Need quick help for catheter in 21mo intact boy...

[boysmom2]

I'm sure this is already here, and I'm sorry to ask again, but I can't find it.  My little guy has a swollen testicle.  It's better now than it was last night, and the ped and I agreed over the phone that as long as it doesn't get worse, we can wait to have him seen in the office tomorrow (monday).  If it does get worse, we head to the ER.  What I'm wondering is if someone could give me a link to something official I could print out to bring with me regarding how to properly cath an intact, non-retractable boy.  I have the flu, and while I'm all about going mama-bear to protect him, I'm so exhausted right now, I don't trust myself to be coherent enough.  If I could hand them something, preferably an official medical source that backs up what I'm saying, I think it could go a lot better.  

So, hopefully we won't need it, but if we do, we'll need it quick, so anything anyone could share would be great!  Thanks!

[Super~Single~Mama]

So sorry!!  Thats stressful.

My ds is intact, and was cathed last summer (about 18-19mo), and I don't have a resource, but I basically told them no way no how were they to retract.  The nurse that did it talked to me, and I compromised by letting her manipulate the foreskin so that she could see the hole (sorry, don't know the medical term), but not retract him.  She was very gentle, and ds was not harmed.

[boysmom2]

Here's hoping we get a kind nurse!  Unfortunately we live in a smallish town.  We have large children's hospitals in 2 large cities near us, each about an hour away.  If this wasn't potentially such an emergency I think I'd rather go there.  I think the combination of more experience plus potentially more foreign born nurses might be better.  But, right now it's not an ER situation, but if it becomes one, we probably shouldn't waste an hour in the car. :(  Anyway, I'm glad you had a good experience.  It gives me hope!

[boysmom2]

Woo hoo!  Found it!  Did you know a live, very helpful person answers the phone if you call the no-circ people on a Sunday morning?!  Anyway, she told me where to find it it's in this pamphlet:

http://www.nocirc.org/publish/6pam.pdf

I'm printing it to keep in my diaper bag, even after this crazy testicle stuff is resolved.  In the unlikely event that we'd have some medical emergency, it'd be better to have it.

[Super~Single~Mama]

Originally Posted by boysmom2 

Here's hoping we get a kind nurse!  Unfortunately we live in a smallish town.  We have large children's hospitals in 2 large cities near us, each about an hour away.  If this wasn't potentially such an emergency I think I'd rather go there.  I think the combination of more experience plus potentially more foreign born nurses might be better.  But, right now it's not an ER situation, but if it becomes one, we probably shouldn't waste an hour in the car. :(  Anyway, I'm glad you had a good experience.  It gives me hope!

You know, I think I would do an hour in the car - unless its life threatening.  I think thats one thing I really like about where I live though, lots of foreign born, lots of people whose cultures don't circ so they don't either.  Most nurses and Dr's are pretty familiar with intact care (however, the hospital we went to b/c its the best children's hospital is a private religious hospital so they were a little less aware - but a good experience anyway, they were very nice and respectful of our choices)

[eepster]

Glad you found the instructions just in case you need them.

If they want to do a cath just to get a urine sample, you can ask for a clean catch baggy instead.  Even with the instruction, it is safer and less invasive to do the baggy.

[boysmom2]

The thing about an hour car ride is, if it gets bad, he'll be in pain.  And, the doc was saying that if we go to the ER I need to make sure they understand that we SHOULD NOT be made to wait.  At all.  And that's with her assuming we go to the ER 5 minutes from our house.  It's not life threatening, but, depending what's causing this, I think he could potentially lose a testicle over it.

And I will definitely ask for the baggie for urine collection, but thanks for the reminder.  I'm more concerned about it if he needs a surgical repair of a hernia and needs to be cathed for that.

Still looking ok, so hopefully this will all be unnecessary.  Thanks everybody!

[MCatLvrMom2A&X]

hope your little guy is still doing better and you dont have to deal with the ER. That is the thing about testicles when they swell unexpectedly it could be something simple or like you said it could cause him to potentially loose the testicle.

that it is something simple.

[boysmom2]

Thanks!  So far, so good!  I'll update after the doc tomorrow.

[Super~Single~Mama]

Originally Posted by boysmom2 

The thing about an hour car ride is, if it gets bad, he'll be in pain.  And, the doc was saying that if we go to the ER I need to make sure they understand that we SHOULD NOT be made to wait.  At all.  And that's with her assuming we go to the ER 5 minutes from our house.  It's not life threatening, but, depending what's causing this, I think he could potentially lose a testicle over it.

Whoah, didn't realize he might lose a testicle!  Yeah, the closest one would be your best bet.  Hopefully you can just go in to his normal ped in the morning!

[boysmom2]

Originally Posted by Super~Single~Mama 

Whoah, didn't realize he might lose a testicle!  Yeah, the closest one would be your best bet.  Hopefully you can just go in to his normal ped in the morning!

Yeah, kinda scary stuff!  I'm glad I looked it up.  I had no idea how serious it could be.  At first I though, "Oh, that's weird, I guess I'll wait to see if it's still like that tomorrow."

[vachi73]

Um, I don't mean to be dense, but I'm not sure why he would need to be CATHED for a testicular injury or infection?? Urethra/Bladder/Ureters/Kidneys -- those I can understand -- but testicle?

IME, ultrasound is much, much better for testicular injury/infection than a cath. Doppler can measure blood flow, and that is the major issue w/ testicular injury -- if blood flow is restricted too long, the testicle dies and has to be removed (e.g., testicular torsion, which a family member of mine had as a teenager following a sporting accident).

The only reason I would allow him to be cathed would be for surgery under general anesthesia (*maybe* twilight anesthesia, but I'd have to be persuaded by the doctor that it was amsolutely necessary versus convenient for the doctor, KWIM?) However, I'm sure you are far more in the know than I am, so please, educate me!

That aside, and most importantly, I hope your son is much better today, and that YOU are also feeling better!!

EDITED -- sorry, should of read more carefully on OP. :)

Edited by vachi73 - 3/8/11 at 8:26am

[Toolip]

The OP said upthread that she was worried about needing the cath for surgery.

OP, how is your son?

[boysmom2]

Sorry I haven't updated!  He's fine.  It never got any worse, and by the time we went to the ped's office yesterday it looked almost normal.  She said she thinks he may have a very small opening and that all the coughing he was doing this week may have forced some fluid in there.  We have an appointment to see a urologist next week at the children's hospital, and instructions to call/go to the ER if it gets bad before that.

And yes, the cath would be in case of a surgery to repair whatever is going on in there.

Thanks again for all the help and support everyone!  And I'm feeling much better AND dh is finally home from his trip, so everything seems SO much better now.  Thanks for giving me a place to freak out a little!