I had to skip a PD exchange tonight

[kickingandscreaming]

I could feel myself working up to it all day.  And by evening I was having a full-fledged asthma attack.  I haven't had one is so many years I can't remember the last one.  But my full PD belly was making it extra hard to breathe.  There just wasn't room for both air and PD fluid.  So I decided to drain and not refill and give my self room to breathe.  Will I be struck down for this?

I am hoping that by tomorrow morning it will have eased and I can fill up again. Then again, it might not ease up.  Ever since beginning dialysis (only since Thanksgiving and then in-center hemo) and I just started PD for real last week.  I have been having a really hard time with a stuffy nose and some upper respiratory inflammation. At first I thought it was from the dry overheated air at the clinic.  But now I'm starting to wonder if it might not also be from the sugar that's bathing my system.  Sugar is pro-inflammatory and that may be triggering these symptoms.  I'm very concerned as I haven't got many choices.  I have no fistula and only an AV Cath that should come out very soon.

[TheLivingWater]

If your asthma is a big hindrance to your PD, so much so that you have to skip
Your nightly PD at times, then maybe hemodialysis would be best for your .
Shortness of breath is also one of the symptoms of patients who have kidney problem.
Not having enough dialysis can also lead to shortness of breath which can trigger
Asthma attack for people who have asthma.
I hope and pray you'll feel better . Take care and God Bless!

By

[Michael Murphy]

I'm not on PD but I have had asthma since I was 18.  Since I have been on Dialysis I have had fewer attacks, I think the Montelukast  (I think it's generic Cingular)my neph has prescribed seems to have helped.  If you are using a rescue inhaler switching to a nebulizer at home may help, I have one and it's broken attacks faster then the inhaler. Finally I use a antihistamine called cloraphenamine mallet which is generic cholra trimeton. This helps keep my sinuses clear since it they clog it seems I have much worse asthma.  Good luck ESRD is bad enough with out Asthma.

[Charlie B53]

Weather/air borne allergens, dust, humidity, or lack of, all contribute to asthmatic reactions.

What else has changed in your environment?

Not knowing which part of the country you are I can only guess that winter temps may have lowered the humidity.  Do you get any improvement while in a steamy shower?

Anything you notice good/bad should be relayed to your allergist.

One of my neighbors rarely comes out of her house, most everything outside causes her problems.  She has a couple of air systems to filter and humidify the house, plus an ionizer that also helps control what little dust that isn't filtered out.  Tore out all carpets, switched to wood and tiles that can be wiped with a Swiffer.  Claims the best improvements measures she has ever made for her health.

[kickingandscreaming]

This was a freak asthma attack.  My asthma is very well controlled, and I haven't had an attack in about 7 years and then it was always from a viral cold that went into my chest.  This one was out of the blue and it totally resolved overnight.  I'm glad I did not fill as that would have definitely made it harder for me to breathe.  There were no ill consequences.  I do not carry fluid, in general, so it was not fluid on the lungs.  It was good old fashioned asthma. 

I use a rescue inhaler on occasions, mostly if I'm out walking on a very cold day (I'm in New England and it's winter). I do have a steroid inhaler and I have started using that more regularly to prevent a further incident.  I have also reduced the amount that I fill, from 2000ml to 1700 which is a lot more comfortable for my 5'3" stature.  I will have the results of my first adequacy test this coming Monday, so we'll see it I can get away with that or not.  My PD nurse knows that I am "short filling." 

I had an interesting experience last week.  After the first week of home PD after my training ended, I was having a terrible time draining --drains were taking 2 hours at times. It turned out to be fibrin in the catheter and then I instituted daily heparin and that has fixed it.  So during that whole week I had only intermittent PD exchanges.  When my nephro heard that I was barely getting any dialysis, she sent me for urgent in center hemo  and also drew blood for testing.  The center turned itself upside down to fit me in on a snow day.  When I arrived there the head nurse remarked "why the urgency?"  "your blood work is perfect."  So I had hemo that day and wondered why my blood work was perfect given I hadn't dialyzed hardly at all that previous week.  I'm still wondering.  But one night without a fill is just a drop in the bucket compared to that.

[cassandra]

Maybe you ate a bit less than usual that week (from stress or something) and you still had some D, but the poisons are bound to build up.
I hope you'll be without asthma attacks for a long time so you can have 'normal' fills again.

Good luck and love, Cas

[Fabkiwi06]

I've been allowed to skip up to a full day due to airport traveling and it was ok. Had to adjust diet and solutions for a day or two to get everything back to normal, but no major jumps. If it was a regular thing, I'd be wary but one night should be alright.

[Charlie B53]

I believe the key is usual daily treatment.  Missing or short-changing one day won't have near the effect that hemo patients have going over the 2 days of the week end without treatment.

I wouldn't doubt that nightly nXstage patients will verify that doing daily treatment is far easier on their systems then the shock of every-other day treatments.  Well, and that they can adjust machine settings, flow rates, and time to make their treatment more comfortable with less insult to their system.  Able to maintain far better blood pressures during treatments without having some of the pressure drops seen in clinic. 

Congratulations are due to all those nXstage users for taking command of their treatment.