No fluid is coming off from PD exchange

[kickingandscreaming]

I have tried 1.5 and 2.5 and there is no UF or only 100mil.  And it's taking me well over an hour to drain, so the whole process is eating up my days entirely and requires that I stay up really late at night to even get 4 exchanges in during the course of a day.  I am so frustrated.  My days are taken up in heating bags, hooking up, draining (forever) and then filling, the un hooking up and then have a couple of hours to dwell, but not the requisites number because I do need to sleep sometimes.  I'm really afraid this is not going to work and then I will have to go in center (with a chest cath) or go into hospice.  My choices really suck.

[Deanne]

It should horribly frustrating!

Do you still urinate a lot? If so, it's possible you might not have extra fluid to remove. Or maybe your dwell times end up being too short because of the other issues. What does your nurse say about it?

[Charlie B53]

What are your blood sugars running throughout the day?

PD works on the DIFFERENCE in sugar between the PD solution % and your blood sugar.  If your sugar tends to run high during the day then you have a problem.  The "red' solution is not recommended for use very often.  That high concentration of sugar over a period of time can develop 'transfer' problems with the peritoneum, reducing effectiveness of PD.

I learned this a few months into my doing PD.  Endo Dr's told me my sugars were too high and I needed to start taking insulin and oral med.  Neph pointed out the orals were pretty much useless as they work through the kidneys and mine are toaast.  So they gave me both types of insulin and I went to a couple of Diabetic classes.  Within 90 my A1C was  6 and PD had pulled another 30 pounds of water off.  The key to that water loss was to get the blood sugar under tight control so the higher % of sugar in the PD solution could draw off the water.

If this isn't clear please ask me to try again.  Let me know which point that I lost you.

This is very important to your success on PD.  Diabetus MUST be controlled.  They go hand in hand.

Take Care,

Charlie B53

[kickingandscreaming]

Do you still urinate a lot?

I still urinate, but not a lot.  I am doing a 24 hour urine tomorrow, so I'll know the amount better after that.
Charlie: Please see my response under PD and Weight
I am seeing my PCP as soon as I have a moment to say "Boo!" and hopefully he can prescribe me something to control my sugar or refer me to someone who can.  I don't test my sugar daily, so I have been getting the results from in-center testing over a couple of months and my sugars were fine until I started PD.  After one fill/dwell it shot up to 198 and that is high for me.  And I know it was in response to the PD fluid (1.5).

[Charlie B53]

High blood sugar during your dwell will limit water drawn off.

Too long off dwell can cause absorption of water.  Dwell time for yellow 1 1/2% should be no longer than 2 hours,  green 2 1/2% four hours.   Going much over these times can cause water to be reabsorbed and seem like PD is not working.

How often do you test your sugar?   Even will controled remember you are now changing everything by adding this 'Kool-Aid' to your system.   Test about mi-dwell and see if, or how much your sugar has risen.  Repeat this at least once or twice for the next few days to be sure of the pattern.  Depending on the numbers your Dr may or may not prescribe insulin.

Needle-phobic?  LOL   As a little kid growing up in the late 50's there wasnot much 'plastic' yet in the world.   I was constantly a 'sick' kid.  The Lady next door was a RN and came over EVERY night to give me a shot in the butt.  Yes, I HATED needles.  Bent more than a few as my little butt clenched.   Mom had a glass on glass hypodermic unit.  Kept it soaking in a dish of alcohol.  I get a wiff of that alcohol yet today and begin to get woosy.  I knew she had it out and was getting ready for Jane to come over and poke me.  Jane taught my Mom how to give 'shots' to an orange.  After not too long Mom was poking ME!    As I grew up so did my 'needle-phobia'.  So much so that I began taking 'Naps'.   High School Biology Lab we had to type our own blood.  I had the lancet poker in one hand, looked at it, looked at the finger of my other hand, back to the lancet, and started getting dizzy.  Ain't NO WAY could I poke my own finger.  I been cut, scraped, bled, had stitches,, but I had NEVER poked myself ON PURPOSE, and couldn't do it.  Fortunately for me the little sweetheart lab partner saw what was going on, how white I was, almost to pass out, and gave me a drop of hers.  Thank the little Angel!  Somewhere along the line in the Army I got better, but not totally over it.  Fast forward another 30 some years, I haven't taken a 'Nap' for 30 some years.  But I will never like needles.  They are a necessary evil.  Since I started PD I've gone well past that 'borderline Diabetic' and need real insulin.  Lots of it.  I tested, poked myself, at least four times a day, injected Lantus nightly and injected Novalog after every meal.  It wasn't enough,  Because of my 'excessive' weight, all that water from poor kidneys, I was insulin resistant,  I had to double my shots.  Take one, wait a couple hours, retest, take another shot of insulin.  It took almost 2 months but I got my sugars down, the PD began working much better now that the blood sugar was down, and ANOTHER 40 pounds of water came off!   And my insulin resistance dropped to normal!

So even needle-phobics can learn to test their blood sugar.   That little 30 gauge needle for the insulin is barely noticeable when new.  If you re-use it more than a few times it dulls then I can feel it.  Change the needle.  No problem.

You learn, when it comes down to what you have to do to gain better control of your life, you CAN do it!  One of those GOT TO things.

Been there, done that, wore out the shirt already.

And I'd bet there are a number in here that can tell much the same stories.  We do what we gotta do.  You can, will to.

[kickingandscreaming]

I checked my 24-hour urine output yesterday and I am producing 36 0z. /day.  That's more than I expected.

[Charlie B53]

lol  At least you are still producing.  This shows you do have some kidney function.  PD should be a good choice for you and you will not have to limit your diet and fluid intake near as much as others on Hemo and not producing at all.

You will still have to pay attention to phosphorus and potassium, and be sure to include plenty of protien that we lose through PD and urine.  Not to difficult once yuo learn a bit.

Dr's have me taking 120MG Lasix twice a day in attempt to make me P more.   If I flood myself I might make that much.  I'm usually under a liter.