I Hate Dialysis Message Board
Dialysis Discussion => Dialysis: Home Dialysis => Topic started by: smcd23 on May 01, 2012, 08:39:04 PM
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My significant other has been on PD for over 2 years. Last month he had his first bout of peritonitis. Today at his first lab draw appointment since the infection, the home PD nurse went on again about my cats. She said that the cats CANNOT be in the bedroom AT ALL because that's where he does his dialysis. Her solution was to put up a gate (apparently, she doesn't realize cats can jump very well) or shut the door. The issue is the cats were here before he was, and we have a 3 bedroom apartment - our room, our kids room and the supply room. Not a lot of places the cats can go and feel safe aside from our room. We also have a dog (and I am going to get a little ranty here, so watch out haha)
So my question: Is she right? Has anyone else been told this? He went over TWO YEARS without an infection, and the cats have been in and out of that room the ENTIRE time. He is fairly confident he messed something up before he got the infection. I think she is just being... a pest and quite frankly I'd get rid of my significant other before I'd get rid of my cats. And the dog who is all over the bed, room and him isn't a problem? He goes outside, the cats do not. Meh, I'm annoyed.
In addition, she gave him a list of things we *must* now do. This list includes cleaning the shower head 2x per month with bleach, using paper towels for everything and basically drowning my house in bleach. We have a small child, I do not use bleach, ever unless absolutely necessary. And the paper towel thing? Does she not realize how incredibly expensive and wasteful that is? It's already distressing enough that we can't recycle all the supplies, but you're telling me I can't dry the dishes with a clean hand towel? Really?
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I did home hemo with a cat who patiently waited at the open door to the room while I stuck needles in my arm. As soon as I was done running the machine, she was allowed back in the room. She loved to sit by the machine while it processed the new fluid in the pureflow - it was warm! The room was also my craft space. Clay, sawdust, plaster powder, lint, batting, and god-knows-what. I never had a problem.
My nurse knew all of this. She stressed to never hook up with a fan on, windows open, or anything else blowing around. Use sterile pads and alcohol wipes, make sure hands are clean, blah, blah, blah - all the stuff you've been doing....
Here's my suggestion - buy props for inspections. A nice stack of paper towels, a big ol' bottle of bleach, and a bag of catnip to keep the kitties at the other end of the house when the nurse is going to be there, so they don't whine at the door. The rest of the time, when she's not there, do what works for you. When she asks, nod, smile, and say you've listened carefully to all her suggestions. I'd only implement the ones that are directly going to affect his access. Say, the shower thing, which is easy enough, or whatever of that mess of advice actually seemed practical. But no dish towels? How on earth is that going to make a difference?
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I think thats overkill. I have my dog and/or cat in the room while I do pd all the time and haven't had peritonitis ever. The peritoneal environment is so perfect for growing bugs if it wss the cat or dog your so would have peritonitis all the time. It most likely came from the environment or by his own breath or hands. If he suspects something happened it was probably that and not the usual presence of the cat.
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Okay good I'm glad I'm not alone thinking she's being a bit ridiculous. Our house is by no means sterile (we have a toddler for crying out loud) but its not a germ factory like she's making it out to be. In betting his infection was caused by him not cleaning the catheter site - he's depressed and hardly showers but were working on that. When he came home with the new list of "precautions" I nearly flipped. I've already gone and purchased the "props" based on her annual home visit but the new stuff seems overkill. I think she's just annoyed that the cultures couldn't give her a difinitive cause so she's blaming the easiest target.
He went over 2 years without an infection and he's ripped the tube twice and had hook up fiascos, I think he's done a pretty good job! Even the nephrologist said he was overdue for an infection.
Thanks!
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The shower head thing was a recent recommendation at my clinic. It's making the rounds. I don't know why you need to use paper towels on the dishes but he should use them when he washes his hands before hooking up. It's important not to touch anything between washing hands and hooking up and regular bathroom towels are not clean enough, esp if you have a toddler. The cat thing? If he touches the cat while hooked up, he should make sure he uses the hand sanitizer before unhooking. I never used bleach for anything. Just try to keep things reasonably clean with your cleaning products.
