What To Expect When Starting PD

[Goofy]

I may be starting dialysis soon and I haven't really ever talked in depth with someone who does PD.  I was wondering what to expect........

1.  Do you go to a center for a while until you learn how to do it yourself? 
2.  Does it make you as tired as hemo? 
3.  In your opinion, is it best to do exchanges during the day or use the machine at night? 
4.  If you work, about how much extra time do you allow yourself in the morning to get off the machine before getting ready for work?
5.  Are there tons of supplies?
6.  If you do the overnight, do you need to have access to a sink in your bedroom?
7.  Does it hurt?
8.  Does it interrupt your sleep?
9.  Did you ever skip a treatment and if you did, could you feel the difference?

I don't want to ask too many questions at once so if there are any little details you know of  how to make it easier on yourself, can you share those with me?

I work full time so it will be difficult to do make exchanges during the day but if it is a better way of "cleaning" your blood, I'll have to figure out a way.  Thanks.

[Jie]

PD is easy, so don't need to have any worry.

1. The clinic will train a patient, usually for one week, at the beginning of the PD.
2. Not sure which one, PD or HD, makes a patient more tired. However, PD is more gentle than HD.
3. It all depends on one's schedule. If working full time, a night cycler will definitely work better. I think a large majority of patients are with cyclers. It also depends on the transport rate. The cycler works better with a high transporter, whereas the manual exchange works better with a low transporter.
4. I need at least 40 minutes, including time for breakfast.
5. About 50 small boxes and one or two big boxes.
6. It is not necessary to access to a sink. A bucket or drain bag can do the trick. The lines are 22 feet, so unless you live in a big mansion, the patient and drain lines can usually reach to a bedroom sink. 
7. It may hurt a little during the drain for some patients. But it is not a big deal, and should not be a concern.
8. It could interrupt sleep, especially if one has backpain. I think one can get used to it.
9. If one's residual kidney function is still about 10%, skipping a treatment may not be a big deal. I skipped only one treatment so far, when the cycler broke down during a trip. I did not feel the difference.

When you start the training, you will learn a lot, so you don't need to know much now. Some clinic is busy and may need some time to schedule the training, so please plan ahead. At the beginning, a nigh cycler with 8-10 hr of dialysis may be adequate. After the residual kidney function becomes very low, some additional exchanges during the day may be needed. Best wishes for your new adventure.

[Rerun]

Goofy,

I'm going to suggest that you go here:  http://ihatedialysis.com/forum/index.php?board=25.0
and scan through and read about PD.  It will answer some of your questions, calm some of your fears and I'm sure generate more questions.  It is a start and I hope this helps.

                                                       

[Hanify]

I have done both haemo and PD and much prefer PD.  Jie has answered all your questions well, so I'll just answer the ones that are an opinion.  In NZ we are encouraged to have a 'day off' once a month.  I usually plan these days around travel, or sometimes if I'm going out and don't want to be stuck on the machine for 9 hours when I get back.  In my opinion the cycler at night is best, but that's not the case for everyone.  I also get about 50 boxes.  I sleep really well.  I don't have drain pain - only did for about 2 or 3 weeks when I first went onto the cycler.  My machine attaches to a big drain bag which we then empty in the bath the next day.  Hope that helps.  PM me if you have other questions.  Or carry on this thread.

[peleroja]

1.  Do you go to a center for a while until you learn how to do it yourself? 
They trained me for a week.

2.  Does it make you as tired as hemo? 
It never made me as tired as hemo.

3.  In your opinion, is it best to do exchanges during the day or use the machine at night? 
Whatever works best for you.  If you're working, you might prefer the cycler at night with one midday exchange.

4.  If you work, about how much extra time do you allow yourself in the morning to get off the machine before getting ready for work?
I don't work, but I take a lot of day trips and longer trips.  Never had a problem getting supplies.

5.  Are there tons of supplies?
Yes, expect to give up one entire wall in the room of your choice.

6.  If you do the overnight, do you need to have access to a sink in your bedroom?
You can drain into a sink, bathtub, toiiet, or drain bag.  My clinic provided a jug to drain into, but it sure gets heavy.

7.  Does it hurt?
It has never hurt me, although occasionally I got a kind of "empty" feeling as I neared the end of the drain, but only on manual.

8.  Does it interrupt your sleep?
I found the machine to be particularly noisy, and went through several machines before I figured out I could put the machine in the hallway and close the door to my bedroom.  You may need drain or patient extensions.

9.  Did you ever skip a treatment and if you did, could you feel the difference?
Just last week I skipped 2 overnights and a midday exchange as I was very ill and weak.  I did not feel any differently.  I had learned while in the hospital in Hawaii that I could go at least 3 days without dialysis.

I don't want to ask too many questions at once so if there are any little details you know of  how to make it easier on yourself, can you share those with me?

