Hi guys,

Still getting use to this pouch. I'm suppose to be on constant drain, but it keeps falling out at night no matter how I secure it, so I'm just intubating as usual, with no leakage. I think the valve (which, if you recall, was twisted last week) is actually working again. Previous to that, and presently, I've noticed that in the late evening I find it difficult to insert the catheter and open the valve. It's as if my stoma and bowel are swelling up, making for a very tight fit. Once I get into the pouch, I'll always see a little bleeding too, I think the catheter tip is actually cutting into my intestinal wall. Has this happened to you? Is this normal? Most times the catheter goes in smoothly, but I've noticed this almost every night, I am weird, aren't I?

Thanks,
Eric aka J2K Razzer
Original Post
Eric,
Please PM me with your Phone number and I will call and explain how to secure the tube into your pouch so that it doesn't fall out...If you are right and there is some sort of swelling going on in there and it is possible, then you must keep that tube in for a while. You could end up not being able to intubate at all and have to go back to intervention radiology.
Also, you may want to try to lay flat on your back with your legs in the air for 5 minutes before trying to intubate, something may be slipped in there and need to slip back into place before you intubate...(am still thinking a tiny peri-stomal hernia that could be allowing your pouch or valve to twist into it when standing...need to let it slip back into place before the tube will go in strait).
While before you call me, go to a pharmacy and get yourself some colloidal patches (they look like thick sheets of creamy plastic about 3x3 or 4x4)...And I will explain it all...
hugs
Sharon
Welcome to my daily hell as I call it. Your story is me every time I intubate. Tight stoma, my valve is on an angle. To keep the tube in it is simple. You have to form a loop like a ribbon, think cancer ribbon, the loop goes under the tube and then the ends go over and secure to the skin that prevents it being forced out. then secure another piece of tape over it.
Eric, I use a strip of guaze and wrap it around my hips and tape it in about 3 areas on my hips to keep it level with the stoma. Then I tie the guaze to the catheter, I bend the catheter so the end is held in place by the gauze...in a U shape. I use a golf tee or dowel to block the end of the catheter so it doesn't leak, and can be removed to empty my pouch. I have no trouble keeping the catheter in this way.

Your valve being closed tight and harder to get the catheter in later in the day, could also mean your pouch is too full and the valve closed very tight from the pressure of the contents within the pouch. So try emptying it more often if the pouch is stretched to it's full capacity. Also, relax and take a deep breath while inserting.

If you were told to keep the catheter in, you may be scarring it in place...that usually takes 21 days for scar tissue to adhere. So it's important to have the catheter in for at least 21 days if that's what the doctor is doing. It will also give the valve a chance to heal and help with inflammation or an irritated valve. Make sure you use some kind of lube on the catheter while inserting. Water soluable or something like olive oil that is digestable.

I am one that swears by inserting the catheter and tieing it in place for 21 days. It does help if it's to scar into place or for inflammation reasons. Good luck and I hope this helps you! Big Grin

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