On another point, if he is so depressed he doesn't even want to bathe, you might want to consider getting him counseling or medication or both. This is a real problem for people on dialysis.
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I have a young toddler as well (and we had a dog but she didn't like the sounds my PD machine made so she was never in the room), but we just use those Clorox cleaning wipes around my machine. If you do use bleach I always dilute it with water anyway, it's less hazardous. My nurses tell me to soak my shower head, and I do, but I also tend to be a little OCD ;) I've never had perotinitis, and honestly, I can say that unless your cats or dog have been licking his tubing sets, or rubbing their hair everywhere all over the machine and he's petting them before he hooks up.. I think that nurse is overly paranoid, and hates pets!
I use my own anti-bacterial wipes around the house so that my son isn't tempted to get into the Clorox ones I use for D... they're easy to make and are safe around toddlers:
http://www.ehow.com/way_5446013_homemade-antibacterial-wipes.html
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He is on meds at the moment, but I don't think he takes them every day and we go to couples counseling and we're working on finding him an individual therapist but a lot of providers here don't accept Medicare ???
I'm glad to know the shower head thing is making the rounds. And I agree that the nurse hates pets. My cats don't love anyone except me, so the only way they are in the room when he's setting up is if I'm in there, or if they are sleeping in the corner. The dog is usually passed out in the couch during the hook up process so I really don't think it's that. But the nurses justification is that every patient she has that got peritonitis has a cat. I assume that's because most people who have pets have cats because they are low maintenance.
I'm going to look into those wipes, sound cheaper than the ones I buy :)
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I am also on PD and have always had cats. When I started, my PD nurse told me peritonitis horror stories about PD patients with cats and that I needed to get rid of my cat. Well, I love my cat so no way. He sleeps on the bed with me every night and so far I have not had any problems. I lint brush my bed every day to remove as much cat hair as possible (he is a long-haired cat) and use Clorox wipes on my cycler before I set up. I think as long as your SO washes his hands thoroughly and connects in the bathroom (this is my only cat-free room) there will be no problems.
I have it up to my neck with insane sugggestions from nurses who don't have any idea what it means to do dialysis every day and how it affects your quality of life. And if the infection was caused by a pet, the culture would clearly show that.
I love jbeany's suggestion - smile, nodd, and buy display props. But as far as I am concerned, one initial home visit is all I will ever allow.
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I have a cat and 2 dogs that are around me constantly. I do try to keep them out of the direct area I'm using when I'm hooking up, but other than that, they are there. My PD nurses know about the animals and just told me to not have them right around while connecting or disconnecting. I do wash thoroughly if I have been petting them and am especially careful if I pet them while I'm either doing my manual exchange or cycling. Haven't had any problems, at least not yet.
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I have been told that over and over again. But I have had mycats in my room and also long as they are on the bed and not near me its fair. One of are cats sometimes that comes in my room does like to jump up and the machine. Especially when it is on and running. that sets off the alam and i just have to put he out and tell her no water bed! LOL Oh I have not had any kind of infection from it.
There is only one other problem that my happen with the cats in the room... Just the cats mite want to play with the tubes and awhile ago the did puncture a hole in it. Yeah that gave me a infection cuz I didn't know it till it was too late. So I took a few days and really watch them and if they got off the bed and near it I just put them out. Didn't take too long before they figured out if they want to warm bed they have to stay there.
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Purgatory we had to have a 2nd home visit after the peritonitis. I wasn't here for that one. And apparently now instead of an annual visit they do it like every 6 months?
My cats seem to steer clear of my SO 90% of the time, so I am almost 100% certain it was not the cats. She just wants a scapegoat. The bacteria came back as a general run of the mill bacteria, so he really could have got it anywhere, or done it to himself on accident. The SO would go before my cats ;D
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i have had 2 dioalysis nurses, the first one ddnt like cats and therefore said all this crap, my nurse now say redicuulous, as long as u maintain sterile conditions, same as u would with any animal. he even said the infections i had ddtn even have to do with the cat... and i have ben on pd for 2 years with the cat