I'm an early riser on a 10 hour dwell at night, so I hook up at 8 pm so I can get off the machine at 6 am.  I use 1 patient extension so I can reach my bed, and 2 drain extensions so I can put the drain line into the toilet.  You do want to be careful about draining into sinks and tubs, as the dextrose in the dialysate can build up and begin to clog the drain.  It will also begin to smell.

[LightLizard]

i agree that P/D does not make you as tired as hemo does. it makes sense, too. hemo requires your blood to be removed from your body and then replaced, about one cup at a time. P\D is a wholly different process and does not require the blood be removed to cleanse it, but instead the stomach lining becomes a natural filter for the blood, inside the body, so naturally, it's not as debilitating as hemo.
i alsothin that the night cycler is the way to go with P/D. it leaves your entire day free.
i find it usually takes me 10 minutes to 15 minutes to set up at night and about the same to un-hook and clean up the next morning. baxter will deliver your supplies every two weeks, if you don't have enough storage space for a month's supplies. if you have the room, they will deliver monthly. to anywhere in the world, so travel is very possible and baxter is a very competent and reliable organization.
i drain into a jerry can. 20 liters, and i empty it in the morning into the toilet. you can also hook up an extension and drain into the bathroom sink, if you want.
i've never skipped a treatment, but i have felt fatifue increase if i delay hooking up for a few hours. i usually hook up around 8 pm. i have a 'patient extension' which allows me to wander all around the apartment while dialyzing. make a sandwhich, watch tv or play my guitar, or get on the computer.
overall, i think you'll find P/D a pleasant change from hemo.
 

[*kana*]

Hi Goofy!

1.  Do you go to a center for a while until you learn how to do it yourself?   I was trained for 4 days(3hrs or so) on how to do manual exchanges.   
2.  Does it make you as tired as hemo?  Not at all.  I work 40+ hrs a week which I couldnt think of doing on Hemo.   
3.  In your opinion, is it best to do exchanges during the day or use the machine at night?  I do manuals because I work full time.   
4.  If you work, about how much extra time do you allow yourself in the morning to get off the machine before getting ready for work?  It takes me 22 minutes to fill and drain on manuals
5.  Are there tons of supplies?  Yes,  do you know how much room 2 wooden pallets take up?  Thats the space you will need.7.  Does it hurt?  Having the cath placed hurts for a couple days.  If the surgeon puts the cuff in the right place it stops hurting.  My first PD cath wasn't placed in the fat and it hurt when I laid on it or bumped it.  I always get drain pain but you learn to deal with it.
9.  Did you ever skip a treatment and if you did, could you feel the difference? I do my exchanges at 6am, 4pm, 7pm and 11pm and I have missed the 7pm one because I was away from home.  No, I didn't feel any different. 


Trust me, you will feel a whole lot better then on Hemo.  I don't even know why anyone would want to do hemo if they had a choice to do PD first.  The little things that bug you on PD aren't nearly as bad as the life draining things on hemo.

I was on PD for 8mths and then went on hemo until I could get my PD cath placed again.  I am going back to work full time next week.  I could never have worked full time on Hemo so that tells you a lot. 

[Savemeimdtba]

1.  Do you go to a center for a while until you learn how to do it yourself?  Yes, for the first week or so.. and then again for a day or 2 to learn the cycler.
2.  Does it make you as tired as hemo?  Absolutely not!  When I wake up in the morning, I feel refreshed and the only time I know I've done dialysis is when I wake up and have to unhook. 
3.  In your opinion, is it best to do exchanges during the day or use the machine at night?  I vote for night time - you can sleep through it and it doesn't interrupt your day. 
4.  If you work, about how much extra time do you allow yourself in the morning to get off the machine before getting ready for work?  I haven't gone back to work.. but you'd really only need an extra 20 minutes I'd say. 
5.  Are there tons of supplies?  There are alot of supplies, yes... but you get used to the "warehouse" as well call it - doesn't bother me at all. 
6.  If you do the overnight, do you need to have access to a sink in your bedroom?  It's a pretty long cord.. I connect it to the toilet in the bathroom near my room.  You can also have drain bags and then just empty them in the morning.
7.  Does it hurt?  It can be a little annoying... but nothing too bad and it definitely gets better with time. 
8.  Does it interrupt your sleep?  Eh, depends... it happens on occasion - don't know the exact reason for it but sometimes when draining it pulls until I bypass it. But as soon as I bypass, the pain is gone and I'm back to sleep. 
9.  Did you ever skip a treatment and if you did, could you feel the difference? heh, I have a few times... and nope I didn't notice a difference BUT I have some kidney function left - a good amount.. so I wouldn't recommend it until you know how well your function is. 

[Goofy]

Thanks everyone for your replies.  These answers have eased my mind.  My doctor kept telling me it isn't so bad doing PD, but then again, he still has all his kidney function left so it's easy for him to say that!