I'm back at home after a few exciting experiences at the hospital and clinic.
I had a referral to see the urologist at our HMO, about my prostate and urinary retention problem. So it begins...
"You need to wear a Foley catheter for a week to relieve the stress on your bladder.". Um. OK? So, lie back and think happy thoughts... Once the nurse detached me from the ceiling tiles, she gave me a quick rundown on how to clean things, and a few accessories to let me engage in now-complicated tasks like taking a shower. I was then sent home, little knowing what was in store...
An hour after getting home, I feel light headed. I check the collection bag, and see about 200 ml of blood. Not pink or red blood tinted urine, but opaque, dark red blood, exactly like what I see in the bag when donating blood. Now, not having medical training, I find this curious, and a bit alarming. I know that on "House" when this happens all manner of medical hilarity ensues. So, I call Urology and leave a message. I call the advice line for our HMO, and listen to Muzak for 20 minutes or so until I am feeling faint. Then I decide on a more direct approach, inform DW, and we head for the ER. There goes my high deductible savings for the year...
We get to the ER, the triage nurse takes the vitals, and checks the collection bag. When the ER nurse looks startled, you know things are going to be interesting. I was admitted immediately, which was a relief for me. I had managed to get myself in an environment where I could be monitored and kept out of further trouble.
Over the next 16 hours I learned all about catheter placement, the different sizes and tip styles, and the wonders of the three-way Foley for irrigation and the hazards of clots in catheters. (The line clogged a couple of times from clots, which were promptly dislodged. If that had happened at home, I would have had more trouble.)
It turns out that bleeding when decompressing a distended bladder is pretty common. While distended, the internal pressure holds the damaged blood vessels closed. When the pressure is relieved, they may open up and bleed immediately, or after some mechanical irritation (like driving home, bouncing and jolting the shrinking bladder). It would have been nice if the urologist had mentioned this. Even better might be to adopt a practice such as telling the patient to walk around and hang out in the lobby for 30 minutes or so, and have the nurse or tech check the collection bag and line for signs of clots or bleeding before sending the patient home. (I'm sure someone will be along shortly to explain why that would be a useless waste of medical resources. Yeah. Compared to 16 hours of ER time? I'll definitely hit my max out-of-pocket on my high deductible plan, but I'm OK, no signs on nasty complications so far.)
So that's what I've been doing. Gad...