PD Catheter Placement

[jcanavera]

My wife's PD catheter exit was placed high, just under her sternum.  I know her nephrologist and PD nurse have always commented that it is in an unusual position and always wonder why the vascular surgeon who put it in, did it there.  Obviously they never asked.  On the other hand they do comment that they think that it is safer up in that location since it is less likely to be tugged on by clothing.  She also wears a velcro belt that has a slot for the other end of the catheter, that fits around her waist line. 

The negative side is that she just cannot drain fully without a lot of gyrations (sitting, leaning, arms over the head, knees bent up, etc.)  She's on a cycler and it usually gives up before she is empty.  We can usually get another 100-500 ml out of her depending upon the color of the fluid used and whether the drain is the initial or final.

I've asked the question as to whether that placement is the cause for her need to do all the gyrations.  Her doctor says the pickup part of the catheter is low, above the pubic bone area so the pickup is in a good location.  To me that fluid has a long way to travel to exit.  I'm just curious do any of you have a catheter position like this, and can this be an issue of a slower drain?  We are going to get an X-ray to see exactly where that cath sits. 

I think someone posted somewhere (i'm not sure if it was here), to talk to the surgeon prior to catheter placement about where it will be placed.  We didn't and sure wish we either knew why he went where he did, or whether there are other medical reasons why different placement locations are used.  It sure would have made life better if we could trust the cycler that when it stopped, we could be confident that she truly was empty.

Jack

[Charlie B53]

My cath is about midway between center and the left nipple, level with the nipple.

I imagine the Dr's take into account breast size when determining placement.  My 'moobs' are about 'normal' for a big guy with a jelly roll around my middle.  (B Cup?). IDK

My cycler is set on Tidal, I don't totally drain real well.  Somehow the machine is set to 'Hold' after the last drain before switching to the Ico fill.  When I get up I usually cap off, go fix a cup of coffee while I have a cigarette.  This gives time for all remaining fluid to pool in the bottom of the abs.  I re-connect, hit Stop, then Start which restarts that drain without skewing any numbers.  In a few minutes it will pull off anywhere from a few ml to a couple hundred ml.  Then I Stop. down arrow to Bypass which then starts that last Ico fill.

Been working fine, so far.  But I've only been on the Cycler 8 or 9 months.  The year and a half prior I was strickly doing manuals, 4X daily.  I REALLY LIKE my Cycler.