Son will need cath after surg-PLEASE dont retract! - Mothering Forums

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#1 of 29 Old 02-03-2010, 11:48 PM - Thread Starter
 
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My son needs a MAJOR surgery on his skull and will need a catherer for sure. I'm so sad because I know they will retract him and the last thing he needs is an infection or some complication because staff has no idea how to cath intact boys.

Any ideas or help?!?!?! I know if I ask for them to be careful the message will get blown off and/or the person doing the cath willnever hear the message. Im going to talk directly to his neurosurgion but Im so heart sick over this.
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#2 of 29 Old 02-04-2010, 12:04 AM
 
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how old is your son?

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#3 of 29 Old 02-04-2010, 12:06 AM
 
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"A catheter can be inserted when the foreskin is retracted just enough to see the meatus (urinary opening). if the foreskin's opening is too small to retract far enough to see the meatus, a catheter can be inserted through the foreskin's opening and into the meatus "by feel." The foreskin should never be retracted by force for any reason"

This is from the nocirc website. Hopefully you can effectively get this point across. Is it possible to have some sort of advocate present during the surgery?
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#4 of 29 Old 02-04-2010, 12:14 AM
 
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I guess it really depends on the age of your son but I don't see why the catheter can't be placed before surgery and you can be there to witness it. This is what I'd say I wanted to happen and then even while you are there witnessing the insertion, make sure the nurse know no retraction, and that you mean it!
Good luck to you and your son during this stressful time!

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#5 of 29 Old 02-04-2010, 12:17 AM - Thread Starter
 
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how old is your son?
Sorry...he just turned one.
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#6 of 29 Old 02-04-2010, 12:29 AM
 
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My son has a serious kidney anomaly and had to undergo an xray test involving catheterization at just 6 months old. I requested to be present for the catheterization and was careful to mention and remention that he was uncircumcised and should NOT be retracted. I cannot tell you how relieved I was when a foreign-born male nurse showed up to do the cath! He did not retract my son's foreskin at all and was able to get the catheter placed very quickly.
I understand your concern and I second the others' comments that you should definitely ask to be present during the cath and just keep mentioning the non-retraction issue, eyerolls or no!!

Good luck and I hope all goes well with your son's surgery!

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#7 of 29 Old 02-04-2010, 12:40 AM
 
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You could also request attempting a "condom cath" instead of an indwelling cath- it might not work out, but it's worth a try!

Jen, L&D RN, CBE, CLEC who loves to knit.gif! I adore my modifiedartist.gifDP, treehugger.gifDD 10/98, & sweet new babygirl.gif5/10!!!
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#8 of 29 Old 02-04-2010, 12:54 AM - Thread Starter
 
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Good idea, they are called a "Texas cath"...I dont know if they have them for babies though? hummmm...I'll ask
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#9 of 29 Old 02-04-2010, 02:05 AM
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Good idea, they are called a "Texas cath"...I dont know if they have them for babies though? hummmm...I'll ask
I'm pretty sure that won't work. Not just because I doubt they make them that small, but as part of his monitoring post surgery they'll probably want to monitor hourly urine volumes to keep an eye on his hydration status and kidney function. This needs an indwelling catheter.

I'd talk to his surgeon.

Personally, and I'm not suggesting this is what you do, but I'd threaten to sue the arse off everyone present in the OR if my son's penis was in any way manipulated that caused even the slightest damage to his foreskin.

I'd put it in writing. I'd shout it from the rooftops. I'd be the nuisance, foreskin obsessed, weird mother in room 6 who you have to watch out for

"Custom will reconcile people to any atrocity."
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#10 of 29 Old 02-04-2010, 03:33 AM
 
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Can you request either a NICU nurse, or a nurse who went to school in a non-circ'ing country. Most of the world doesn't circ so that would be most places outside the US. Around here there are many nurses from Ireland and Russia, as well as many other countries.

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#11 of 29 Old 02-04-2010, 04:42 AM
 
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I'm pretty sure that won't work. Not just because I doubt they make them that small, but as part of his monitoring post surgery they'll probably want to monitor hourly urine volumes to keep an eye on his hydration status and kidney function. This needs an indwelling catheter.
Well, if the cath was working and catching the urine, why wouldn't they be able to monitor the urine output????

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#12 of 29 Old 02-04-2010, 05:10 AM
 
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I'd talk to the pre-op nurse and make sure you write on his diaper in Sharpie "intact don't retract!". They will probably remove the diaper (and insert the cath) after anesthesia so it will be a reminder

((HUGS)) for you and your DS!

