What can I tell my urologist?

[pantyman]

I want my urologist to give me a catheter. What can I tell him that would help a decision to be made to give me a catheter. I know if I just tell him I want to simulate and continents he won't give it to me. What if I tell him some symptoms that I may have in which I truly may have? Maybe he will prescribe one. I already have an enlarged prostrate and at times my stream is just a dribble. I have already told him about it but he is in the let's try a medicine phase. Should I just tell him I want a catheter? I would rather be his ideal. My wife would accept it far easier if he said I should have one.

[adhb]

Just go to a medical supply store and buy what. you want. You don't ned to tell your urologist anything.

[pantyman]

In the past I have done that. But I can only wear a catheter for short periods while not around my wife. If my urologist said I needed one I could wear all the time and not be questioned.

[~Brian~]

50 minutes ago, adhb said:

Just go to a medical supply store and buy what. you want. You don't ned to tell your urologist anything.

@pantyman

I agree with @adhb:  You should NOT have to tell your urologist anything, because you are wanting to have 'fun' with a catheter.  You just have to careful to keep the thing clean, and make sure you don't get any irritation/redness or rash:  You also want to make sure that when you have it IN you, that it is not causing any problems for you.

IF you were to tell him something, and elude to the fact that you want to use a catheter, that could open up a whole host of questions that you may not want to have to answer:  Best NOT tell him anything, or that could cause some problems for you, if he is asking YOU "Why?"

Good Luck!

Brian

[jeremy12312]

Wouldn’t it just be easier to lie to your wife about what the urologist says, than to lie to a trained professional who isn’t going to believe you anyway?  They’ll run a scope up your urethra looking for blockages before suggesting a catheter. 

[superabsorbantpolymer]

You are old enough to have an enlarged prostate. Do you have any symptoms? You could complain about it to your wife and go through the process of seeing a urologist, then just wear the catheter (easily bought online) and explain to your wife this is how you're handling the issue. Simple.

[superabsorbantpolymer]

To the person reacting with confused emoji, what's confusing about my response?

[pantyman]

So recently I have had a problem that when I pee my stream splits several ways and sprays in multiple directions. Also when I am done it seems like my penis is still holding pee and then drains into my pad I am wearing. Also when peeing if I push to hard it stings in my meatus. The research I have done said it's likely a urethra stricture . There are several ways to treat it and one is stretching the urethra as an out patient followed by a catheter as it heals.  I'm going to ask my urologist if that's a option. 

[superabsorbantpolymer]

If you say that to them, they will do a cystoscopy to check for a stricture. Have you had urethral surgery or catheters before? I think it's unlikely you would have developed on without a history of interventions. They won't just take your word for it and put a catheter in for no reason. 

It would be simpler and cheaper to buy some online and put a it in yourself. There's training videos on YouTube for the correct procedure.

[superabsorbantpolymer]

Urologists don't exist to fulfill your fantasies, if you go to them complaining of an issue they will investigate and treat it if they find anything wrong. If you complain of retention you may be instructed on catheterization, but they'll at least investigate and try to find a source. Its very possible they don't find a source (idiopathic is the term for this, and many urological cases are labeled idiopathic) and still treat you with a catheter. But if I were you I'd just say you can't pee and let them handle from there. No offense, but even as a layman, your understanding of urology doesn't seem that great. It's a red flag for doctors if a patient comes in knowing lots of terms and suggesting a treatment for a unlikely diagnosis. 

[pantyman]

I have played with catheters on my own before. Several months ago I had a cystoscope done because of recent bedwetting. But its due to a medicine change from my neurologist. He has done ultra sounds and medicine changes because of it but My urologist hates that I'm okay with wearing protection at night . At this point I'm just going to ask him straight up to recommend a catheter .  I have an enlarged prostrate. Currently have urination issues and am a bed wetter. I think a catheter works for all. The only thing is instead of a leg bag I will wear a diaper.  Problem solved.

