PD surgery. What to expect?

[marlinfshr]

Tomorrow morning I will have my PD catheter placed.

What should I expect?
It seems to be more involved then I was thinking because they said I am scheduled to be in there for 1 1/2 hours. I've been going up to this point thinking it's not going to be much more involved then the catheter placed in my chest but I've obviously been wrong.
How long should I expect the pain to last afterwards?

I just like to be prepared for what to expect afterwards. Being mentally prepared helps me out. This is not my first surgery as I've had a testicle removed due to cancer and have had an operation going in to re inflate my lung after it collapsed due to same cancer. I have also had a chest tube placed so this won't be my first time being cut up.

[marlinfshr]

Never mind. The anesthesiologist just called and said he doesn't feel comfortable doing the surgery right now, even though my cardiologist gave the OK. I am on plavix and aspirin and they told me last week to stop taking it 5 days beforehand---which I did.

I had 3 stents placed the in my heart after a heart attack at the end of April this year and he feels it is still too soon.

I'm not having much luck in this whole ordeal. I feel great and my kidneys still function and I pee everything out I drink and I don't want to make them worse with the hemo dialysis I'm currently on.

[papacat]

Hi Marlinfshr,
Even though your surgery is postponed for now, here is some info based on my experience.

You might try searching for PD surgery on IHD. I have not since I found IHD after PD surgery.

The only problem with my PD surgery was that the catheter was placed just above my belt line about 1". When I started to use a belt a few days after surgery, I found that when I bent over the catheter would be pushed up by the belt and the exit site started to bleed. The nurse suggested I get elastic waisted pants or use suspenders. I decided to use suspenders since I wear dress pants for work, but I really prefer using belts. The exit site should have been about 2" above my belt line. The surgeon did check where my belt was located in the office, but not the day of surgery. If I ever have to have my catheter replaced, I will have the surgeon mark the exit site location on my body just before surgery.

I might mention that I had serious pain the first two days after surgery. The surgeon did prescribe some oxycodone pain medication which was very helpful to reduce the pain. By the third day the pain was almost completely gone. I thought the pain would be minimal. Little did I know!
papacat

[MaryD]

I second papacat's suggestion to have your exit site marked on the day of surgery.  Both my exit sites were below the waist line (but I'm female) and were/are quite comfortable.  My second catheter exited in a downward direction and is quite uncomfortable if I 'drop' it.  I wear Stickman belts and on the current catheter I use tape to anchor it securely.

On the other hand I didn't have any pain after either operation - or nothing that one paracetamol didn't fix.

[marlinfshr]

Thanks for the reply's. During my PD evaluation the surgeon didn't look to see where my belt line was. Whenever I get re scheduled, I wonder if I should put on a pair of jeans with a belt beforehand and trace around where the top of my jeans go. Half the year I wear jeans, the other half I wear board shorts which are either elastic or tie up. I should probably trace them as well. I'm thinking that because I'm sure the next time I see the surgeon I'll be in the operating room in which case I'll already have the hospital gown on.

[adairpete]

I went in to my PD surgery thinking it would be a breeze and in some ways it was, but it was more pain than I expected for longer than I expected.  It was painful to straighten up and walk for the first few days.  I was on pain meds for about 2 weeks and out of work for about 10 days (I was on my feet a lot at that time at work and just couldn't do it).  Also, the best advice I got was to take a stool softener while you're on pain meds and after surgery.  Constipation is a concern with PD and also you don't want to be having a difficult time going when your abdomen is sore.  TMI, I know, but it was good advice and I'd hate for you to have to learn the hard way (no pun intended).  Good luck!

[blondie1746]

I second that advice about the stool softeners.  I got constipated badly after my PD surgery and it was painful!  I am a woman, and the prep nurse drew a line where the top of my underwear was, and they place the catheter about an inch above that.  In retrospect, I would have preferred it be place below that line.  Sometimes, depending on the pants/shorts I wear, they hit right at my exit site.  A lower exit (if possible) wouldn't interfere with most of my clothes.  As far as pain, I only took 1 pain pill when I got home from the surgery, and that was it.  I was sore and tender, and every time I stood up, I thought my stomach was going to fall to the ground .  But the day after my surgery, I had to go to chemo.  So, it is not unbearable, and this was my first ever surgery.  You will do fine!  I just hope they get you in soon.  PD is so much better than hemo!  (IMO)

[Simon Dog]

When I had mine done there was ZERO discomfort except for a slight soreness of the throat from the intubation that only lasted a few hours.   I was given an Rx for oxycone, but never required so much as a tylenol after being surged.  The biggest hassle was keeping the dressing site dry until given the medical go-ahead to shower like a normal person.

