Loosing sleep because of PD drain issues.

[sahern]

I thought I was on my way to an easy time with PD after a rough start.  After the fill and drain pain at the beginning and having to stand up to get fluid to drain properly everything started to settle into a routine.  I was even starting to sleep through most of the night.  Well the last two weeks has not been going well.  For me to drain it is very positional.  It involves a combination on sometime sitting on the edge of the bed or at other times making sure I am flat on my back.  A lot of time it takes a combination to get the drain to go at a normal speed.  I am taking Heparin and have only a few small flecks of fibrin in my drains. I have been on PD for two months now and wondering if it gets better or anyone has any suggestions.  I am becoming very cranky and ready to smash my machine because of the alarms.  Any help would be great.  Thanks Shaun

[Charlie B53]

I am sorry that I failed to see your post and reply sooner.

I am also on PD using the Cycler at night.  I do not drain well on my back or left side.  I am often wakened by the alarm and roll onto my right side and it drains OK.   Because of this my Nurse has set my machine on 'Tidal' and 'Hold Before Last Fill'.  This requires her to figure just what % of fill to drain each time and a slightly smaller fill to allow for that fill that was not drained such that I am never way over-fillled.

I carry Ico throughout the day, so that 'Hold Before Last Fill' pauses the machine until I get up and restart the program.  What I do here is hit the 'Stop' then immediately hit the 'Start' which causes the machine to resume the last drain.  Now that I am vertical I drain out ALL fluid, when it stops I then have to hit the button to go to that 'Last Fill' to fill me with the Ico.

Three years in May, so far I am doing well.

You need to talk to your PD Nurse about possible options to your treatment program to make it easier for you.

Take Care,

Charlie B53

[sahern]

Thanks for the reply.  I have been on tidal from the start.  I have started to sleep in a recliner in the living room so as not to wake my wife with the alarms.  This seems to be working well as it must keep me in the right position to drain as now the alarms do not come in very often.  I do miss my bed though.  I have talked to the nurse and it seemed as if she was not sure what to do.  When my oldest moves out this fall I am going to set up a room with a bed that can raise the head and feet.  I do hope with time it will get better as I do like the freedom that PD gives me.  Thanks Shaun

[kickingandscreaming]

I'm still on manual PD. so I can't comment on the cycler yet.  But I can tell you that I am a major fibrin factory and that has caused untold problems with draining.  I now have to use heparin for 2 our of my 4 exchanges.  That seems to be working well so far, knock on wood. But the point I want to make is that I never see flecks of fibrin in my drain bag, so if I were going by that I would be sure I had no fibrin at all.  And yet I do, and the double heparin seems to fix it.  Maybe you need more than you're getting.

[Charlie B53]

About the only time I see strings of fibrin in my drain is days after a particularly bad drain pain, or sometimes days after an sudden voilent body movement.  I suspect the cath had 'rubbed' or scratched the lining, either the peritoneal membrane or a part of the intestine.  Sort of how a scratch on the skin forms a scab,  I have to wonder if the fibrin forms over these slight inside injuries then is sloughed off after sufficient healing has occured, thus floating until desolved or drained.

Who knows?  Sort of makes sense, to me.  But who am I, just a patient.

Glad you have found a method that is working for you.  Quality rest is hard enough to get, especially if your machine is alarming and causing you to get up and move.

Take Care,

Charlie B53