[deewet]

The comment you made about urologist's hate for the use of protection certainly rings true for me as well.  When visiting my Doc a few times back, I told him that my day time frequency especially in the morning was becoming worse, and in fact I had several instances of bed wetting as well now, he started me on a course of meds as he suggested they should allow me to avoid the use of the protection I have gone to. 

Well, the first med slowed down my frequency for sure, but when my bladder was full, I needed to be very close to a potty or I would certainly have an accident.  Same thing for the night, it allowed me to sleep through the night, but come morning, as soon as I sat up or stepped out of bed, my full bladder was going to empty.  Even if I could deal with this new urgency, the side effects were not worth it.  I had constant heartburn and upset stomach, and dry mouth all the time. 

At my last appointment, I told my Doc that this was not worth it for the benefit of frequency lowered, and he said we should try a much better med to see how it works but it was expensive, and he would work with my insurance to get it approved.  The med did remove the side effects for sure when I started to take the several weeks of samples he gave me but the insurance would not allow it after several tries.  I could use it, for about $900/month and I said no.  Finally, he suggested other alternative which the insurance said they would approve, but after the first script was filled for 30 days, I went to pick it up and was told it was $589/ for the month after insurance, and I said NO.

Why don't these docs understand that when you are in your mid 70's, wearing protection products that work every time and add peace of mind are well worth the cost they have which is a fraction of any meds that may have other impacts to your health as well???

 

[deewet]

I was going to avoid offering specefic info about my situation, but since you asked in such a nice fashion, I feel compeled to answer.   First , I will say that as a Mn resident, I am using the home founded insurance provider for my Medicare Advantage plan.

My wife is in full support of my use of protection, as I made a promise to her some time back to protect our bed at night after my first accident in bed, and she helped me find the day time pads that I use that work the best. 

My Urologist started me on the "prefered drug" that my insurance covers, that was Oxybutunal ER and that was what was causing me the upset stomach and dry mouth which I put up with for several months, going on and off the meds to prove the symptoms were caused by that only which I was able to do prior to complaining to my urologist again.  I told him at that point, the side effects were not worth the benefit I was getting.   He than told me about the best drug he has found, something with no side effects, a drug called Gemtesa which he offered me more than a months worth of samples to try, as he said it was expensive (1000/mo)and he would have to do some forms for the insurance to cover it.  He was right, the side effects were nonexistent and the drug was working as planned with my frequency, but as I mentioned prior, when my bladder got filled, I had to find a potty in a hurry!   The Urologist did his job and sent in the skript, filled out the paperwork and the insurance came back with first denial, telling us to use the first drug with all the side effects!  A second appeal was lodged with another form, and the insurance co came back with another letter, telling us that we had to try at least one other drug prior to them allowing the use of the one that worked.  

My doc reviewed the list provided, Myrbetriq, Solifenacin, and Tolterodine ER and due to my other medical concerns, chose the last one, and wrote the script.  

My suprise when I went to get it and found that even "approved" by my insurance, it was costing almost $600/mo for me to use, so I said NO

Bottom line, its not the docs that are at fault here, its the govt sponsored so called insurance that is the issue as prior to my retirement, my company medical insurance had coverage for everything needed by my medical team, and my company copay was a fraction of what I have to pay now for my lifetime paid for government health coverage that picks and chooses what it is willing to pay for.

So people, think twice about what you want your government to do for you, as they don't care about your best interests when it comes to health care for sure if you are older and have already paid more than your share over the course of your 50 years of hard work!!!

[jeremy12312]

1 hour ago, mirrored said:

I'd love to hear their justification for so many denials of these medications and why they make us fight for it.

It's a business for them.  If they pay more in benefits than they take in with premiums, then they lose money.  So they make it as hard to get the revolutionary, new (expensive) treatments as they can.  

For government-sponsored health plans, Medicaid and Medicare are already the 2nd largest national expense behind defense.  I'm entirely for socialized medicine, but a lot of people don't want that kind of tax burden.

