In this issue: What is a nephrostomy? Kidney stones/renal colic Welcome to Whizz Kidz Affinity News Issue 15 – Summer 2024 Member of the
Welcome from our Director 3 Tayla update 3 What is a nephrostomy? 4 Caulifl ower fried rice recipe 8 The team at Manfred Sauer 9 Kidney stones/renal colic 10 Welcome to Whizz Kidz 12 Summer word search 14 Free Home Delivery Service 15 We would love to hear from you 16 Inside this issue Nephrostomy catheter Drainage tube 12 10 8 Nephrostomy catheter 4 This yearʼs charity is
We are delighted to announce that as of3 June 2024, Tayla will be taking on the position of Helpline Advisor here at Manfred Sauer UK. Many of you may well have spoken to Tayla already as she has been working as part of our dispensing team for the last year. We feel sure that the knowledge and experience she has accrued in that role, as well as time spent previously as a Healthcare Assistant, will put her in a great position to manage the helpline effi ciently and support the many people who call in for advice and samples. We wish Tayla every success in her new role. Tayla Trigg Helpline Advisor Dear reader Welcome to our Summer 2024 edition of Affi nity News. We are halfway through the year already! I can’t believe it, where has the time gone? I do hope the Summer is fi lled with bright sunny days, so we can all get out in our gardens or visit local parks and enjoy time with family and friends, following a damp and wet Spring. This edition is all about kidneys. Kidney Week is from 11-13 June so we thought we would include articles about Kidney Stones and Nephrostomies in this edition. This also coincides with the Kidney Week conference which Manfred Sauer will be attending in Edinburgh. COMING SOON! Watch this space. we are soon to launch our new website, which will have an ‘online order facility’ for you to request your prescription items through Manfred Sauer Care. We hope that you will fi nd this feature helpful and convenient. Please don’t forget to submit your useful hints and tips, along with stories or suggestions for future articles you would like to see in our newsletter. I hope you enjoy reading this edition of Affi nity News. Kindest regards, Kim Taylor Director & General Manager Issue 15 – Summer 2024 3 Affi nity News
Nephrostomy catheter Drainage tube A nephrostomy is an artifi cial opening created between the kidney and the skin which allows urine to be diverted directly from the kidney to an external collection system. It exits the body from the lower back and can be single or bilateral. A nephrostomy tube is a narrow catheter with a pigtail end. It is inserted into the renal pelvis (a funnel-shaped part of the kidney that collects urine) of the kidney to drain urine. A nephrostomy catheter will normally be inserted by an interventional radiologist in the radiology department using ultrasound guidance and will often be stitched in place for security. What is a nephrostomy? Renal pelvis Ureter Kidney stone Distended renal pelvis Weak flow of urine Blocked ureter Normal flow of urine Normal Kidney Hydronephrosis Why a nephrostomy? A nephrostomy is inserted when there is a need to bypass the normal route urine would take. This could be due to a blockage or obstruction caused by stones, tumours or stenosis (narrowing). It could also be due to acute renal failure, renal or ureteral trauma, ureteral fi ssure or fi stula, or herniation of a urostomy. The aim of a nephrostomy is to preserve the kidneys and their function. Left untreated, this would lead to hydronephrosis (a condition where one or both kidneys become stretched and swollen because of a build-up of urine inside them) and long-term damage to the kidneys and urinary system. The aim of a nephrostomy is to re-establish kidney function and reduce pressure within the kidney. The length of time a nephrostomy catheter is in place will be dependent upon the reason it was fi tted. It may be permanent, or temporary while waiting for a stent insertion (a thin tube inserted into the ureters to open the passage and allow urine to properly drain from the kidneys), treatment or improvement in kidney function. If the nephrostomy does turn out to be permanent, the nephrostomy catheter will normally be changed every 12 weeks in interventional radiology. 4 Issue 15 – Summer 2024
