My dad recently had nephrostomy tubes put in. I almost said “installed.” Anyway, they were put in a month ago, and then he stayed in the hospital for about a week, and then went to a nursing home for rehab for another couple of weeks. He came home a week ago today, and now emptying nephrostomy bags and flushing tubes is the “new normal” around here. We have hospice/palliative care nurses and other hospice people coming in and out daily, plus his regular 3x a week CNA. And my sister and I have been at Dad’s house in shifts, daily and overnight.
On Monday one of the hospice nurses was here to flush the tubes and change the dressings where the tubes come out of Dad’s back. I watched, so I could learn what to do. The flushing is pretty straightforward, you unscrew where the thinner tubes (the ones that come from his kidneys) connect to the wider tubes (which connect to the bags at the other end), clean the connections with alcohol swabs, and then empty a pre-loaded saline syringe into the thinner tubes.
Changing the dressing involves removing the cotton padding and the plastic film that covers the padding and sticks to his body to hold the padding in place over the sites where the tubes come out. The film is sticky, like a huge section of scotch tape, and it does its job, sticking to the padding, the tube, gloves, whatever. After all that covering is peeled and snipped away, the insertion sites (if that’s the correct term – I have no idea) are swabbed with more alcohol pads and cleaned off), and then new pads and new tape are put on.
And that’s it. Not really difficult.
If you know what you are doing.
So last night when I was emptying the bags for the night I got ambitious and decided to change the dressings. One side looked like it was maybe a little damp or something, so I figured it would be good to do it then, rather than wait for the next day when a perfectly capable and trained nurse was scheduled to do it.
I got out the bags with the syringes and alcohol swabs and pads and everything, and got to work.
First I emptied the bags. That part’s easy, the ends of the bags just unscrew a bit and I drain them into the toilet.
Next, rather than flush the tubes, I figured I’d go ahead and remove the dressings, then do all the alcohol swabbing everywhere, and then flush tubes and re-dress.
It took me a while to get the dressings off because, as I said earlier, the tape/film stuff sticks to everything. I used scissors to snip away where it was all stuck to the tube, and I had visions of snipping the tube itself and having a geyser of urine shooting everywhere, and then I’d have to bring Dad to the ER or something to have a new tube put in. So I was very careful with my scissors and no such disaster occurred.
Still – I am inexperienced and slow. Dad was standing in the bathroom, holding onto the windowsill for support, and I kept asking if he was okay and apologizing for how long it was taking. He always told me he was fine. He is 91. He is a WWII vet. He can take anything.
So then I flushed the tubes. First the left one. I unscrewed the connection, swabbed the ends, and started plunging saline into the smaller tube. I think I plunged too fast because I had a puddle of saline on the floor. Not a lot, really, but of course it seemed like Lake Michigan. I flushed the right side at a slower pace and that worked much better.
And then it was time to redress the wound sites.
Now, when I cook, I get everything ready first. Get all my ingredients out first, then start putting everything together.
I should have done the same thing with the dressing supplies, but of course, I didn’t.
So during the whole process I was reaching into bags and rummaging around looking for whatever I needed. And that was fine with the flushing because there were plenty of swabs and syringes.
I fished around and found the pads that are cut down the middle half way, so you can just slide them up and around the tube and you don’t have to cut them yourself. And then I went fishing for the plastic tape/covering things I’d seen the hospice nurse use the other day.
I found one. One.
I read labels of other mysterious packages of things and tossed them into the sink if they didn’t look like what I needed.
I got the left one re-dressed with moderate success.
Now what to do with the right side.
I poked around in the bin where I’d put all the band aids and things when I cleaned the bathroom closet earlier in the week, but there was nothing, really, that was big enough or plastic/seep-proof to protect the site.
What was I going to do?
Now that I’m typing this, I suppose saran wrap or something would have worked, but my brain was only working with the things available in the bathroom, and it was sort of frozen in mild panic, too, so I couldn’t think outside that little box of a room.
So I grabbed a glove and tape. And yes, I covered the split pad with the palm part of a glove, and taped it on and used enough tape to wrap Christmas gifts for my whole family to make sure that glove stayed in place. And I taped the fingers down too, for good measure.
I think I’d begun sweating at some point. But the wounds had clean dressings and were covered, so I chose to consider it a success.
I wrapped the bags and tubes in this stretchy thing that’s like a girdle – it holds the bags and tubes against his back so they don’t get caught on anything and so he doesn’t yank them out when he’s fidgety.
And that was it.
A success, of sorts.
Update – when the Hospice nurse called the next day to set up her time, I told her about my little adventure. She rearranged her schedule and came out sooner rather than later, and told me, when she saw my handiwork, that I was very resourceful.
It’s amazing how much that little bit of feedback did for my self esteem. What with worrying about and caring for my father, my family, and working, and all the many little things that make up each of those larger categories, I’ve been feeling overwhelmed, drowning at times, under everything that makes up my life right now. Writing it out – and finding the humor in it – helps tremendously. My sister and I are doing all we can do to juggle everything, and I am so grateful to have her as my teammate. I think we mostly just try to keep each other sane.
I’ll be sharing other bits and pieces of this “new normal” in our lives, partly because if there’s funny stuff, it should be shared, and because I know there are plenty of other people out there – I think we’re referred to as the sandwich generation, taking care of aging parents on one side and children on the other. Plus spouses – who are going through the same or similar experiences. Talking – or writing, in my case – keeps the tidal wave in check.