[zzyzx]

14 hours ago, mirrored said:

Thanks for sharing your experience, its very insightful. I just started a trial of the oxybutynin ER too, but I'm hoping for some good results from it. I wouldn't be quick to blame government insurance here, as I've had the same experience with my private employer provided insurance. I know that these guys who manage these plans are cheapskates but I'd love to hear their justification for so many denials of these medications and why they make us fight for it. I wish some of these guys denying these claims would experience the symptoms we do for a day and see how it feels! 

Medical insurance coverage of some of these drugs gets interesting, even under employer plans...

I was on a long term trial run of Mybetric.  I got a 3 month trial followed by a 1 year planned trial.  At first my employer plan covered the drug with just the "normal" co-pay (at the most expensive co-pay level).  When the next year's company insurance plan showed up they changed their drug plan to a new 4-tier formulary (vs the previous 3-tier formulary).  If the drug had been covered under the new plan, my costs would have gone up significantly.  However the new plan also did NOT cover Mybetric under the plan's forulary, leaving me to pay the entire cost if I wanted it.  And the drug was over $1000 under Good Rx for a 90 day prescription.  I opted to cut the experiment short and not get the final refill.  While I was seeing some good affects from the drug for what I was working on, it didn't fully address the root problem, so what's the point of taking it when I still would have needed (heavy) diapers at night....  According to my Urologist, Mybetric was covered under Medicare's part D drug coverage....  Something in me suspects if I was doing things that way I would quickly blow through the plans doughnut hole in drug cost coverage....  And two other drugs the Urologist had previously prescribed I told him I was not refilling due to side affects....

[kittyfur]

Quote

So people, think twice about what you want your government to do for you, as they don't care about your best interests

You said you are on a Medicare Advantage plan, which means you opted out of government coverage and bought private health insurance instead. So you can blame the private company you signed up with for your Medicare Part C plan.

I'm not criticizing you, I know Medicare Advantage has a lower premium. But poor coverage is what you get for the savings.

I hate that medicare has the "Advantage" option that locks you into a private company that just wants to profit off you. You may still be able to switch to Medicare Part A/B/D and be fully on the government plan. The premiums cost more but the coverage may be better. I've read articles recently about how Advantage plans often don't let you see your preferred doctors and will avoid it when my time comes to sign up for Medicare.

[WBxx]

12 hours ago, kittyfur said:

You said you are on a Medicare Advantage plan, which means you opted out of government coverage and bought private health insurance instead. So you can blame the private company you signed up with for your Medicare Part C plan.

I'm not criticizing you, I know Medicare Advantage has a lower premium. But poor coverage is what you get for the savings.

I hate that medicare has the "Advantage" option that locks you into a private company that just wants to profit off you. You may still be able to switch to Medicare Part A/B/D and be fully on the government plan. The premiums cost more but the coverage may be better. I've read articles recently about how Advantage plans often don't let you see your preferred doctors and will avoid it when my time comes to sign up for Medicare.

Not exactly, see –

https://www.medicare.gov/Pubs/pdf/12026-Understanding-Medicare-Advantage-Plans.pdf

[deewet]

In general the coverage is about as expected.  No complaint there.  The problem is the drug coverage, which by the way is modeled after the medicare coverage of drugs IE the drug pricing  and coverage is what medicare recomends, that is the problem.  If a drug is not covered by medicare, or considered a teir 3 drug, so it is in my PartC plan.  That is the concern for me!!

When I was employed and covered by my companies PPO self insured plan using the typical other health plans as trusties to administer that plan, drugs as prescribed were never an issue, there was no tier structure, and I could go to any reffered specalist without any additional fees.  Granted there was a monthly copay, but when I retired and went to medicare originally with a supplement, the monthly copay tripled and coverage fell way off.

Why does the govt involvement always seem to work the same???  It should have been better considering the years of prepayment I contributed, but of course not.

