Cycler question

[highway61]

Hey everybody.

Well we are settling in with the cycler and have some questions. We have the Liberty Revolution through Frensenious.

The starting setup is for 4 exchanges across 8.5 hours. That doesn't allow for very long dwells. We set it up with 2 5000ml green bags. Would it be more beneficial to have one less exchange and have longer dwells?

Our other exchange is to be done at 6-6:30pm when I get home from work. Now with the last fill prior ending at 4:30am that makes it 12+ hour dwell. We tend to go to bed at 8pm which leads to a very short dwell. Does this make much sense to you all?

We are a bit confused. :-)

Thanks.

[jeannea]

Actually I do 6 exchanges in 8.5 hours. I think it works pretty well. You want the dwell to be long enough to draw out toxins but not so long that you start to reabsorb fluid. Tricky.

I'm not sure about the extra exchange since I don't need one. Have you told these times to your nurse and asked her if it's helpful? Maybe you don't need to do that one or maybe you need to do it at lunch at work. She should be able to tell you.

[fearless]

I think that very long dwells are not as helpful as dwells which are 1.5-2 hours.  I think 8.5 may be plenty of time for 4 exchanges, but it would also depend on how long it takes you to drain and fill.  If I remember correctly on the Liberty, you can choose your total time and number of exchanges, OR you can chose the length of each dwell and # of exchanges, and the machine will simply add in the times it takes to fill and drain to the total time.  Your nurse should be able to work this out with you.  Since you're going so long between ending the cycler and doing your first evening exchange, and then only a couple hours til you start the cycler again, why not just lengthen your time on the cycler and do 5 exchanges per night?  Again, your medical team would have to see whether this would give you adequate dialysis.

[Joe]

Highway, I do5 exchanges in 9 hours on my Baxter cycler. My dwells are 1.5 hours and I end the night dry. Like you, I also do a Pre-fill about 2 hours before I connect to the cycler for the evening. All in all, it seems to be working fine. I'm typically on the machine around 7 so I finish about 4 in the morning, or so. It lets me do my final manual drain and then get ready for work. I'm usually at work around 6.

Hope this helps

[highway61]

I appreciate all the info. This is great. In class they said that with manual exchanges work best with 4-6 hour dwells. Then on the cycler they set it up for short exchanges so I was a bit confused.

All this info is very enlightening.

Thanks everybody for all the help.

[bleija]

have they done a PET test for u? this will tell them the best way to setup ur machine... right now ur prolly just doing a general prescription. after they do the test they will know how it takes for ur body to start absorbing, and find out whether u are a high or slow transporter... u have to have a new whenever something happens tht afffects ur peritoneum, such as infections, or whenever u first get a cath. i know im scheduled for one in a couple weeks bc i just got  my cath functioning properly... takes about 4 hours total, but all they do is take a little fluid out at intervals

[highway61]

have they done a PET test for u? this will tell them the best way to setup ur machine... right now ur prolly just doing a general prescription. after they do the test they will know how it takes for ur body to start absorbing, and find out whether u are a high or slow transporter... u have to have a new whenever something happens tht afffects ur peritoneum, such as infections, or whenever u first get a cath. i know im scheduled for one in a couple weeks bc i just got  my cath functioning properly... takes about 4 hours total, but all they do is take a little fluid out at intervals

Hey bleija,

No, I haven't had a PET done yet. I am not sure when it will be. Thanks for the info.

[bleija]

your welcome, i wondered the same thing when i started... i wondered if everyone just started with the same prescription then modified it from there but then they gave me the pet test, and i ask questions about everything, i could prolly do their job w/o any training lol, but thats what im going to school for, use my first hand experience lol