Holy hell! I am now BARELY beginning to entertain the thought of home PD - WHY?

[jmintuck]

http://ihatedialysis.com/forum/index.php?topic=31045.0

Go back to this old article written. I couldn't reply as that thread was older than 100 days plus. I thought shotgun dialysis was really OK. Some @$$#!!! did not spill the beans clearly on this!! I am just barely beginning to hardly even entertain the idea of home dialysis Peritoneal, because of this pro alone. People tried over and over again to convince me on pd, but I could have had a block because of the low, but real incidence of excruciating peritoneal infection chances. OTOH, I have heard of doctors prescribing an always available antibiotic to drop into your peritoneum or take a pill if you notice anything like this.

[Charlie B53]

I'm on PD now over 3 1/2 years and done quite well.  From what I've seen and heard the 'shock' to the system of limited Hemo taking off at least two days accumulation of water and toxins are the leading cause of peoples problems of doing hemo.  Where with PD I am taking off that water daily.  Far easier with no shock to my system.  And using the Cycler I get my treatment during the night while sleeping so my whole day, every day, I am free to be as normal and continue to live my life doing what I may, not interrupted by having to do dialysis.  It actually works out very well.

Granted the risk of infection can be great, whether that is greater than hemo I don't knkow.  A blood borne contamination can be just as deadly as a peritoneal infection, so I think it actually evens out.   The risk of contamination with PD can be minimized by YOU using clean technique.  My recent infection, my ONLY infection, had to be caused by ME.  I must have become complacent in making my connections.  I will change my procedure just slightly to ensure my hands are far more sterile EVERY time.  This should not be a problem.

[Simon Dog]

Done just about every modality except transplant.     PD was great; wish it had worked for me.   I think the average rate of PD infection is something like once every few years.  NxStage does a nice job addressing the fluid shift for hemo patients (a one day skip is my long gap)

It is useful to have your doc prescribe an emergency kit of antibiotics.   It won't be enough to cure an infection, but as a first dose it will allow you to show up at the ER with your lab sample (PD drain fluid) and a belly full of antibiotics starting to work while you wait for hours to be seen, as opposed to writhing in pain thinking "lets get this show on the road".

I never used my antibiotic kit, but it was reassuring to have.  Procedure was to never "help myself" but to phone the on-call RN for to go-ahead to medicate.

[Charlie B53]

I was fortunate the local ER got me straight in.  However they were reluctant to dose my belly and only IV med for the first day and a half until I transferred to the VA Hospital were my Neph is based.  I finally saw my Dr at the VA.  I've only been seeing him at the Dialysis Clinic since I started PD over 3 1/2 years ago.  I have seen him there every month at Clinic.

Once they started dosing my belly as well as keeping the IV going, I felt better within a few hours.

The morphine may have had a lot to do with that.

[Simon Dog]

I was fortunate the local ER got me straight in.  However they were reluctant to dose my belly

If you had "the kit", you could have arrived at the ER with a dose already in your belly.