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Dialysis Discussion => Dialysis: Home Dialysis => Topic started by: rookiegirl on December 30, 2008, 05:38:10 PM

Title: Exit Site Panic
Post by: rookiegirl on December 30, 2008, 05:38:10 PM
Last night when I was cleaning my exit site, I noticed a small scab around my PD cath.  I haven't seen a scab around the cath in over 1 year since they placed it.  So I did the press check like they do at the Dialysis Clinic.  When I press down, I noticed some moisture around the cath.  So I took some gauze to wipe lightly.  There was pinkish color on the gauze.  It wasn't  a lot and it didn't hurt.  I started to worry thinking it has to be an exit site infection.  I'm beating my head  :banghead; trying to figure out, how on earth did I make the mistake and infected my site.  I'm always so careful about my hygiene and such.  So, after the panic attack, I cleaned the area as norm and used Gentamacin cream.

This morning around 8:00am, I called the clinic and told them what I noticed last night.  They told me I needed to come in ASAP so they can examine the exit site.  I live an hour away from the clinic.  So I called work told them I would be late and headed to the clinic with my husband.  When I got to the clinic, the nurse did the press check and no drainage was coming out.  Only thing she saw was the scab.  She said it didn't look infected, but she wanted to call my Neph to see if he wants to put me on antibiotics.  So my Neph prescribed Cephalexin just to be on the safe side.  I have to take the antibiotics 4X/day for 7 days.  The nursed told me it was a trauma on my exit site.

The only thing I can remember that would have contributed to the trauma is work.  A few days a go I had to move to a different office and my job didn't have anyone moved us.  I made sure I didn't lift anything heavy.  I had my co-workers do all the heavy lifting.  But I was up and down, bending and squatting and on my feet a lot.  Could that have done it?  I have no idea how I could have injured my site.  I guess using your stomach muscle bring trauma to the site???? It just doesn't make any sense.

Has anyone been in this situation before?
Title: Re: Exit Site Panic
Post by: Rerun on December 30, 2008, 06:00:05 PM
It makes sense that you could have moved it around too much moving.  I know your were careful, but this is a wake-up call to be even more careful.  Take your antibiotics and call them back if you see more problems. 

I hope and pray you are in the clear.  Rest and take it easy.

                                                                      :waving;
Title: Re: Exit Site Panic
Post by: pelagia on December 30, 2008, 07:19:42 PM
RG - I am completely clueless...sorry.  But I'm sure it must be a scary thing to see that moisture and scab.  I hope the antibiotics end up being only a precaution.  :cuddle;
Title: Re: Exit Site Panic
Post by: peleroja on December 31, 2008, 07:28:55 AM
I routinely had scabs on my exit site, and they always washed off in the shower.  I never even thought to check them with my PD nurse.  I sincerely hope it's nothing serious.
Title: Re: Exit Site Panic
Post by: Ken Shelmerdine on December 31, 2008, 10:19:14 AM
I quite often had an inflamed looking exit site but it was mainly just trauma but always have it checked out just in case.
Title: Re: Exit Site Panic
Post by: george40 on December 31, 2008, 12:41:25 PM
Hi RG, it never hurts to check with your pd nurse. One thing I have learned is the more active I am, the more the exit site can be agitated. I found this out recently when I painted the babies nursery. As far as scabs, they come but never pull them off just let them fall off by themselves. I pray everything works out.
Title: Re: Exit Site Panic
Post by: nursewratchet on December 31, 2008, 01:10:19 PM
If the fluid is "pinkish clear" all is ok.  Antibiotics to be safe.  If it has bright blood drainage, or white, yellow or greenish drainage, you would usually see reddened area around the site, maybe some swelling or heat.  That would always signal an infection.  Sounds like you caught the problem, and took care of it.