PD cycler and long shift at work any suggestions?

[Sydnee]

So we (Ed) has been on PD for about a month and a half. manual  until 2 weeks ago. Ed works at Lowe's distribution warehouse  on the weekend  Fri-Sun on a 12 hour shift. He leaves for work at 6:30 in the morning and gets home 8 pm.  As soon as he gets home he has to hook up to the cycler. And he barely has time to get ready in the morning for work.

We are eating dinner in the living room because he can't reach the dining table. I miss the family around the dinner table thing. (with 4 kids I think it is important)
In the morning he unhooks and leaves everything there gets ready for work and leaves. I clean the cycler and throw all the used tubing away so that it is ready for him to start when he gets home. Then at work he does 1 exchange around 12 it ends up being a really big exchange cause he doesn't seem to be draining completely while lying down. the one at work is 3500ml-4000ml drain and 2500ml fill.
this cycler seems to be changing our lives even more than going on dialysis did. 
How do others with long shifts work with a cycler? any suggestions?

[Joe]

Hi there Sydnee. I too am on PD with a manual thrown in for good measure. When I was working I worked days for an aerospace contractor and evenings at Home Depot (sorry  . I would come off my cycler in the morning and go to work, do my final drain at work and go the rest of the day dry. I would come home, set up my stuff for the evening, let my manual bag warm for about 15 minutes and then fill before going to work at HD for 4 hours. When finished there, I came home and immediately hooked up for the evening. It was a tough schedule to keep and I finally had to let HD go. I really saddened me as I really liked that job, it was fun. It sounds like Ed's schedule is pretty packed, but if he's able to keep it all together, that's good. I finally had to let work go and am on disability.

I can relate to Ed not draining completely while on the cycler, I have the same issue. How do his UF numbers look when he finishes in the morning? If they are really low, he likely is retaining fluid from the cycler session. Given that, it appears that he is getting it off with the manual later in the morning. As I said, I have the same issue but my PD team thinks it's ok as I get the fluid off with the manual drain later in the morning.

 

[Annig83]

Could he do 2 manuals during the day and then have shorter time on the cycler?  I know he just got off manuals, but I would call the doctor and ask if there is a solution to this issue.  I know I started on manuals and had to do 4 a day and it wasn't efficient for me with a newborn at home.  Maybe if the manuals and cycler could be split a little more evenly, he could have more time to do dinner and have family time? 

[Sydnee]

Thank you Joe and Annie,
Joe- they will not let Ed go dry yet (if at all), UF while he is laying down are - so not good. sometimes only 50 sometimes 500 the highest was -604. Thou over the whole night he is doing ok because his first 2 drains are 500-1000 each time.

Annie- I told Ed and he said that he might as well go all manual . It's not easy to do manual at his work. I get the impression that they are only letting him do dialysis there because they legally have to.

Then there is the dr who says we can do the PD however is most comfortable to Ed since he is clearing so well. And then FMC PD nurse you will do it this way period.

[Joe]

It certainly sounds like he is getting his fluid off with the numbers from his manuals. He might check and see if his Neph will let him go back to CAPD and just do 4-5 manuals during the day. He might have to increase to 2 manuals at work, but that should be workable.

Good luck!

[Willis]

I often worked late hours over even all night and then have to go back in to work the next afternoon. It's not an ideal situation but if necessary I will just adjust the time on the machine so it will finish when I need to get up. Usually that's only been an hour or two but a few times I had to go with just 4-5 hours (I usually do 4 cycles in 9 hours). Some people are reluctant to do so, but I will use Red on one bag when doing a short session and that usually gives me a better UF. When I'm lucky enough to have an off day and can sleep a bit longer I'll do the opposite and run the cycler for 10 hours to get some extra D.

I realize everyone's situation is different, but I've been determined to run this show and not let the PD clinic have TOTAL control over my life. So far my labs have always been OK even though my PD cycle times often vary--so my nurse hasn't questioned me about that aspect of my therapy. High phosphorus is a bigger problem for me than for others and increasing my dialysis time probably wouldn't help that too much. Someone else might get totally screwed up on such a schedule so I'm just relating my own experience.

I've also found (especially relating to phosphorus) that what I eat makes a big difference. If I have to short my cycle times and then go off on a tangent eating chocolate I'm just looking for trouble. So when I make adjustments I have to watch my diet even more carefully than usual (and I love to eat so that's not easy!).

 

[Grumpy-1]

I work what one could be consider long hours. I work 9 hour day but add to it a hour commute in the morning and 1 1/2 - 2 commute in the afternoon (traffic).  This my schedule for the weekdays.

alarm goes off at 3am, get up takes a hours to unhook from the cycler get showered dressed out the door by 4am (more time closer to 4:30).  Get to work around 5:30 and ready to start at 6am.  I do a manual between 6:30 and 7:00 and a second manual around 11:30.  I leave work at 3pm and get home around 5pm.  Hook to the cycler right awaya and do the first exchange.  There is a pause in the sequence that allows me time to go have supper with my family.  Then hooked back up at 7:30 this next sequence is 3 more exchanges with 2 hour dwells between.  The cycler finished up about 2am and alarm goes off again at 3am. 

Yes it gets old - The only nice thing is Friday night and Saturday night, I can increase the pause for a few hours and go out with friends.

Grumpy