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BCG and dealing with catheter pain

10 years 11 months ago #19612 by wsilberstein
js219 wrote:

Thanks!! I still don't know why the doc didn't use any kind of gel last week, but this week I'll let him know I want gel and a smaller catheter. A #10 you say? I think another part of the problem was that I may not have been completely healed from my surgery from a few weeks ago. The doc said he had to dialate me quite a bit and there was some tearing. ...Jon

Dear Jon,
First, let me say that lidocaine gel does work. Is it great? - unfortunately no, but having a little less pain when something is inserted makes it easier to relax and not tighten up, making things feel even worse.
I can't imagine passing a catheter without any lubricant, but it's possible the lubricant was applied to the catheter. Lubricant isn't generaly squirted into the urethra like the lidocaine gel is.
I've been away for a few weeks so I might have missed previous information about your circumstances, but bladder cancer surgery should not result in anything that needs to be dilated. Just what did he dilate? A urethral stricture is not a common occurrence from the treatment of bladder cancer or even repeat catheterizations. As the proud owner of a urethral stricture which needs to be dilated before every cysto, and a few times to deal with secondary inflammation of the stricture, I can tell you that I've found few bladder cancer warriors who've devloped a stricture. I'd sure like to know (I'm sure you would too) what your doc is telling you is going on down there and what you can expect in the future. If you do have a urethral stricture, you might like to look at some of my past posts. Plus, I'll be happy to talk to you about it any time.
Dilation is unpleasant, but survivable. I've been running about 2-3 dilations a year. Since these have mostly been done in the office, the only anesthesia has been the lidocaine gel. I won't say you ever get used to it, but these days, the original surgery and catheterizations seem comparatively like a piece of cake. After the last successful in office dilation I went back to work (that evening) catheterized.
And here's the thing. I regularly encourage the newcomers by telling them that I've been cancer-free for 7¾ years.

-Warren
TaG3 + CIS 12/2000. TURB + Mitomycin C (No BCG)
Urethral stricture, urethroplasty 10/2009
CIS 11/2010 treated with BCG. CIS 5/2012 treated with BCG/interferon
T1G3 1/2013. Radical Cystectomy 3/5/2013, No invasive cancer. CIS in right ureter.
Incontinent. AUS implant 2/2014. AUS explant...

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10 years 11 months ago #19601 by DIB
Yes - call ahead of time. Get your anxiety over with; just ask to speak to nurse.

Male Dx T1G3 5/08 @ Age 59. TURBT 5/08; TURBT+40 mg MMC 6/08; BCG (6) 7/08-8/08; Cysto & TURBT 9/08; BCG Maint(3) 10/08, 3/09; 7/09; 11/09; 5/10; & 1/11. Clean cystos 2/09, 9/09, 3/10, & 10/10.

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10 years 11 months ago #19600 by DIB
Jon:

Update from my nurse at this morning's BCG:

She said she uses a "#8 French feeding tube" catheter. Says she gets some ribbing from other nurses for going that small but that her patients love it and the BCG fluid still goes in quickly - I do not think it took more than 3 minutes or so this morning.

She also said she uses a Lydocaine/KY jelly mix (2:1) on the tip and inserted inside the penis. Then let's me "cook" for 5 minutes. I had no discomfort at all this morning having the catheter go in but she told me the discomfort could increase on #'s 3-6 as things get more irritated from the BCG.

So try asking for a #8 French feeding tube (leave it to the French :) and let me know how you make out.

David

Male Dx T1G3 5/08 @ Age 59. TURBT 5/08; TURBT+40 mg MMC 6/08; BCG (6) 7/08-8/08; Cysto & TURBT 9/08; BCG Maint(3) 10/08, 3/09; 7/09; 11/09; 5/10; & 1/11. Clean cystos 2/09, 9/09, 3/10, & 10/10.

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10 years 11 months ago #19575 by js219
Thanks!! I still don't know why the doc didn't use any kind of gel last week, but this week I'll let him know I want gel and a smaller catheter. A #10 you say? I think another part of the problem was that I may not have been completely healed from my surgery from a few weeks ago. The doc said he had to dialate me quite a bit and there was some tearing. Also, I'm just not good with pain, especially in that area of my body. Just the idea of a catheter still gives me the willies. I wonder if I'll ever get over it. Did you guys ever get used to it?
Do you think I should call and make sure they can accomodate my requests ahead of time?

Jon

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10 years 11 months ago #19559 by slabman
Jon, the numbing stuff is simply a lidocane/gel mix. My nurse thinks the numbing really isn't that good and the relief comes mainly from the gel. Comes in a syringe-like container sans the needle and they just put it into the opening of the urethra and wait a couple minutes. My "plumbing" has gotten so small in diameter after the repeated trips in and out that the regular-sized #14 catheter doesn't work for them. (Although the Doc is able to cram that sucker in 'cuz he's a guy, I think, and knows just how it feels to us guys....ha). But the nurses seem to be much more careful not to hurt us. :laugh:

Last time a new nurse tried a #14, then a #12 and gave up, so the regular nurse came in with her #10 catheter and pushed it in in a flash...no pain. Didn't even feel it going past my prostate like usual. And the BCG goes in so fast the small one isn't really of any consequence. One caution is the small diameter could cause it to reverse itself while going in, so she always checks for urine flow back out before putting the BCG in.

I guess I'm fortunate since the only effects I seem to have is the constant urge to go for several hours after the treatment, but I can live with that.

One last thing, when I started these treatments, the nurse did mess around with a needle, trying to numb things down for me - didn't work. But I think that is a big waste of time since the needle stick is far worse than the catheter going down. I think the key here is to use a # 10.

Bob
T1 G3
Age 66
DX April 2008
TURB April 2008
Last BCG (#15) April 2009

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10 years 11 months ago #19526 by js219
Thank you so much. I didn't even know a smaller catheter was an option!!

As far as the needle thing goes, I read on one of the posts that someone had gotten an injection for the pain.

When I had my Cysto the doctor did inject some sort of gel, but it wasn't to numb the pain, it was just for lubrication. I know this because I asked what the gel did. He didn't use any type of lubrication for my BCG, which I'm thinking couldn't have helped the "burning." He told me I'd develop a sort of callus and by the last treatment it'd be no problem. I wonder if he's ever had any kind of catheter...

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