Scared of hemo

[amccurley]

I came down with peritonitis on Friday morning. Caught it fairly early but what miserable pain. They said that it grew back as some gram negative bacteria that comes from the water supply. I'm putting antibiotics in my bags every day like they are instructing   But they said that there is a possibly that the infection could cling to my cath. If that happens, they will have to remove the cath until the infection is cleared up. I guess that means I would have to go on hemo until I'm well.  I'm scared to death of hemo I just don't know what I could more to make this pd work. Anyone else in this situation

[Michael Murphy]

Hemo is not so bad,  pd scares me.  However even if you avoid hemo this time I would have the fistula created so you can avoid the use of a cath.
If and when you start hemo.  Hemo with a fistula is a pain but a lot better than with a cath.

[jeannea]

I was scared to death of hemo. It turned out to be nowhere near as bad as I feared. I used a cath because it was an emergency. Keep using your antibiotics. Get lots of rest. Hopefully the infection will be treated. But if not, you can do this!  It's not as bad as you think.

[estonb]

I agree with Michael about getting a fistula before you actually HAVE to go on hemo. Having to do hemo with a catheter, vs a fistula or graft, is indeed painless but comes with a host of problems which include the fact that it can very easily be infected - and forget about taking a shower with a catheter in!

I, too, started dialysis doing PD. But, after 2 bouts of peritonitis, I decided that I NEVER wanted to go through that much pain again. I decided to go in-center. I started with a catheter, which I hated, then had a fistula created and all has been well ever since. I, too, was scared of hemo. But, once I experienced the small amount of pain created by the needles I realized that I had hyped up the whole "in-center dialysis using needles thing" way bigger in my mind that what it actually was.

[Jean]

Me Too, and I hope you take everyone's advice. I know I would.

[Speedy1wrc]

Assuming hemo would be temporary and maybe not an emergency but imminent, I am going to guess they will place a catheter. Maybe even at the same time they would pull your PD catheter.

The process of hemo with a catheter is pretty straight forward. No dialysis is fun, but hemo is probably no worse than PD.

If you have handled PD thus far you will have no issue with hemo. Being that it is a more rapid UF it will feel different. A bit of a learning curve but nothing outrageous.

You can do it.

[Tío Riñon]

Sorry to hear that you've got peritonitis.  Hope the treatment goes well. 

Adding my two cents to the discussion, it sounds like the removal of your PD catheter would be temporary to allow your system to recover from the infection.  Given that situation, I would plan on getting the neck catheter instead of a fistula.  I had a neck catheter for a few months before I switched to PD and it wasn't a problem.  There are ways to cover it to shower and it wasn't a big nuisance if you wore suitable clothing.  Don't be scared of hemo...while it isn't always as pleasant as PD, you'll be fine--especially since it would be temporary.  Getting the neck catheter inserted and removed were outpatient procedures that weren't a big deal and you won't have any major lasting marks remaining.

While I know that everyone talks about various concerns and issues of a neck catheter, I know someone who has had one for 3 years without an issue.  Therefore, it shouldn't be a problem for you for a short period of time. 

I suggest that you discuss your concerns with your medical team and, if possible, visit the in-center unit where you might be assigned and talk to some of the patients.  They can probably address your fears with personal examples.

Good luck with your recovery!

[obsidianom]

Well folks I disagree on the catheter . Yes it is ok for an emergency but the statistics are horrible for patients in the long run on catheters. Starting on a catheter is so much riskier.
Given that PD cant be forever generally, this would be a good time to get a fistula and have it mature slowely and ready in the future when needed. That way any issue with PD can be dealt with easily by fistula and no catheter need be rushed into place . Then you can do PD and not worry about any problems . Havng a fistula ready in advance saves lives . Period.

[Simon Dog]

There are times when a fistula in advance is a losing proposition.   I know one transplant patient who was on PD and got a precautionary fistula.   He got a xplant before he needed the fistula, however, in his case the fistula was a big an ugly one so he had it tied off after the xplant.   His xplant is now showing signs of being at the end of its life, and if he needs a fistula he has already burned up his first coupon (the left radiocephallic).   He would have been better off not having it done.

On the other hand, I did not have one done.  When PD failed, I was subject to the risk and inconvenience of the catheter.    My fistula was slow to develop, and I needed  a second surgery to tie off tributaries to get enough pressure for the fistula to fully develop.    Even now, after using it for 6 months, it's hardly noticable (but works wonderfully).   I would clearly have been better off getting a precautionary fistula.

So, like so many other aspects of this process, there is no free lunch and each decision brings benefits and risks.

[Speedy1wrc]

IF she has an infection in her PD Cather and IF if needs to come out she won't have time to let a fistula mature.

[obsidianom]

Obviosly the fistula is for future use.