Is this normal, fellow PD patients?

[Annig83]

Okay, so you know the little cusp that holds the catheter in place... it's like directly under the catheter exit site?  I already asked my doctor about this, and he didn't seem too concerned, but I'm very uncomfortable still.  If I push, lean, or my son crawls over me, I get pain just in that spot where the cusp is... there's no redness, no fever, some oozing...but it like scabs over *I use Gentamicin antibiotic cream everyday* I also have some fibrin in the tubing, but nothing massive...just the normal for me.  I've been using Heparin 1-2 weekly to get rid of it.  Has anyone else had this issue?  I had pain a few weeks after initially getting the catheter in and the cusp was bothering me then... but it's now well over a year...why is this still bothering me?  Should I get a second opinion?? Could it be the start of perotinitis?  I've never had it... would I already be feeling pain everywhere? 

[MaryD]

Annie

It's unlikely to be the start of peritonitis.  Peritonitis hits you with a bang!

I never had any discomfort with mine.  I use an antibiotic ointment too, but I have been told to only use it for five days in a row each month (or if it starts looking red) so that any bugs are less likely to work up a resistance.

I don't remember any oozing though.  Our renal unit works on the theory that if anything can ooze out, infection can get in.  Maybe a second opinion would be wise.

Good luck

[Restorer]

It may be just at the edge of your skin, and starting to extrude. I had a partially extruded cuff for over a year, until it finally worked its way all the out ("fully extruded"). While it's partially extruded, it's at a greater risk for exit site infections. Ask your PD nurse and nephrologist how to keep it as clean as possible. I washed it well in the shower, then scrubbed the cuff with hydrogen peroxide (to break up any gunk stuck in it) and Betadine (to keep it sanitary), and I kept the exit site and cuff covered with a dressing and sometimes gentamicin cream.

[Joe]

I haven't had that exact issue, but I do get occasional redness around my exit site. I would think if you are having oozing from the site, you may have a mild infection. If your Neph and PD team think it's ok, I'd look for a second opinion.

[amanda100wilson]

Don't worry about the crusting as long as it is red or sore, leaking serous fluid or pus.  If your doctor can't answer this for you ask ( and there is a strong likelihood that he doesn't know the answer),   for a referral to a vascular surgeon ( they are the ones who put in PD caths. For their opinion.

[Grumpy-1]

Anne

It's unlikely to be the start of peritonitis.  Peritonitis starts down inside your stomach area, not at the exit site.   For the oozing - you do need to have that checked out.  It could be the start of an infection.  Grumpy

[Willis]

After a year and a half, I often have small scabs around my exit site and occasionally a little blood but I've never had an infection. The built-up "cusp" of skin around the cath still gets irritated and if scabs form they will "stick" me a bit and that hurts sort of like a needle stick. In my case I exercise hard at least 3 times per week and I think that causes a bit of strain on the cath. In all cases though, even when exercising, I always tuck my cath into a Stickman belt rather than use tape (which causes severe rashes). I also get a bit of reaction if the tubing touches my skin and I get a small welt that itches like crazy so I try to move it around a bit.

Here: I can't imagine not having these... Stickman Belt. 

 

 

[amanda100wilson]

Willis, you ate right.  I have described what you see when there is a problem and where there isn't.  I am not saying that you shouldn't run it by your nurse, but a little crusting  does  not mean the start of an infection.  If it is oozing, red, puffy sore - be concerned.  Otherwise, clean it as you are and you will be fine.  I didn't even apply anything to mi e, I just used soap and water when showering and then made sure that I dried it well.  I was on PD for a total of nine and a half years and never had an exit site infection but a little crusting was very common so what I am saying comes from a lot of experience of dealing with a PD catheter.  Be vigilant, but don't over angst about crusting.

[Annig83]

Thanks guys!!  Like I said, no fever, or reddness.  I think it's possibly what Restorer has mentioned with the extruding.  I see a small section of pink skin (almost looks a bit like a hernia) near the exit site.  I've had so many belly surgeries too.  Willis mentioned the scabbing too.  I guess it's more of the scabbing over than the oozing.  I will ask my nurse and see what she thinks.   

[Joe]

I'm with Willis on the Stickman belt! I use mine all the time.