[WBxx]

Additionally, because reimbursement rates are lower under Medicare than company private insurance providers tend to favor their non-Medicare patients.  Reagan was right –

https://www.google.com/search?q=i'm+from+the+government+and+im+here+to+help&rlz=1C1CHBF_enUS869US869&oq=i'm+from+the+g&gs_lcrp=EgZjaHJvbWUqBwgBEAAYgAQyBggAEEUYOTIHCAEQABiABDIKCAIQLhjUAhiABDIKCAMQLhjUAhiABDIKCAQQLhjUAhiABDIHCAUQABiABDIHCAYQLhiABDIHCAcQABiABDIHCAgQLhiABDIHCAkQABiABNIBCTEzODYyajBqN6gCALACAA&sourceid=chrome&ie=UTF-8#fpstate=ive&vld=cid:ed4f4c3f,vid:nCedOQJ0ZEA,st:0

[WBxx]

As for Medicare Advantage, since retiring I’ve tried both traditional Medicare (without a supplement) and a zero premium Advantage (Aetna).  So far I prefer Advantage in that it’s proven easier to use and in total cheaper than traditional Medicare.  Both fall far short of my pre-retirement company sponsored PPO.

[jeremy12312]

OK, Boomer.

[rusty pins]

Tell the truth.  There is no way anyone can fool a doctor, especially a specialist unless they are one themselves.  Also don't try and fool an insurance company with a false claim.  That is fraud and could land you in big trouble.  Also think of this - if you do get caught submitting a false claim for a condition that doesn't exist, there is no way any public defender or lawyer you hire will be equal enough to go against a team of corporate lawyers and win.  It may be embarrassing for you, and a urologist may refuse your request, but being honest as to why you want catheters is the best all around approach if you just can't get them on line or through a medical supply company yourself.  Read up on them first to make sure you are aware of all risks so you don't do irreparable damage to yourself. 

[SunOfSheep]

It's unlikely any urologist would recommend long term catheterization without a very good reason. Catheters cause infections, and can be uncomfortable to many people.

I've had a catheter before when I was younger, for around 6 months, I wasn't in the best of health at the time and even then I remember how uncomfortable it was at times.

 

If this is something you actually want to do, id highly recommend researching how to do it yourself, practice sterile fields, buy the stuff you need online allegro medical and many other sources will let you purchase them without any questions.

 

Having a catheter in is far more serious than most people in this community seem to actually rationalize. What's your plan for when an infection happens? (Not an if but when, when going long term) Along with possible complications often times it's just not worth it 

[~Brian~]

On 4/3/2024 at 6:49 AM, deewet said:

Why don't these docs understand that when you are in your mid 70's, wearing protection products that work every time and add peace of mind are well worth the cost they have which is a fraction of any meds that may have other impacts to your health as well???

@deewet

I don't understand that either:  Most people that deal with incontinence have probably decided that the best way to handle it is the way that you are handling it.  Truth be Told, I'd rather have Medicaid in Vermont Pay $400 a month for Diapers for me,  than try medicines that would cause bad side effects, like heartburn, dry mouth, etc - and cost hundreds and thousands of dollars AFTER insurance:  Wearing Diapers is  cheaper, and I am NOT taking any more meds than I have to because I NEED it:  $227 is I believe what they pay for them whenever I order, so as long as the state is willing to pay for that, I'm not changing what I do, as it works well for me.  The State KNOWS I need them for IC. so they said I would NEVER have to worry about it again, because, having severe incontinence BOTH ways, plastic backed diapers that last as long as possible are what i need, and the doctor and medicaid knows I need them, and they said if they found the  products that work for ME, that they would not change it, but they TRIED to do that to me last summer, but I was able to talk to someone at the state, and they kept the pricing contract I use, and I can continue to use what works, as I proved that I need what I need, and what they Did was work with ActivStyle, and they, as well as ANY other company have CLOTH BACKED diapers that are TRASH, and I've Tried every one of them (Cloth backed products that are made, from EVERY company) and they don't work for me!

