Difficult start to PD

[cookie]

My husband has just atarted PD using the Baxter cycler.  We spent a couple of days training at the clinic, and all seemed to go well.  Once  he got his cycler home he has had a problem of not being able to drain enough while sleeeping.  The low drain alarm goes off after each drain waking us up.  We have had no sleep in three nights, and are exhausted.  When he sits up he does drain, but he really can't continue this if he has to wake up six times a night.They questioned him about being constipated, but he is not.  The doctor had an xray done today to see where the catheter is, but we have not heard anything yet. 

Has anyone else had similar problems, and how were they resolved?  He will be really dissapointed if he cannot do this at home and has to go to a center for hemo.

Thanks for your help !!  Cookie

[KICKSTART]

I do CAPD at home , the reason i dont use a machine is because my catheter is stuck under my 12th rib!. I have had x-rays to confirm this , but i still manage to do my dialysis anyway!. It is possible that his catheter has moved , an x-ray will show it up. There are ways of bringing it back down into place , eg; a strong dose of laxatives, i was given this and mine did drop down, but because of the time it took convince doctors that something was wrong ( i was told the pain in my side ,was all in my head!) and it took my gp to organise an x-ray ,it had been used to bending round by then and so just flipped back up. So if you think that something is wrong the sooner you get it looked at the better.

[cookie]

 Thank you for the information.  He has had an Xray, we just have not heard back from the doctor yet.  The dialysis nurse has put him on day dialysis until we can figure out what is going on so that we can at least sleep at night.  I hope it can be worked out.  He doesn't really want to have to keep doing this during the day.  That kind of takes away from some of the advantage of doing PD.  Thanks again.  It is nice to know that you are not alone in this !!

Cookie

[Rerun]

Cookie, when I did PD 20 years ago they didn't have the "cycler" for night.  All I did was day exchanges.  I did fine.  Believe me doing PD during the day stilll beats hemo. 

I hope they get this straightened out for you.     

[KICKSTART]

I will second that 'Rerun' somehow it justs get to be part of your daily routine , like making your dinner 
'Cookie' dont know how things work over there , im in the UK, but i got my x-ray results straight away , in fact i looked at my x-ray myself and could see my catheter! .I would chase them up , so if his catheter is tilted upwards, it doesnt get left to long like mine did and then wont come back down. 

[angieskidney]

Could be that your bed level and machine level are too much the same? I don't know how Baxter works as I was on Fresenius PD at night (CCPD/APD) but for me it was just the initial drain every night. So I would not go to sleep til after that first drain. But if this is happening with every drain, I would consider the height of the bed or table the baxter machine is on. But I might be wrong. I have heard that even though the Fresenius PD nocturnal machine works on gravity that the Baxter one doesn't. Is that right? If that is so, then my advice is worthless in this case lol.

Have you asked your doc for options?

[billoggblog]

I also had problems with drainage when I first started on Baxter's Home Choice machine.  Over a period of time this started to improve, I don't know if its because your body gets accustomed to the machine or not, occasionally I still have to sit up if the machine alarms but this only happens on my tea time exchange.  The Baxter's machine has a pump, it does not rely on gravity, so I don't think adjusting the height would help.
I hope this situation improves for you soon, you have enough to cope with when you start dialysis, the last thing you need is interupted sleep.

Bill.

[Wattle]

I am on the Fresenius Sleep Safe (APD) and it also has a pump. It does not rely on gravity. The inital drain ALWAYS alarms no matter how I sit/lie. It is set to alarm if it doesn't get an inital drain UF reading of+150. All the alarms are able to be ajusted and I can also override them. I also sit up on the last drain ( it alarms for me) to ensure I get a good final drain.

The sleeping will improve , you will get use to the machine and all the sounds. It took me a while but it is much better now. 

[angieskidney]

I am on the Fresenius Sleep Safe (APD) and it also has a pump. It does not rely on gravity.

Do you have a pic? I would like to see that

[rimbo74]

Hi Cookie

I am using the Baxter machine at night.  I have been using it for about 3 weeks.  I get the "low drain volumes" on most every drain.  My machine does 4 exchanges a night.  I have not figured out how to stop it.  I have tried almost everything.  I even had pain when draining, like a sharp pull feeling.  They said the pain would go away but it hasn't.  They switched my machine to tidal mode, which keeps me from having the pain but doesn't help with the "low drain volumes".  I had an xray done and it should my catheter was sitting perfect.

It he ever figures out how to keep it from the alarms I'm interested and I'll let you know if I figure it out.  None the less, doing the cycler at night, I feel so much better I don't really mine been awaken a couple of times a night.

[rimbo74]

Cookie

I used about 5 pillows and kind of made a wide wedge for my upper body.  I made it where I wasnt raised too high but comfortable.  I went through the night without any "low drain volume" alarms.  I know its not the best solution but it seemed to work last night.

[goofynina]

Rimbo, when you drain are you on your back?  I find if i drain while being on my back, i get the worst pain, but if i am on my side, i feel absolutely nothing.   

[cookie]

Rimbo74

Thanks for the input.  It helps to know you are not alone.  They tried the same thing with my husband, putting him on Tidal.  It did not help.  He is doin it during the day for awhile until they cn figure it out.  The Xray he had taken shows that the catheter placement is O.K. I think they are probably going to give him a huge dose of a laxative enven though he says that he is not constipated.  We would eventually like to go back on nights. I am still working  so I do have to get some sleep( if not I may end up strangling one of my high school students !).

                           

[rimbo74]

Goofynina,

I've tried all sides and my back seems to be the least painful.   

Cookie, my nurse keeps telling me its because I'm constipated so they have me on a daily laxative so maybe its helping.  Since I still work, I don't mind the occasional alarm as long as I don't have to do it during the day!!   

Hopefully tonight will be another successful night, I'll be on a month coming up next month and I'm ready for no pain and no alarms!!

[Wattle]

Rimbo, when you drain are you on your back?  I find if i drain while being on my back, i get the worst pain, but if i am on my side, i feel absolutely nothing.   

I find that I also drain better on my side than on my back. One side also drains better than the other.   

I hope they can work it out and you can get a good nights sleep! 

[Ken Shelmerdine]

Cookie
      There is a recent thread called 'DRAINING' which has quite a few posts about this problem which you might find usefull.