The procedure: Fixation device A nephrostomy is usually fi tted in the radiology department under ultrasound guidance. The patient lies fl at or nearly fl at on their stomach. Sedatives and painkillers may be given and covering antibiotics are administered in some departments if required. The interventional radiologist uses ultrasound to fi nd the best place in the back to access the kidney and insert the catheter. Following local anaesthetic, a fi ne needle is then inserted into the kidney and, once correctly positioned, a guidewire is passed and the needle is then removed. The nephrostomy catheter is then threaded over the guidewire into the kidney. The nephrostomy catheter is sometimes sutured to the skin and a drainage bag is then attached. The procedure normally takes about 20 minutes, but in some cases may take longer. It is vital that the nephrostomy catheter is secured to the skin to minimise any risk of pulling and to optimise comfort. The catheter will normally be secured with a fi xation device such as DrainGuard, Grip-Lok, Skater Fix etc. The site and fi xation device will then be covered and protected with a waterproof dressing such as a Tegaderm, Clearfi lm or similar. The fi xation device should be checked and changed weekly. Wound care The initial dressing changes will be done by the district/practice nurse and, in time, some patients' carers/ relatives can be taught how to change the dressings and bags. When changing the dressings, you should wash hands and prepare all equipment. Apply sterile gloves and, using adhesive remover, gently remove the old dressing and security device taking care not to pull on the catheter. Wash hands again and apply new sterile gloves. Clean the entry site with sterile 0.9% saline and sterile gauze, dry thoroughly before applying a new fi xation device and showerproof dressing. This should be done every seven days. Issue 15 – Summer 2024 5 Affi nity News
Drainage options: NephSys – a nephrostomy drainage system from Manfred Sauer that has a luer lock and connects directly to the nephrostomy catheter and can be worn on a belt around the waist. Pouch System – a stoma pouch that fi ts directly to the skin and contains the nephrostomy catheter. Drainage Bags – various tube lengths and capacities, often requiring an adaptor to connect to the luer lock. Manufacturers of nephrostomy bags: Manfred Sauer, LINC Medical, GTA Medical, Argon Medical Devices, Nephrostomy UK. Nephrostomy bag changes It is recommended that the nephrostomy drainage bag is changed every fi ve to seven days and is usually done at the same time as the dressing changes. This is a sterile procedure. If using a urostomy pouch, changes will be more frequent. Flushing the nephrostomy catheter: Equipment needed: ● Sterile dressing pack ● 10mls luer lock syringe ● 10mls sterile normal saline or a pre-fi lled 10mls syringe ● Alcohol wipe ● New drainage bag Hopefully, the nephrostomy will continue to drain freely for the duration. However, sometimes the catheters can become blocked and may need fl ushing. This will usually be done by a suitably trained healthcare professional. Check the tubing and bag and make sure there are no kinks that could be causing the problem. If there is a physical obstruction that can be easily resolved a fl ush, will not be necessary. If the tube seems to be prone to blocking on a regular basis, then it may require fl ushing more frequently. This would only be done with the approval of the consultant in charge of your overall care. Procedure: 1. Wash hands, open pack and prepare equipment. 2. Draw saline into syringe if you do not have a pre-fi lled one available. 3. Apply sterile gloves. 4. Remove drainage bag. 5. Wipe the port with the alcohol wipe and allow to dry. 6. Use gentle, even pressure and instil 5-10mls saline into the nephrostomy tube. 7. DO NOT use force – if the saline will not go in STOP! Seek medical advice at this point. 8. Allow saline and urine to drain out of the tube naturally and DO NOT pull on the syringe. 9. Fit a new sterile drainage bag. 6 Issue 15 – Summer 2024
Fluid intake Encourage two litres intake daily unless otherwise instructed due to cardiac or renal impairment. Urine should be a light straw colour if well hydrated. Encourage plenty of water or diluted cordial. Avoid excessive amounts of caff eine. Infection When to seek help: ● Blood in the urine ● Signs of a UTI ● The catheter becomes uncomfortable or painful ● Signs of swelling or redness around the catheter entry site ● Urine fails to drain ● The catheter falls out ● Non-drainage Anyone with a nephrostomy catheter in place is at risk of infection and it’s important to be aware of the signs and symptoms of infection: ● Loin pain ● High temperature ● Fever/shivers ● Thick, smelly urine ● Lower urine output ● Redness and/or swelling around catheter site ● Increased pain around the catheter site ● Discharge where the catheter enters the body Contact us Please see useful links below: https://online.anyfl ip.com/eams/lpcd/mobile/index.html The Care and Management of your Nephrostomy https://online.anyfl ip.com/eams/btbj/mobile/index.html