Hell:  I'm 51, and I've dealt with incontinence on and off since I was born:  My brother Richard was disabled, non verbal, and non mobile, and was disabled as a result of an accident that my parents had when they were going somewhere.  Mom was holding him in her lap, and he and Dad went through the windshield.  Dad was seriously injured as a result of the accident, and mom and Grammy and Grampa took care of him as he  healed at home.  So, because of Richard's accident he was disabled, and had to wear diapers for the rest of his life, so I and my family know about them, and have used them as needed:  I am glad I have the Megamaxes, and I am NOT gonna get railroaded into cheaper products:  Plastic Backed Diapers have absorbancy and CAPACITY and ODOR Control, and when I TRIED the cheap Cloth backed stuff, I might just as well NOT use a diaper and PEE and MESS all over the floor:  additionally the diapers that I had to try were sub par, did not have much capacity or odor control, and my skin was irritated because the diaper gave off a foul smell and was FLOODED when I used it, and that wasn't my fault - I use diapers, not Bounty Paper Towels with Tabs!

At least with my Megamaxes, I can be ASSURED that I CAN use them as INTENDED for #1, #2 and #3:  and the padding can take it, and if I have a messy accident the Northshore's HOLD for me until I can get home and change. 

For the Record:  I have Medicare Parts A, B, and D, and I can't Apparently GET Part C.  First and foremost, they said that it would make my medical costs increase, and I don't have to do any copays unless it's meds or dental services, and that costs me $3/visit - Second, I would end up NOT being able to get the VISION coverage i need, as my Eye Doctor is NOT in the network that accepts the plan that they wanted to sell me, but my next set of glasses will cost me $300, so I don't know how I am gonna be able to get my new ones when I need to.

Insurance Companies decide what they cover and what they will not cover:  The problem is that some decisions are not based on the person's NEED of the products or services:  Decisions are based on COST and if it costs  them $500 for something you need, and they can get away with paying $50, they are gonna DENY the claim at $500, and "cheap out", and I would be surprised if the Insurance Company denials they throw at you DID NOT CAUSE the death of someone - Insurance is always trying to spend the LEAST that they CAN and HAVE to, because that saves them money, when some products you may need may COST HIGHER, and for that, you need to ask for a waiver or whatever they call a Prior Auth for the services you NEED - I think my doctor can Justify what I use, so I'm not as worried, but one of these days theur decision will cause harm to the insured party, and then it will be hell for him/her and the families dealing with the medical needs of the insured:  Sometimes I think Private insurance is a RIPOFF - and the State can say "We don't cover this or that anymore.......due to Medicaid rules", and then they tell me to go read it, and it's TECHNICAL, wordy, and makes NO sense

On 4/4/2024 at 7:45 AM, deewet said:

Bottom line, its not the docs that are at fault here, its the govt sponsored so called insurance that is the issue as prior to my retirement, my company medical insurance had coverage for everything needed by my medical team, and my company copay was a fraction of what I have to pay now for my lifetime paid for government health coverage that picks and chooses what it is willing to pay for.

So people, think twice about what you want your government to do for you, as they don't care about your best interests when it comes to health care for sure if you are older and have already paid more than your share over the course of your 50 years of hard work!!!

That is the problem nowadays:  We hear that the Government "takes care of" those that are/were Veterans, and they say that they can get what they may need if you go to the V A - Truth is, I HIGHLY doubt that we do ENOUGH to help or Veterans, and people that need the healthcare coverage, or those that are disabled or elderly:  WE NEED to do MORE for those that are vulnerable, as they can't afford to pay for a lot of things, and Veterans and their families should be able to be covered as well, and if a Veteran serves our country, and DIES, the government should be able to help the spouse of a Veteran:  That's only fair in my opinion:  You help the spouse and family

Brian