked into my jeans and the air made it cold. By that time, there was a sizable puddle on the floor. Probably the best piece of luck I’ve had in the past several weeks was the fact that Bob had hard wood floors. I jumped up and cried “oh my god,” and we all sprang into action. Bob, who was unbelievably understanding, lent me a pair of pants after sending a few towels my wife’s way, all while I was in the bathroom cleaning up.
One change in my behavior that I took away from that incident was NOT to wear jeans, but rather loose-fitting pants with plenty of wiggle room inside. I also now compulsively check the connection by feeling for it several times a day. If you are going to wear jeans, be very aware than the tubing on a Hollister leg bag is made of soft rubber that easily clings to denim and can be pulled around inside the pant leg.
The large drainage bag incidents
When I’m not going out or expecting visitors, I often keep my large bedside drainage bag on instead of changing to a leg bag. It’s a bit more inconvenient, forcing me to wear short pants and carry my bag everywhere. But it does have the advantage of minimizing opening that closed system by eliminating one bag change.
But the process for emptying this bag is a bit different from emptying the leg bag. For one thing, there is no separate cap on the bedside bag like there is on the leg bag. I use a Hollister Urinary Leg Bag which has a flip toggle type valve control for opening and closing the bag. In addition there is a little cap that goes over the outlet. It is really difficult to pull your pants back over the valve control if left in the open position, which means it’s sticking out and away from your leg at a 90-degree angle. So that acts like a built-in reminder to close the bag. Plus, you’ve got this cap in your hand when emptying it, so when you’re done, it’s sort of automatic to put it back on.
However, with the bedside drainage bag ( I use a bag very similar to the Covidien Bedside Bag with anti-reflux valve. See picture to the right), the open/close control is in circular unit at the bottom of the bag. It has a little flat piece of plastic at the top that slides about an inch to right or left (left is closed, right is open) to move the circular valve. I don’t know the stats on this, but I would be willing to wager really large sums of money that people forget to close this valve WAAAY more often than they forget to close a leg bag like the Hollister. I can tell you with certainty that I forget to close mine a LOT more often. I’ve actually never forgotten to close my leg bag.
Now usually I notice very quickly that I’ve forgotten to close the big bag, because I start to feel wet drips on my leg. Remember, you have to wear shorts with this type of bag due to the long tube. However, yesterday I was just sitting around with my wife, binge-watching old Ellery Queen episodes on Hulu. I did NOT feel any drips on my leg on my way back to the chair in our carpeted living room (some of you see where this is going:)). I did not notice that I had left my valve open. So I sat down for about 20 minutes with my bag flat on the floor (a minor silver lining in this particular adventure).
If you’ve ever watched the Ellery Queen series from 1975, you may remember it has a very cool, very swing-danceable theme song by Elmer Bernstein. My wife said “hey, this song is slow. Pick up your bag and dance.” Of course as soon as I did that, I got all wet and so did parts of the carpet. So, again we sprang into action. I closed the valve and ran to the bathroom to rinse the bag and change my wet clothes. Then my wife supplied me with paper towels, dark hand-towels, a pitcher of water, and a bottle of Citra Spot. I laid down paper towels to find where the wet spots were, sprayed them all with Citra Spot, Then poured water over everything and soaked it all up with dark towels. Sigh.
After that was all done, I developed a new bag-emptying process that has worked perfectly so far. Your results may vary. When I am done emptying the bag, I tear off a bit of toilet paper and use that to close the valve before wiping the opening at the end. New rule: If I didn’t grab the valve handle with toilet paper (not my fingers), then I did it wrong. This basically only changes the sequence I was using before, which was to close the valve (usually!), then tear off some toilet paper and wipe the opening. So far, so good. Of course the slightly traumatic memory of the spillage could be helping here too;).
I mentioned incidents (plural) with the bed bag. The other one happened in bed. I woke up for some reason, about an hour after going to bed, and shifted around. Just then I felt a “pop” in the area of my leg and knew immediately what it meant. The catheter connection to the bag had come loose. I immediately jumped out of bed and cleaned up. Fortunately, not much had leaked out that time, but the take-away from that was to make darned sure before bed that I tightly attach the end of the catheter to the tube on the bed bag.
[Added since the above was published] I had an accident that could very well have injured me badly. Though urine still spilled, my suprapubic catheter could very well have been ripped out of my abdomen. I was spared the injury solely because I was wearing a Grip-Lok Large Foley Securement Device rather than the type of catheter holder that stays on your leg via stretchy fabric (like an ACE™ bandage). See the details of the accident here: Tip To Avoid Tearing Out Your Foley Catheter
If you would like to purchase the Grip-Lok catheter holder ($5.69 apiece), Click Here.
Hopefully my accidents will help you prevent your own embarrassing moments.