Nephrostomy Passport www If you require any further advice or support with your nephrostomy then please call our Helpline 01604 595 696 Target range – correct volumes of fl uid Severely dehydrated – MUST drink more Dehydrated – increase your fl uid intake 1 6 3 8 2 7 4 5 ● Strict hand hygiene before and after touching the nephrostomy catheter. ● Keep site completely dry for the fi rst 48 hours post insertion. ● After 48 hours, the patient can shower but site must be covered/protected; use showerproof dressings. ● No swimming or bathing. ● Change dressings if they get wet, dirty/soiled. ● Check and change fi xation device and dressings weekly. ● Clean site with sterile saline. ● Empty drainage bag when ½ to ¾ full to avoid tension/pulling. ● Change drainage bag weekly and encourage use of a night bag if required. General advice Issue 15 – Summer 2024 7 Affi nity News
Caulifl ower fried rice Prep time: 20mins Cook time: 20mins Ingredients: 1/2 large head caulifl ower 2 tbsp vegetable oil 1 orange pepper, cut into thin 1/2" pieces 1 scallion/green onion, thinly sliced 1 2” piece ginger, cut into thin matchsticks 2 tbsp low-sodium soy sauce 2 tsp chilli garlic paste 2 tsp honey 4 large eggs 1 cup frozen peas, thawed 1 cup frozen edamame beans, thawed Lime wedges, for serving Method: 1. Cut the caulifl ower into fl orets, discarding the tough inner core and leaves. Working in batches, transfer the caulifl ower to the bowl of a food processor. Pulse until the caulifl ower resembles rice, about 15 seconds (be careful not to over-process or caulifl ower will get mushy). Set aside, then repeat with the remaining caulifl ower (you should have about four cups of caulifl ower). 2. Heat 1 tablespoon of oil in a large cast-iron skillet over medium-high heat. Add the pepper, the white parts of the scallion, and the ginger; cook, stirring for two minutes. Add the caulifl ower, toss to combine and cook, cover, stirring once, for fi ve minutes. 3. Meanwhile, in a small bowl, whisk together the soy sauce, chilli garlic paste, and honey. In a separate small bowl, lightly beat the eggs. Push the caulifl ower mixture to one side of the skillet, add the remaining one tablespoon of oil, then the eggs, scrambling for about two minutes until cooked. 4. Remove the skillet from the heat and fold in the eggs, sauce, peas, and edamame beans. Serve with thinly sliced scallion/green onion and lime wedges. Serves 4 08 Issue 15 – Summer 2024
The team at Manfred Sauer To speak to a member of the team, please contact the helpline on: 01604 595 696 [email protected] Aga Leskiewicz Terri Dolbey Janine Starkey Craig Smith Laura Johnston Carol Hutchings Carolyne Tobin Tracy Reed Steve Marriott Tayla Trigg Ashleen Filer-Hobbs Tom Rust Jason Tate Andrew Harrison Affi nity News Issue 15 – Summer 2024 09
When Carolyne worked in the urology department of her local hospital, she noticed each year during the summer holidaymaker season (‘grockle’ season as it’s known in her area) the rate of emergency admissions with renal colic would rise considerably. So, as we are now in ‘grockle’ season we thought a brief piece about this subject might help to reduce the incidence of suff erers. Firstly, let’s talk about the kidneys They are fi st-sized organs situated either side of your spine under your lower rib cage. Their job is to control the body's fl uid and chemical levels. They remove fl uid and waste products from the bloodstream to produce urine which travels down the ureters into the bladder. This is then excreted via the urethra. The kidneys control the levels of sodium, calcium and potassium in the blood. Urine contains dissolved minerals and salts. Elevated levels of these can form stones. What are kidney stones made of? ● Calcium stones are most common (80%) Too much calcium in the urine will produce kidney stones. ● Uric Stones (5-10%) Uric acid is a waste product from chemical changes in the body. Uric acid crystals don’t dissolve in acidic urine and will form stones. Causes: Being overweight, chronic diarrhoea, Type 2 diabetes, gout, a diet high in animal protein and low in fruit and vegetables. ● Struvite/Infection Stones (10%) Related to chronic urinary tract infections. Common in people with indwelling catheters. Bacteria makes urine less acidic and more alkaline. Struvite (magnesium ammonium phosphate) stones form in alkaline urine. These stones tend to grow fast. Causes of kidney stones/renal colic Dehydration. If a person doesn’t drink enough there is less fl uid to keep salts dissolved. This is why holidaymakers are more prone to it during the warm weather! Kidney stones/renal colic Causes: Being overweight, chronic diarrhoea, Type 2 diabetes, gout, a diet high in animal protein 10 Issue 15 – Summer 2024
