New Baxter Machine by December

[Whamo]

Interesting.  My nurse increased my number of cycles from four to five in ten hours.  I usually drink some water for slow drain signals, but tonight it was impossible.  After four cycles I halted the treatment.  My UF was 1,400.  Usually it's around 2,000.  I didn't want to call my nurse in the middle of the night.  I looked up protocol in the manual and found no help.  It just said call your kidney center.  I'm dry so if I start a new cycle I know I will have problems.  I'll call my nurse in the morning.  I hate to bother her on a Sunday.  I think I've been draining too much water.  The last two or three nights I experienced cramps.  I got through it by drinking water and/or fresca with ice. 

[Marilee]

My hubby has been using the Amia since July 2017, so I have a few comments about it:
1. UNBEKNOWNST to our PD nurse and not well documented in the Manual is a feature that lets him do a final Manual Drain. On the Treatment Complete screen, press Treatment Options
button and then the Reduce Fill Volume button to do a final drain. Lordy, I hope they never take away this feature.
2. The voice can be turned off - there's a button on the front of the machine.
3. We set it to "Advanced User Mode" to reduce some of the screens and therefore some of the time wasted in setting up. This is better, but it could go so much further. It needs to mature.
4. It's error handling is not very robust: If it encounters an error, it directs us to Power Down and start everything all over, which takes another half hour.
5. It's crazy fussy about putting the patient line into the patient holder - just so - before it can proceed.
We've had to have the machine replaced twice and they are quick about getting a replacement to us (special courier).

[Whamo]

Can you give me the pages in the manual that cover this? 

[Marilee]

Hi Whamo -
Pages 182 - 183 talk about "Reduce Fill Volume", which is the "Final or Manual Drain" to us. Our PD Nurse said this feature is there for folks who do an all-day fill and just want to drain some off before disconnecting (hence, the obscure-to-me label). I hope they don't figure out that the feature is there for all to choose.
Pages 231 - 244 talk about the "Advanced User Mode", and it is selected via page 216.

[Whamo]

Thanks Marilee,   I did an initial drain, no fluid, and stopped the drain phase.  I read the manual until I found it.   

[Marilee]

Excellent! Now you know how to drain outside of the cycles - before AND after.

[jcanavera]

Another way to deal with this is by upping the UF expectations on the initial and final drains.  This will prompt you to deal with slow drain since the unit will prompt you since it hasn't reached the program drain thresholds.  Once you determine you have gotten all the fluid out, you can then choose the option to end the drain and go to the next cycle.

My problem with this machine is that I don't believe the estimated fluid levels that the machine thinks that are in you.  In many cases I'm finding that even with upping the UF drain expectations, I'm finding that my wife is completely drained, but the unit will say she has as much as 300-400 ml in her.  For example the last time we used the new cycler i drained her as much as possible.  We did all the repositioning etc.  Machine said she had 300 ml still in her.  So when it came time to fill her with her final extraneal bag, I cut the fill off when the fill indicator said she had 2000 ml in her.  At that point I replaced the Amia with her Home Choice Pro.  That night I did the initial drain and did our manual drains to make sure she was empty.  We only were able to get 1,750 out and from my experience I know she was completely drained.  That means the Amia's estimate of fluid in her was off by 250 ml.  I know she didn't absorb 250 ml of Extraneal.  We've never seen absorption of that fluid.  Quite honestly I don't trust the metering numbers that the Amia displays and I question making any kind of judgements on a slow drain patient based on the estimated peritoneal fill numbers. 

What's also troubling is the process of handling slow drains and the amount of time the machine takes in trying to correct what it considers of line occlusions, which in somepeople who are slow drainers, is a matter of how the peritoneal line was placed by the surgeon, not occlusions.  My recommendation is that if you are a slow drain person during normal tidal therapy and in initial and final drains, don't move to the Amia hardware.  Stay with your Home Choice Pro.  You will have fewer alarms, your therapy cycle time will be better controlled, and you will be assured that you are empty on full drains.  To me Baxter took a step backwards with the Amia at its current programming for patients who are exceptions in the draining process.

Jack

[Geiser100]

I'm just starting PD. I'll be training on the Amia machine. I'm young so I should get the hang of it quickly.

[Whamo]

I've had slow drain problems in the two months I've been using the machine too.  I also had problems with the cassettes failing the last priming test.  Lately, however, things have been going well.  Knock on wood.  Just as you think things are copasetic something goes wrong.  My Baxter trainer said a new software update is in development.  I'd like to see them get rid of the window that says the expected outcome came out wrong near the end.  Every time I've gotten the therapy it's come up.  My nurse says to just ignore it.  Why do they tell us to call our kidney center because of it?  When I do they ignore it.  WTF?  Actually I feel great despite my health problems.  Must be the PQQ, Coq10 (ubinol), tumeric, and other supplements I take.