My problem after having near 40 instillations is if I stand up to leave I void..... no stopping that fact. So lay on table and nap & read Bible. On the Lidocaine I have ask my doctors to not use it due to mess and fact it worsens the retention issues with me and they are adamant about using it.... for ease of catheter insertion. Truth is I'm such an old hand at doing this that catheter doesn't bother me much at all anymore. Also they tend to insert the cath immediately after lidocaine which makes no sense to me.... least give couple minutes to numb a bit? Just an added mess to me that prefer not have.
Thanks for the link to the NCBI study. I read the report. One item noted that I found curious was they recommended not using lidocaine for the administration of BCG. I'm going to a National Cancer Center for my infusion of BCG and they use lidocaine prior to the catheter insertion. Not sure if it is a different variety of lidocaine or if the center deems the lidocaine has a insignificant impact on the BCG. I will ask the nurse next week.
I have noticed that many hospitals are not requiring the rolling anymore according to several patients' comments.
It is likely because the consensus among a medical community stated "when considering other practical issues for BCG administration, the Task Force determined that it is not necessary to rotate patients every 15 min post BCG instillation". See the section What are the most important practical aspects of administration of BCG? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5557323/
The detail explanation of why the rotation is not required is mentioned in the paper by Dr. Ashish Kamat of MD Anderson and others. http://txcercit.org/Files/publications/23540779.pdf
"An interesting practice among some urologists is to have patients lie recumbent during the instillation period and to have them rotate every15 minutes in an attempt to evenly expose the entire bladder surface to BCG. Although well intentioned, this rotisserie method does not seem to have any basis in the scientific literature. The elastic nature of the compliant bladder suggests that it changes size to accommodate the volume of fluid inside. Therefore, unless the instillation was incorrectly done and a large air pocket was introduced in the bladder, serial turning of the patient is not necessary. It is the authors’ practice to have patients lie recumbent for several minutes
after instillation of the BCG and then to allow them to ambulate normally during the 2-hour retention period."
Still, it would not hurt to rotate just in case there is a large air pocket as it could be the case. But, the consensus by urologists says we do not have to worry much on rotating.
Update: Completed my 4th round of BCG today. Fortunately, I didn't have any issue but a little burning which on lasted a few hours.
My only concern is that I always leave the medical center after the procedure to go to my own bed to roll around and flip sides every 15 minutes. My commute lasts about 30 minutes and I spend the rest of the two hours changing positions. It's more comfortable in my own bed but I'm giving up flipping over during the first 30 minutes. I'm not sure how everyone else does it or if I should just stay in the medical center for 2 hours and flip around. Anyone have an opinion on what is the best way to do this? Am I ok doing it this way?
I have seen no evidence that any dietary supplements have any effect on bladder cancer. Before you invest in any such, please check with your doctor to be sure that they do not affect the pH or any other factor in the bladder such that they would interferes with your treatments.
Diagnosis 2-08 Small papillary TCC; CIS
BCG; BCG maintenance
Vice-President, American Bladder Cancer Society