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#13 of 29 Old 02-04-2010, 02:30 PM - Thread Starter
 
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I talked with the surgeons nurse today (They called for some info) and she was VERY cool about it. (a good sign, but Im still weary)
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#14 of 29 Old 02-04-2010, 04:24 PM
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Well, if the cath was working and catching the urine, why wouldn't they be able to monitor the urine output????
A condom cath requires you to actively pee, whether through incontinence or consciously urinating.

A one year old would only pee when his bladder was full every few hours. Post major surgery there is a chance as part of the post op monitoring, they will want to monitor the mount of urine being produced hourly (as an indication of kidney function and hydration)and the only way to do this is with an indwelling catheter that drains urine as it's produced.

The hours that it takes to fill the bladder till it empties on it own could allow a patient to become dangerously unwell without any interventions because no one would know.

"Custom will reconcile people to any atrocity."
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#15 of 29 Old 02-04-2010, 05:06 PM
 
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Originally Posted by dkenagy View Post
My son has a serious kidney anomaly and had to undergo an xray test involving catheterization at just 6 months old. I requested to be present for the catheterization and was careful to mention and remention that he was uncircumcised and should NOT be retracted. I cannot tell you how relieved I was when a foreign-born male nurse showed up to do the cath! He did not retract my son's foreskin at all and was able to get the catheter placed very quickly.
I understand your concern and I second the others' comments that you should definitely ask to be present during the cath and just keep mentioning the non-retraction issue, eyerolls or no!!

Good luck and I hope all goes well with your son's surgery!
DS2 was cathed to have probabily the same test (VCUG) as dkenagy is talking about at just 8 weeks of age. He was not retracted and the whole insertion took just a couple of seconds and didn't appear to hurt. I would stay and remind them not to retract, but I would not think it would be an issue.
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#16 of 29 Old 02-04-2010, 07:41 PM
 
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I'd write it on his belly, even, in addition to the diaper. I'm not sure what the procedures are like, so I don't know when his dipe would be removed.

Mama to twin boys, Oct-'09 and baby girl, Apri-'12!

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#17 of 29 Old 02-04-2010, 11:46 PM
 
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A condom cath requires you to actively pee, whether through incontinence or consciously urinating.

A one year old would only pee when his bladder was full every few hours. Post major surgery there is a chance as part of the post op monitoring, they will want to monitor the mount of urine being produced hourly (as an indication of kidney function and hydration)and the only way to do this is with an indwelling catheter that drains urine as it's produced.

The hours that it takes to fill the bladder till it empties on it own could allow a patient to become dangerously unwell without any interventions because no one would know.
Oh right- of course! Lol! I obvious don't have tons of experience with them as I work in L&D and well, we don't "do" men! Thanks for clueing me in!

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#18 of 29 Old 02-04-2010, 11:54 PM - Thread Starter
 
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Thanks so much for all the ideas, but most of all, encouragement to stand up for my and my sons convictions and health.

I've talked with both doctors (that will be working on him) staff today about the issue. Both were great and supportive and said I will be called tomorrow by the nurses that will be working with the doctors during the surgery and to discuss it with them and stress several times how you feel and what your needs are. Pretty cool so far.

He's going to All Childrens in St. Pete Florida and Ive heard that everyone at this hospital is amazing and loving. Please send them all love and wisdom for us! Thanks for your help!
Nicole & Family
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#19 of 29 Old 02-07-2010, 11:27 PM
 
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Wishing you good luck with your little one!

I'm a few days late, but if there is still time- request a nurse who is experienced with intact children. If that's unavailable, see if they would have a pediatric urologist stop by and insert the cath.

I hope things go well and your baby is home to you soon!

Mom, wife, full-time student.  And tired.  DH, DS#1 (9/99) and DS#2 (9/09), and 2 dogs.

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#20 of 29 Old 02-08-2010, 12:21 AM - Thread Starter
 
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FANTASTIC IDEA! Thank you! I see the doc's tomorrow and we go up for pre surg stuff. I will ask about the intact nurse of ped uroligist! Great plan!

I can barely breathe...It all starts tomorrow after 8 weeks of waiting.

Thank you all for your help, I will be using all your suggestions and strength!

With love,
Nicole
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#21 of 29 Old 02-08-2010, 12:37 AM
 
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...It all starts tomorrow after 8 weeks of waiting...
Hugs, mama! Thinking of you and your son.

