HELP - NO DRAIN!!!

[Python]

Ian (Shades-Elfen) has just had the PD nurse come and try a manual bag exchange.  The fluid at first refused to go in, eventually did (just under 2 litres) but is refusing to drain out.  What little did drain out before it stopped completely, was blood-stained.  She's gone now, is off for the weekend but want's Ian to go to his hospital tomorrow for an x-ray to see what the problem is.  Has anyone else had a problem like this, and how was it resolved?

This means he can't use his machine tonight.  Help!!!

[billable]

Other than being some blood in it, what else did you notice?  Does it have fibrin (white stuff floating around)?  Is it cloudy or clear?  Is he running a temp?  Is it tender in the lower part of his abdomen?  Is this the first time it has been used or have you been using it and just now developed the problem?  There are only a few explanations for this and all are common sense.  You have a tube in the abdomen that has a hole on the other end.  It is getting stopped up or has flipped up where it is no longer in his lower abdomen to pick up the fluid.

Because of the possibility of peritonitis, I would want answers today, not tomorrow.

[Python]

It's not peritonitis.  What happened was about 6-7 weeks ago, Ian went down with appendicitis and had to have his appendix removed so they removed his PD catheter at the same time and put him on haemodialysis to let everything heal up.  Unfortunately, his Tessio cath has become infected and they have been keeping it at bay with  Vancomycin.  The original plan was to keep Ian on haemo for 3 months then put in a new PD catheter.  Because of the problem with the Tessio cath, they decided to put in a new PD cath two weeks ago and today was the first time it had been used, so this is a completely new cath.  Ian's been on PD dialysis with only two haemo breaks in nearly 5 years.  This is the first time we've encountered this problem.  He has to go to the hospital tomorrow and they are going to x-ray him to see if they can spot the problem.  How they will resolve it, I don't know but it is a worry because of the Tessio being infected.  Not only that, he doesn't get on very well with haemo.  He just tried to drain off justnow and not even a tiny dribble

[Michelle]

I have had both occurences but for different reasons. The drain blockage in my case was constipation which had flipped the tube up to the top of the abdomen so it couldn't get any fluid out of the peritoneum. The blood was down to adhesions from abdominal surgery which broke apart and then bled into the peritoneal cavity and I am wondering if this maybe a settling down period from the tube being put in which is causing this.
Obviously I don't know exactly what the problem is but the adhesions were not really addressed as they were considered a benign reason and the constipation well I had to have strong laxative medication to make it all shift. Whatever the reason an x ray will at least show if the tube is sitting right and whether there is likely to be something blocking it.
I really hope Ian gets on ok as it sounds like he has had such a rough ride and that he doesn't need any more issues.

[Python]

Well, Ian went to the hospital this morning and they think that either the tube has a kink in it or it could be blocked, say by a blood-clot or piece of fibrin.  They x-rayed him but that didn't really show up much although Ian saw the x-ray and thought the tube looked blocked but like he said, it's difficult to tell.  What they've decided to do is give him haemo tomorrow and Tuesday then try the PD cath again.  They seem to think that the tube might unkink itself as this sometimes happens.  Ian also suggested that they flush it through with heparin so that if there is a blockage, the heparin should clear it.  They may try this if it still doesn't work.  The other possibility is that he's developed adhesions and if this is the case, he might never be able to do PD again.  We hope this isn't what's happened but only time will tell.

[Epoman]

If it something that will not allow him to do PD anymore I highly recommend that you do what ever you can to get him on daily dialysis, with the NxStage System One. If you have to travel DO IT! I'm sure you already saw my other site but just in case here is a link: http://www.ilovenxstage.com

[Python]

Yes Epoman I have seen your other site and the NXStage looks very good.  I'm not sure what system they use for home dialysis here, possibly Baxters or Fresenius.  I'm not sure if they have NXStage or not.  Ian's consultant is a great believer in home haemodialysis - especially for teenagers and young adults as it gives them much more freedom.  Hopefully we'll get the tube sorted out but in the meantime we're looking at all the scenarios.