Diet ● Studies show restricting dietary calcium can be bad for bone health and increase the risk of stone formation. Instead of lowering calcium intake, the salt intake should be reduced. Salt in the urine prevents calcium from being reabsorbed from the urine to the blood. ● Low salt = low calcium in the urine. ● A diet high in animal proteins can increase acid levels. High acid levels = calcium oxalate and ureteric stones. Bowel conditions ● Conditions that cause diarrhoea such as Crohn’s disease or ulcerative colitis, also gastric bypass surgery, increase the risk of forming calcium oxalate stones. ● Diarrhoea = loss of large volume of fl uid = low urine volume = less fl uid to keep salts dissolved. Obesity ● Obesity changes acid levels in the urine = stones form. Medical conditions ● Parathyroid glands control calcium metabolism. ● Increased calcium levels in the blood and urine = stone formation. Medications ● Calcium and Vitamin C supplements can cause stones. Family history ● There appears to be a family connection if a parent or siblings suff er. Diagnosis Often seen on an X-ray, CT scan or IVP (X-ray with dye) during investigations into blood in the urine or renal colic pain. Symptoms ● Sharp, cramping intermittent pains in the back, sides and abdomen/groin. Caused by the stone moving down the urinary tract. ● Intense need to urinate. ● Blood in the urine. ● Nausea and vomiting. ● Pain in the tip of the penis. Treatments Treatment depends on the size, type and position of the stone. Consideration is also given to the symptoms and length of time of the symptoms. ● Watch and wait. Small stones are more likely to pass without intervention. If the symptoms are bearable, the kidneys are not blocked and there is no infection a wait of approximately six weeks can be advised. ● Medication. A medication called Tamsulosin is often prescribed along with analgesics (painkillers) to help with the passing of the stone naturally. ● Surgery. If the kidney is blocked, a stent may be inserted to help the kidney drain and dilate the collapsed ureter beneath the stone. There are three diff erent types: 1. Ureteroscopy and stone extraction – a procedure to look up the ureter and remove the stone using a scope. 2. Lithotripsy (ESWL) – Shockwave treatment. Non-invasive treatment where shockwaves break the stone into passable stone fragments. 3. Percutaneous Nephrolithotomy (PCNL). The stone is removed under ultrasound guidance through an opening in the skin. Please note that with the surgical option, there is a 50% risk of forming another kidney stone within fi ve to seven years. Ways to reduce your risk of kidney stones ● Drink enough to make your urine a pale straw colour. (Please see page 7 regarding fl uid intake information.) ● Increase the amount of fruit and veg in your diet as this makes urine less acidic. ● Reduce the amount of salt in your diet. ● Try to keep to a 'normal' weight but avoid using high protein or crash diets. ● There is insuffi cient published evidence to support the use of herbal substances. Drink enough to make your (Please see page 7 regarding Issue 15 – Summer 2024 11 Affi nity News
Welcome to Whizz Kidz! Manfred Sauer UK’s charity for 2024 Thank you for choosing to support Whizz Kidz. Your donation will help more young people across the UK get the wheelchairs, support and opportunities they need to go further in life. The difference you will make There are over 75,000 young people in the UK who need to use a wheelchair to be mobile. Unfortunately, they cannot access the equipment that fully meets their needs through local services. At Whizz Kidz, we want to build a society in which all young wheelchair users are mobile, enabled and included. With help from supporters like you, we can provide high-quality wheelchairs and mobility equipment tailored to each child’s needs. We also deliver training, fun activity programmes, social events and employability services, enabling young people to develop independence, skills and confidence. We campaign for a fairer and more inclusive society for young wheelchair users and their families – but we need your help. Your support will allow us to continue our vital work and reach even more young people – thank you. 12 Issue 15 – Summer 2024 www.whizz-kidz.org.uk
To donate please scan the QR code or visit: Alternatively, donate directly to Whizz Kidz at: secure.whizz-kidz.org.uk/public/index.aspx or by calling 020 7789 6111 to pay using a credit or debit card. www.justgiving.com/page/manfred-sauer-1707820333157 © Whizz Kidz 2023. Registered charity in England and Wales (802872) and Scotland (SC042607). Company registered in England and Wales (2444520) Affi nity News Issue 15 – Summer 2024 13
