Supplies

Just some bags, right?

Here are the supplies we found most people like:
1) Daytime strap-on leg bags- Uresil TC600 w/20″tube, or TC600L w/36″tube
2) Overnight Hanging bags- Bardia 2000ml (we modify the hanger)
3) Dressings- SorbaView SHIELD SV353UDT medium
4) Disinfectant- ChloraPrep Clear 3ml Applicator
5) Cleaner- Alcohol Prep Pads– Covidian Webcol Large 2ply
6) Adhesive remover pads- Smith & Nephew
7) Skin prep- AllKare Protective barrier wipe
8) Shower Barrier- Aqua Guard 7″x7″
9) Gloves- for dressing changes
10) Red Cap/Plug– Braun R2000 Red Cap
11) 0.9% Sodium Chloride Injection syringe

How many Bags do I want, how many do I need?

This is a tough question for a few reasons.
1) The best practice, is to be able to change the bags every day, but fewer times also works.
2) Bags can get very expensive, very quickly.
3) Are you paying for them out of your pocket? Or is Insurance.
4) How many will insurance pay for?
5) How soon do they get stinky.

These considerations will dictate how many you use. It’s nice to be able to change them daily. But the reality may not follow the ideal. I read a product review from “Rich” complaining that “a specific bag” was no good “it starts to leak after only 1 month”. Hopefully, we can change bags more frequently than Rich.

Insurance

If insurance is going to pay, you may figure you have it made. Think again.

Two dynamics come into play here. First, you have to find a Nephrostomy supplier that takes insurance, surprise, they are few and far between. Second, your insurance company will have “some” guidelines on what they pay for. Nephrostomy supplies are not a popular supply, even among medical supplies, suppliers.

Here is a story from one user that will give you some insight on what it takes to successfully work with your Insurance Company, and the Supplier and how to get your needs met:

“I have bilateral (both kidneys) Nephrostomy tubes in place. Based on my hospital discharge, my Insurance Company approved me for 5 bags per month. I called the insurance company several times thinking this was ridiculous, having two kidneys involved it should at least be 6 bags (even number). The people I talked to always agreed with me, but nothing changed. I also complained to the Supplier to advocate on my behalf, again I got nowhere.

In June I got a Nurse Case Manager from my Insurance Company, and explained to her my situation.

She did some behind-the-scenes work and told me that I was actually approved for daily bag changes, for each kidney, plus extras. This allowed amount was over 60 bags/month! I asked my urologist to write me the prescription for these quantities, which he did, all this was sent to the Supplier.

End of story right? No such luck.

The Supplier, didn’t like the way the prescriptions were written, So I had to have the urologist re-write one prescription for 32 bags for each kidney, left and right. Then the Supplier didn’t like the way that was written. They needed the urologist to write two separate prescriptions, one for the left kidney, one for the right kidney.

Once we got that done, it went into the Supplier’s review process.

Keep in mind, we have the prescription from the doctor for the full amount, we have the insurance company case manager in touch with the supplier, verifying that the insurance has approved the full amount, and it still took SIX MONTHS for the Supplier to finally start sending the prescribed, approved quantity of supplies.”

The take-away is, Get A Nurse Case Manager!

Whereas Insurance should be paying for, and sometimes IS willing to pay for some of the other peripheral supplies listed above, we haven’t found too many suppliers that take insurance, or ones that aren’t a PITA (read: difficult) to deal with. It’s usually easier to just pay out of pocket for the other supplies. If that’s not ideal, and your insurance will pay for them, ask your Nurse Case Manager to help set it up with a Supplier they work with.

Out of Pocket

If you are going to be paying out of pocket, the question can move from, “How many do I want” to “How many do I need”, even to “How many do I think I can live with?” That’s going to be your own personal financial decision, somewhere between the ideal, and “Rich”.

Here are some Nephrostomy user ideas for getting by with fewer bags, when situational reality and medical guidelines don’t quite meet.

1) Wash your hands before handling open ends of tubes
2) Keep your equipment clean
3) Do not over tighten or over loosen the drain on the bag, just snug both ways
4) When disconnecting/reconnecting bags always sterilize with an alcohol pad, wipe well!
5) Always place Red Cap/Plug, on male Luer Locks of bags not in use

Bags will last longer if not allowed to become overfilled before draining, drain at 1/2 to 3/4 full. Switching to overnight, large volume bags will keep you from stressing your day bags, thru overnight use.