[Grumpy-1]

I've had two PD surgeries.  The first one was 3 1/2 years ago and finally had to remove it because of infections they couldn't get cleared up.  I've just had my second PD tube inserted.  Neither one gave me too much pain except if I turned or twisted wrong.  Then I would KNOW it.   As some have said, it takes a while to heal up and pain meds help.  BUT after that, comes the part of getting use having your belly filled with fluid.  Right now that is my issue.  Filling for the flushing seems to hurt a lot more than I remembered the first time. It maybe due to the tubing location, but not sure.  The nurse said if it continues to hurt, I have to go in to have it repositioned.  But we'll see.  My tube exists fight under the belt line and it doesn't seem to be an issue. I can see where if it was higher, then bending over could pinch it.   I will third the stool softeners.  Even coughing pulls at the site and hurts.  But when the initial pains are over, I think you will be glad you switched to PD.  I'm glad to be back and hoping this one will last until the TX comes along.  Grumpy

[marlinfshr]

Well, I'm going in for my re-scheduled PD surgery tomorrow and this time it sounds like a go since they made sure to tell me to not stop taking my plavix. Hopefully it heals by next Monday as I will be crewing on a boat for a fishing tournament 3 days next week. I had already commited before the last scheduled surgery and since fishing has been my career (up to this ESRD point) it will be a way to keep involved.

[tito]

I had the catheter installed four years ago. There was very little pain. The surgeon placed it at my belt line, which is not much of a problem, as I have started wearing elasticized pants due to my big PD stomach.

I do get a little bleeding when the tubing gets tugged in my sleep, as I am on Warfarin. I, too, was on Plavix after a stent procedure (heart attack the first night of Passover!). I couldn't have a  transplant while on Plavix, so the cardiologist took me off. Said I didn't need it after 30 days, and the efficacy of triple therapy (Warfarin, Plaviz and aspirin) was unproved.

[JLM]

http://www.carriagehouse-enterprises.com/

This company sells a t-shit that will hold your cathater secure during the night (or anytime).  It has a "buttonhole) in the front of the sit and it has 2 Velcro tabs on either side of the hole to secure.  I think the size runs true, but I wish that I would have ordered a size larger because I use it a a nightshirt only.

[Simon Dog]

No pain when I had one installed, but it was a hassle keeping it dry for the first couple of weeks.

When you wake up, your first words should be "Somebody get me out of this place before I get an infection".

[Deanne]

I had mine put in yesterday. It went well. I was taken back for surgery just after noon and my neighbor was there to pick me up at about 3:30. I came home, checked email, watched tv for a little while and went to bed. I was sooooo tired. I took a couple of the pain pills, but will probably quit taking them now. I'm still tired this morning and I'm aleady counting the days until I can shower again.

[Grumpy-1]

My update.  Well the last PD catheter was put in and the next day it was full of blood.  Seems there was bleeding from the surgery.  They tried to drain it, but no luck.  Also the surgeon that did the surgery, said that the scar tissue from the surgery, and infections was extensive and he doubted that there was enough good tissue to sustain a good exchange session.  But no one knew that I Was still bleeding until my BP dropped so low that I was back in the hospital and getting a blood transfusion.  So, bootom line.  PD is out for me - the new PD catheter will be removed when they put in a new fistula.  And I'm back to hemo dialysis for good.  Looking at doing home hemo instead of in clinic 3 days a week.  For those interested in PD,  I loved it and wish I could do it again.  Also,  Keep everything clean all the time.  Work at preventing infections.   Grumpy

[Joe]

Grumpy-1, sorry to hear that your PD placement didn't work. Hopefully you will ramp up on HD quickly and transition over to HHD easily.
Wishing you the best.

[Quickfeet]

Good luck grumpy