For the chance to win a £20 voucher all you need to do is complete our Summer word search. Then identify the missing word and send your entry, along with your name and address to: Newsletter Word Search Manfred Sauer UK Unit 3, The IO Centre, Barn Way, Lodge Farm Northampton NN5 7UW OR Email: [email protected] Competition closes Friday 2 August 2024, T&Cs apply, please see below. Summer word search HEAT RELAX SANDCASTLE SEA OUTDOORS BERRIES SANDALS SUNNY SUNFLOWER WATERMELON TRIP GARDENING Prize Draw Rules 1. No purchase necessary. 2. The closing date for entries is Friday 2 August 2024. The winner will receive a £20 voucher. 3. The winner will be notifi ed in writing. 4. Entry to the prize draw is free and open to residents of the UK aged 18 and over. 5. Only one entry per person. 6. Employees of Manfred Sauer and their families are not eligible to enter the draw. 7. The winner’s name and county will be available after the closing date by writing to Manfred Sauer. 8. Entry to the prize draw is deemed to be acceptance of these rules. 9. Manfred Sauer reserves the right to amend these rules or withdraw the prize draw at any time without notice if events or circumstances occur outside the control of Manfred Sauer which makes this necessary. 10. The prize draw from all correct entries will take place on Monday 5 August 2024. Win a £20 voucher Answers will be published in the next issue. Spring issue word search solutions Missing word was FRESH Spring2024 Solve the following puzzle by finding all the hidden words! O G I A R I T A L R T O A P L P A A E C A L R K G P E H N N R C P H B C I N N I E T R N A E N W R T Y E T A T L E U P G T U R E C O B E E N C O E T P S I L B E T N E I A I D T C K H B O B U N E C B N B L R T S R O N F N E U B T P N E E B L N R B T S C E G U S C L N E S T C E A N L B A M C O G N H R E R N L G A B L S H E O I R E I L I W O F A F B B E A I T N O L I S L N H R R N P S S A P L I N G G I R M Y A C S L L E B E U L B D N P Y P H C T A H A N O K G N I L D E E S W H D U C B U O E L B U P I S O H G B A R I B L N O G N N U O C T L R M A Y P O L E E E A L L R L L U E W E C B L A R L P A C A N B L O G A Y N N D N N E E G R B D E L M H E G O A N N O T B L N U R U E G L N F S T E T T A M E E G P I L N F L E S Words List BLOOMING MAYPOLE BLUEBELLS BUTTERFLY CROCUS NEST GREEN HATCH GARDEN PLANT RAINBOW SEEDLING SAPLING NECTAR CHICKS Summer24 Solve the following puzzle by finding all the hidden words! S R N N R E S N R S R R T T U W E L N L S T G O X R A H A A E S T R L T U R S L G I R L R E A D S L O E N S A L L U C D H S A E O D E A L D I I R A T S E E N O D E S M L L S M A W R R E T W T U R L E A C L R D A N N N T T R E T A F W O N R G A S E S S X X R E T E A E R E E L A P D S M T A E A O S E A B H F E E D S E A E N O A T X E S A E U E E T E L E X S O M D S W R E W O L F N U S S E A G I A D A C E O I E S S T A E L T S A C D N A S U L O F P U E E O S D H I S D O D F N A G R E T A R S L X D G N S S D L W S R O S N O O U T D O O R S G A R D E N I N G N L A O A E E L X C A E S S E O S H I E Words List HEAT RELAX SANDCASTLE SEA OUTDOORS BERRIES SANDALS SUNFLOWER WATERMELON TRIP GARDENING Summer word search Name: Phone no: Missing word: Address: Postcode: 14 Issue 15 – Summer 2024
To join, please contact: FREEPHONE 0800 999 5596 [email protected] Please have the following information to hand: Name, address and telephone number Date of birth NHS number GP name, address and telephone number Product reference Prescription exemption status (if known) Wash bag containing ‘Just Can’t Wait’ card are available with fi rst order only. Radar key available on request. Complimentary items are available with every order. Free Home Delivery Service Join our Free Home Delivery Service and enjoy the benefi ts We supply all makes of urology, stoma and wound care products 20 years’ experience and knowledge in dispensing medical devices. Swift, effi cient and discreet delivery, on a day that suits you. Personalised product customisation. Electronic Prescription Service (EPS) and postal prescriptions welcome. Our Standing Order Service takes the headache out of remembering to place regular orders. Affi nity News Issue 15 – Summer 2024 15
Manfred Sauer UK, Unit 3, The IO Centre, Barn Way, Lodge Farm Industrial Estate, Northampton NN5 7UW Telephone: Prescriptions: 0800 999 5596 Helpline for advice and samples: 01604 595 696 Email: [email protected] [email protected] [email protected] We would love to hear from you We value each and every one of our customers, therefore, any suggestions for our next edition of Affinity News would be welcome. You can send them via email to: [email protected] or pop them in the post to the address below.