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#22 of 29 Old 02-08-2010, 01:30 PM
 
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squirrelleta: g will come through with flying colors, mama! just hang in there, because you have the hardest part right now. we're all praying for you and g, and love you all. my littlest nephew will be up and running in no time!!
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#23 of 29 Old 02-10-2010, 03:45 PM - Thread Starter
 
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Graham had his surg and came out with flying colors! (He is in a lot of pain and the hard part starts, but his pain is being managed well and he seems to be more like "Just feeling like total Cr#p" type agony...if that make any sense!)

I told EVERYONE I encountered I didnt want him retracted and why, I had that quote printed out and I gave it out. They all said "tell the nurse who will be in the OR"..when I met the nurse who introduced herself as the one, she smiled and looked over at the nurse aneth. that I had already talked to and smiled (Grrr...Im sure she heard "This woman is more worried about her sons foreskin then his surgery"...I didnt care and said what I needed to say.) Then, of course, she says...*big sigh..."Well how do you clean him then?" UGGGG! (So attitude RIGHT OFF THE BAT even though everyone else was super nice, it figures the one who would be doing this was defensive!) I *calmly* said "An infants foreskin is still attached, it doesnt retract till...yadda, yadda, " She wasent listening and I handed her the sheet with the quote she didnt even look at it and set it back down on the counter...

I tossed it on his cart as they wheeled him away and hoped for the best even though I got super upset because I was fine until I encountered ONE person who acted like they didnt care about my son's comfort.

LONG STORY SHORT: He was NOT retracted!!! (At least not that is evident at all...His penis looks great and no redness at all, they removed the cath this morning and it looks same as always. Happy weiners! LOL


SO....Graham was OK....Now my question is WHY IS MEDICAL STAFF NOT BEING EDUCATED ON CARE OF INTACT BOYS YET AND WHAT DO I DO TO HELP THIS ALONG? Free classes?
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#24 of 29 Old 02-10-2010, 05:45 PM
 
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Glad everything went OK.

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#25 of 29 Old 02-10-2010, 11:07 PM
 
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They should not push his foreskin toward his body to catheter him. They can very gently tug the foreskin outward (away from his body) and insert the catheter through the foreskin opening then the urethral opening. No retraction at all is necessary.

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#26 of 29 Old 02-11-2010, 12:37 AM
 
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... Then, of course, she says...*big sigh..."Well how do you clean him then?" UGGGG! (So attitude RIGHT OFF THE BAT even though everyone else was super nice, it figures the one who would be doing this was defensive!) I *calmly* said "An infants foreskin is still attached, it doesnt retract till...yadda, yadda, " She wasent listening and I handed her the sheet with the quote she didnt even look at it and set it back down on the counter...
I'm glad your son is okay and on the road to recovery!

You could send a letter to the hospital outlining your experience and kindly suggest they educate their surgical nurses on foreskin care. But truthfully, it may just fall on deaf ears.
Every hospital where I've worked and all surgical centers where I or family members have had surgery has either mailed a post-procedure post card or called for a follow up. They always ask what I liked, didn't like, what would have made the experience better, etc. If they contact you, mention how you had a valid concern and how your son's surgical nurse was dismissive to your concern and was ill informed on proper intact cleaning. If you know her name, great. If not, don't worry, they'll know because the info is on your son's chart. It won't get her in trouble, not to worry, but this type of feedback is how hospitals improve their care and hopefully get your return business.

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#27 of 29 Old 02-22-2010, 06:47 AM
 
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WHY IS MEDICAL STAFF NOT BEING EDUCATED ON CARE OF INTACT BOYS YET AND WHAT DO I DO TO HELP THIS ALONG? Free classes?
I am in nursing school and you can bet your booty my class will be educated about proper circ care!

CPST & mom

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#28 of 29 Old 02-22-2010, 02:24 PM
 
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I'm pretty sure that won't work. Not just because I doubt they make them that small, but as part of his monitoring post surgery they'll probably want to monitor hourly urine volumes to keep an eye on his hydration status and kidney function. This needs an indwelling catheter.

I'd talk to his surgeon.

Personally, and I'm not suggesting this is what you do, but I'd threaten to sue the arse off everyone present in the OR if my son's penis was in any way manipulated that caused even the slightest damage to his foreskin.

I'd put it in writing. I'd shout it from the rooftops. I'd be the nuisance, foreskin obsessed, weird mother in room 6 who you have to watch out for
THIS is what I was going to say.

Living DAIRY AND GLUTEN FREE for my SPD and Aspergers Little Man.
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#29 of 29 Old 02-22-2010, 04:58 PM
 
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I am in nursing school and you can bet your booty my class will be educated about proper circ care!

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