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Dr. David
Dr. David, Board Certified MD
Category: Medical
Satisfied Customers: 48809
Experience:  Board Certified Physician
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Hi my brother is 65years old and he has severe form of Spina

Customer Question

Hi my brother is 65years old and he has severe form of Spina Sifida. He was born in 1948 and he is probably one of the few survivors from that time. He was only to live for 8 weeks. My brother has a supra pubic catheter for about 30 years. He was always told to drink plenty of water to keep his kidneys clear. In the last few years he has been having occasional seizures. He has a pacemaker in place but he is still getting occasional seizures ... twice or three times a year. He curvature of the spine from years of being restricted in a wheelchair and his back is tender and he can't lie on it. His heart is not on the right side of his body possibly due to his weight and internal restriction. He is in a care home for the last two years but there is no specialisation care for his condition as in Ireland the ageing Spina Bifida has no special care facility and no experts for his condition as he is getting older. Following his seizures which are epileptic in nature and have only been witnessed lately in the care home, the hospital has found that he has low sodium. They have told him only to drink 1 litre water per day including tea etc., As a result he is getting more kidney infections and blockages in the catheter resulting in leaks etc., Since he moved to the Care Home he doesn't attend the hospital he used to any more and the nurse in the home changes the catheter for him. He used to have a size 22 and they are using 18. Could this be the cause of blockages? Have you any suggestions for his future care regarding the catch 22 he is in. Should his doctor refer him to a urologist as he hasn't seen one since he moved from his home. He also has problems with his bowels as you can imagine but there is no irrigation being done or any intervention like that. Mary O XXXXX

Submitted: 3 years ago.
Category: Medical
Expert:  Dr. David replied 3 years ago.

Dr. David :

This is Dr. David

Dr. David :

it sounds like he needs to drink more water to help flush out his kidneys and foley catheter.

Dr. David :

this can be done, but he has to take in more salt as well.

Dr. David :

if he has low sodium, they do make sodium chloride tablets for patients who don't get enough sodium in their diets and their blood sodium levels are too low.

Dr. David :

I would recommend that you talk to his nurses and doctors at the nursing home about giving him more sodium chloride in pill form and also have him drink more fluids to help him keep his catheter from blocking up.

Dr. David :

these low blood sodium levels could be causing his seizures.

Dr. David :

is he also having constipation because he is not drinking enough water?

Customer: replied 3 years ago.

Well I was wondering if the doctor can tell me if the difference in the
guage of the catheter is relevant. Secondly he was left with
leaking catheter for over an hour before it was dealt with and I was
wondering if this could be serious for him. He had been told that they had
to observe for an hour but it was pouring out and there was no measurement taken of the amount already in the bag for comparison after an hour!

Mary O

Expert:  Dr. David replied 3 years ago.
no, the guage of the catheter is not relevant.

a leaky catheter would cause urine to leak out and become irritating.

this is irritating and smelly, but not super dangerous if it is cleaned up in an hour.

it would make any measurements of accurate intake and output of fluids incorrect.

some patients have to have their intake and output of fluids measured very carefully. these are sometimes called ins and outs measurements.

so if they didn't measure the leaky catheter fluid, then the ins and outs measurements would be incorrect.