Peritoneal dialysis

[mike22]

i am a college student thinking about switching to pd. i wanted to know how do you fell with pd. what are some of the pro and cons. i here that pd makes you feel better because you do it everyday. i would like to here some stories about your experiences with pd.








EDITED:Moved to home dialysis section-kitkatz,Moderator

[Loretta]

I second Mike's question.  I have been on in center hemodialysis for two years.  I have had 11 surgeries to try to get a working permanent access.  My doctor asked me to think about PD.  Quite honestly it scares me to death.  I don't want to do it.  But maybe I am just uneducated.  Those of you who are doing it, how is it working?  Did you do hemo first was it hard to change?

[george40]

Hello, I did hemo a few years back and now I am doing pd. Hemo was rough on me, it just about wiped me out most days. PD is very different since you are being cleaned continuously. It takes some scheduling to get in four manual exchanges per day, but it works out. Then there is the cycler which works while you sleep. I started with the cycler, however it has not worked out very well for me. Overall, I have pep in my step with decent energy at times. We just had a baby 8 weeks ago and pd has allowed me to feel good enough to help out with the baby, work, and take a class. If anything the schedule for my midday exchange is most challenging and has interrupted the work day which my employer was fine with in the beginning, but now seem to have flip flopped some. I do not like the bloated look because I carry 2500 ml in my stomach all the time (don't let that amount scare you because it differs from person to person). I still have not gotten use to this. The other thing that I'm always conscious of is peritonitis, however people go years without ever having peritonitis. I'm coordinating my first trip while doing pd. For example were going away in April, the supply company will send my supplies to the hotel before i arrive. I had to call the hotel and supply co. to coordinate (they do this for cruises, etc). You will need space for lots of boxes, a 5x5 area I believe they generally say. If I think of more I will post again. I hope this helps some.

[Red from Canada]

PD  to me is the absolute best!  You feel better, fewer restrictions on food and fluid and you can travel with the machine.  I have had tubes adjusted and replaced and been on hemo in between, but I would do anything I had to to be back on PD!  We are getting ready to laod our small motorhome for a trip to Gulf Shores for about a month, camping.  Can't do that too easily on hemo.  The two big disadvantages are always carrying fluid and looking pregnant, and the amount of space for the supplies.  Neither is a really big problem for me compared to hemo.

[peleroja]

I second what Red said, and I can't wait to get back to PD.  On hemo days I never go anywhere just in case they call me to come in early.  As george40 said, many days on hemo I come home wiped out.  For 5 years I went everywhere and did my PD (even in a few places my nurses raised their eyebrows at!).  Then the dreaded peritonitis struck (no fault of mine, who knew I had a hernia which became infected and gave me peritonitis).  Actually it wasn't as bad as I had been led to believe, felt kind of like gas.  It was the 3 surgeries in 15 days that did me in!!!

[kitkatz]

Wait all day, so they call you in early? No way, go have a life!  Make them wait on you! 

[Loretta]

I would love to spend a week with my sister who lives in a small town without a close hemo unit, but she is not much of a house keeper.  Can you do pd exchanged in areas that are not steril

[BigSteve]

Loretta: How dirty is your sister's home? Is there any area you can isolate during your time there? If not
I would not push your luck. I know peleroja has done manual exchanges in places like the back of buses, but
I have my qualms about exchanging in strange places. For Mike: I hated hemo, I liked manual exchanges even
having to do them four times a day, I am now on the cycler and like it even more. My life is free and I am feeling
better both physically and mentally.

[drinkboy]

I can only speak to PD vs hemo at a clinic, since my mom never did home hemo.  She never liked hemo from the start, and she switched as soon as she could to PD.  The hemo wiped her out and was rough on her system. Also, she did not like having to go to a clinic three times a week and sit there for hours, and waste half the day there. The PD allowed her more freedom and was easier on her system.  She would go to her clinic once a month for tests, etc but that was it.

She had two cyclers in the time she spent on dialysis and both were easy to use, and she and my dad were able to master them and the procedure quickly. Since she didn't start dialysis until after she retired, she never had to worry about a schedule conflict with work for doing the afternoon pause exchange.  The only thing she needed to do was schedule appointments either in the morning or late afternoon so she could do the mid day exchange. Obviously, everything else is done while you sleep.

As far as traveling, they never had an issue.  When they went to Florida in the winter, they had a cycler and the supplies shipped there and they were always there waiting for them when they arrived (they had a clinic only 15 miles away and was very good).  When they took overnight trips, they could pack their cycler and bags of solution easily and never had a problem with that.

The main concern is possible infection, especially peritonitis. However, in seven years of dialysis, she never got an infection from doing PD at home. She and my dad took every precaution when hooking her up to the machine, etc.  They never cut corners and they washed their hands thoroughly, shut off the heat/AC, wore masks and basically took no chances.  Sometimes she would roll over on the tubing at night and an alarm would go off to let them know something was wrong, but that's about it.

Overall, I guess it depends on your lifestyle, what you prefer, and what your body responds to best;  for my mom and my dad, who was her caregiver, PD worked best for them. 

[rookiegirl]

I started PD October 2007 and to be honest with you, I don't feel any different compare to when I was pre-dialysis.  I sometimes forget, as I go through my day to day routine that I'm on dialysis.  I'm currently doing 2 manual exchanges a day.  I carry Icodextrin fluid all day and Dextrose fluid at night.  I really don't have any diet restrictions.  The only thing noticeable about me is that my belly is bigger because of the fluid I carry 24/7.  But, I've gotten use to it.  I still work a full time job Monday-Friday 8-5.  I'm still active as before.  I'm really glad this was an option for me.  I'm hoping to continue this treatment (2 changes/day) as long as I can.  I've been very fortunate that I don't have as many exchanges as others.  But when that time comes, I know I will learn to adjust.

[peleroja]

Can you do pd exchanged in areas that are not steril

I don't think it's possible to ever be truly sterile, not even in the hospital.  As I used to tell my doctor, there's optimum and adequate, and I'm doing adequate. As Steve says, maybe there's some little corner that you could isolate and keep clean just for you while you're there.

[Ken Shelmerdine]

Can you do pd exchanged in areas that are not steril

I don't think it's possible to ever be truly sterile, not even in the hospital.  As I used to tell my doctor, there's optimum and adequate, and I'm doing adequate. As Steve says, maybe there's some little corner that you could isolate and keep clean just for you while you're there.

I always did optimum heigene routine and still got peritonitis.

[drinkboy]

that stinks Ken;  I guess no matter how careful you are, there is always a chance, so a little luck always helps