Do you ever skip PD?

[kickingandscreaming]

Some months ago my Neph suggested that I do some traveling--for a change.She was suggesting that i could skip a night of PD.  I never did it--- until now.  Tonight I am skipping PD, both a manual treatment and the cycler. I'm just too f---ing tired today and I have to get up very early tomorrow to deal with a plumbing situation.

Will I be struck down for my "badness?"  Anyone else do this ever?

[iolaire]

I would be careful about skipping treatments around the house because you feel poor etc. that seems like a slippery slope and could get you in trouble.

When I traveled on HD often I'd do extra treatments before had to give me an extra free day. So go in Thursday am (right after Wednesday pm) so I could be in transit on Friday pm.   I don't know if that is an option for PD?  Try to get your blood extra clean before you skip a day?

[kickingandscreaming]

PD is different from HD (as you well know).  Since it's done every night, the blood, at a given moment is "cleaner"than it is on HD especially between treatments.  I am still skipping tonight and NOT tomorrow.  I just need a break.

[PrimeTimer]

Healthwise, skipping ONE treatment may not cost you but just think of what ONE little mistake could cost you if you screw something up because you're too tired. A skydiving instructor once told me that if there was ever a day when I just did not feel quite right or up to it, don't jump because that would be the day it would cost me. Get some rest. Good luck with the plumbing in the A.M. We know how that goes.

[kickingandscreaming]

Thank you.

[AaishaDar]

Hi, ive traveled before to relatives house and asked if I could skip pd for the night. It was too much of a hassle to bring the supplies and i wasnt sure if their house was as clean as it shpuld be when ur on dialysis. I dont recommend skipping. You feel sluggish and end up really swollen. Also i would develop a runny nose for two days. My doctor told me once i would get home immediately start dialysis and they added a couple extra hours.

[sahern]

I was told I could skip a few nights when out of town.  I have gone as long as three nights and my labs are still perfect.  I still pee a lot so I have never felt bad or gained any weight.  The last time I went out of town I took everything with me.  It was a pain as I had to travel on small planes (4 seats).  When I got there I did not trust the how clean the place was.  It probably fine.  The other problem was that a shrew(mouse) had fallen down the well with no way to get it out.  We were finding hair in the sink strainers. Such is life in a remote village.

[kickingandscreaming]

Well, I survived my cyclerless night.  Nonetheless for wear.  Weight is same as yesterday, I'm not puffy and I feel "normal."  I won't make a practice of skipping, but it's good to know I'm OK.

[cassandra]

I'm glad you are okay

[kickingandscreaming]

Thanks.  Totally fine.  Even my ankles are boney.  No extra fluid anywhere it shouldn't be.  And it was such a pleasure to have a "normal" evening and not have a ton of stuff to put in the trash.

[Cupcake]

I was also told I could skip one night and I do when traveling. Dragging all that stuff into a hotel is a real pain, and I just can't count on getting things set up- sometimes o place to park the cycler. But last month when I was fleeing hurricane Matthew I skipped 2 days in a row. I definitely was fluid overloaded and blood pressure was up. I increased the volume of fluid the next 2 days and was back to normal. I could have used a 4.25 bag or two but I try to avoid them.

[Charlie B53]

You really have to use good judgement balancing your daily weight and how you feel to decide if it may be safe to skip a treatment.  If you stay very firm with your fluid intake and your labs are always very good, that may have far less negative impact than it could be if one was not so restrictive with their fluids and labs running on the high side.

I myself skipped a Hemo session, first time.  Nasty side effects of oral antibiootics had me unwilling to get very far from my toilet, so I called in and stayed home.  Being so tight with my fluids, plus the added dehydrating effects, I am well under-weight.  So far my labs have been near perfect, or as well as ours can be.  I will, or should be, fine by Fri's session.

There are some patients that do so well that their Dr's have approved an alternate schedule, less treatments than most of the rest of us.  But these people are few yet doing surprisingly well.  It all depends on our labs and fluid control.













Sp mod Cas

[Tío Riñon]

It is fine to miss a treatment once in a while, KickingandScreaming.  As you have correctly stated, our PD regimen allows us a few exceptions or benefits that aren't available with HD.  I've had cycler issues, solution that wasn't delivered, or even family emergencies which precluded my nightly run.

If you have been diligent about your treatments and diet, you should be fine as you learned.  What is important is not to let it become a habit!  After experiencing the freedom, it can be easy to justify skipping on a more regular basis.  Don't fall into that trap.  I sometimes yearn to have days or weekends off like HD patients, but it would come at a cost.

As far as traveling goes, like Cupcake mentioned, I'm careful about that too.  Between time zone changes and running around in a new city--which probably means I'm eating out and not able to have a good control of my rental diet--you don't want to mess too much with your PD.  I've paid the price and learned to plan accordingly when I travel.  However, when done right, PD is actually a very flexible modality since you don't have to send records, have additional tests, or schedule sessions at a transient clinic.  Overall it is a worthwhile treatment for my lifestyle.

[smartcookie]

I am glad you found a little freedom, Kickingandscreaming!  I am definitely not as familiar with skipped treatments on PD as I am hemo, but I would say if you need to skip a treatment, watch high potassium foods along with the fluid gain.  That is what gets a lot of my patients in trouble.  They start feeling chest pain, go to the hospital and find that their potassium shot up.  You seem to be well aware of your body and how it reacts to things, so I say do what you need to.  I would probably be a terrible patient because I love fluid and I am not sure how compliant I could be with the strict no skipping protocol. 

[kickingandscreaming]

PD actually "washes out" potassium on a daily basis--often requiring PD people to supplement potassium and force potatoes.  I realize that the day/night that there is no treatment that washing out doesn't happen, but I would think that in general PD does a very good job of removing excess potassium and creating some leeway. 

The only impact I notiiced after skipping a night of PD is that I was very fatigues as evening approached on the day after. 
So there probably was some toxic build up, but nothing that couldn't be cleared by a good night on the cycler.