A dumb question regarding PD

[mariannas]

Although I have my catheter, I haven't started PD yet and my numbers are still ok so it might be a few months before I actually start.  Anyways, I haven't started my training yet, but there's a question I'd like to know the answer to now.

Let's say you want to go to an all day event (or work) how do you do your exchanges during the day if you aren't on a nighttime cycler? 

I always forget to ask these kinds of questions at the clinic because I only go there for flushes and I don't have a lot of time there.  Thanks in advance for your help!

[goofynina]

You can always do your exchanges in the evening, maybe omit one exchange if your not overloaded so it doesnt run into the late hours.  That is the joy of doing it at home, you work it so it works for YOU and your schedule.  I do however highly recommend the cycler if it is avaliable for you, that way you run it at night while you sleep and you dont have to worry about anything during the day    Good Luck and please keep us posted 

[mariannas]

Oooooh thank you!  So it doesn't matter if you do them all at one time (say between the hours of 6 and 11?).  I mentioned that I want to go on the cycler eventually, but I think the dialysis folks want me to do the manual exchanges for a little while.  Also, are the cylers big?  Could you theoretically take one on a road trip if need be?  The reason I ask is because of the hobby I am involved in.  I usually have an event once a month and every once in awhile I go to one out of state.  I hate the idea of having to give that up since it keeps me sane, but I also realize my health comes first.  Does anyone have advice as to how to deal with mini vacations and PD?

[Wattle]

Once you get the hang of the manual exchanges you can do them anywhere. I have a travel box with everything I need in it. I have done exchanges in the car, at work, at the beach (in the surf club) etc. Good Luck.  

[Wattle]

So it doesn't matter if you do them all at one time (say between the hours of 6 and 11?). 

You can't do the exchanges all at the one time. There is a dwell period between the exchanges that maybe around two to four hours. The fluid has to be able to do its job.

I am on the cycler over night. I have three exchanges in an 8 hour period. I have a final fill that is carried during the day and exchanged in the afternoon. So I do one manual exchange per day and the cycler all night.

[Ken Shelmerdine]

Once you get the hang of the manual exchanges you can do them anywhere. I have a travel box with everything I need in it. I have done exchanges in the car, at work, at the beach (in the surf club) etc. Good Luck.  

I've heard this before about doing exchanges in the car etc. isn't that a bit risky infection wise because there would be nowhere to do the 1 minute handwash? You'd be relying entirely on handrub.

[Ken Shelmerdine]

Also, are the cylers big?  Could you theoretically take one on a road trip if need be? 

The baxter cycler is about the same size as the very first top load VHS recorders. If you go to the Home Dialysis pictures page on this site you'll see what I mean. You can fit one easily in the boot of your car. It also comes with a flight case which has it's own wheels like a large luggage case.
Why don't you ask them if you can go on the cycler right away. They are so easy to use. I learnt both methods in my week's training period so I always have the option of CAPD or the cycler.

[MyssAnne]

A lot of clinics prefer to start you on manuals, then train you on cycler, that way you have a backup for emergencies, trips, etc.  I have also done manuals in the car, had to, we were on a road trip, and my nurse said it was safer in the car with known germs than to leave it. The Baxter cycler seems to be more portable than the Fresenius, that's what I'm on, it's a heavy sucker at times!  I have been known to do manuals on weekends if I am gonna be out of town. You do have that flexiblity!

[KT0930]

I've also done exchanges in my car (always carry antibacterial gel & use it liberally!!), at work, even in a spare room when I was at a dialysis patients' convention at a civic center! Like others have said, you make it work for you. I've heard of dwell times ranging anywhere from 2-8 hours, longer overnight, of course.

I'm on the Fresenius Newton IQ cycler, and when I bought it home earlier this week with a box of tubing, the stand, and two boxes of fluid, it took up the trunk of my car and a portion of the backseat (I drive a Honda Accord). It can probably be condensed somewhat, and Fresenius will deliver fluid anywhere you want, with some advance notice, but we're still talking about renting an SUV for our trip so we also have room for all our luggage!

Hope this helps, and you get the chance to use the cycler, it's really much easier to plan around. BTW, I had a full week of training for manual, but the cycler only took about 2.5 hours.

[mariannas]

Ooooohkay...I think I'm catching on now!  So you can have really long dwell times if necessary?  Is there a time limit?  Again, let's say I'm at an event from about 7 am to 5 or 6 pm (including travel time).  Would I be able to keep the solution in for that long or would I need to make sure I could do another exchange sometime during the day?  Knowing I can do them in the car is helpful. 
Thank you so much for answering all my questions everyone.   

[KT0930]

Mariannas, yes, 10 hours during the day would probably be a bit too long to go. Most people doing CAPD (manuals) are prescribed four exchanges a day. Occasionally, if you were going to an all-day event and no matter what you do, you could only fit in three, it probably wouldn't be the end of the world. Usually the worst that will happen is you might retain some extra fluid, in which case you might use a stronger dextrose solution for your next exchange or two. The longest I ever went without an exchange (except for overnight) was probably 8 hours.

[goofynina]

Ooooohkay...I think I'm catching on now!  So you can have really long dwell times if necessary?  Is there a time limit?  Again, let's say I'm at an event from about 7 am to 5 or 6 pm (including travel time).  Would I be able to keep the solution in for that long or would I need to make sure I could do another exchange sometime during the day?  Knowing I can do them in the car is helpful. 
Thank you so much for answering all my questions everyone.   

Not if your a high transporter.  If you are then that means your body will start reabsorbing the solution after a certain amount of time.  They will take all these tests when you start to find out   Good luck and ask away my friend 

[Ohio Buckeye]

One time when I traveled I did a manual fill before I left and drained when I got
there, was empty during the day, and did a manual fill and drain when I got home.
I'll be glad when you get on the cycler.  I only did manual a short time and switched
to cycler.  Good luck. 
Goofynina si right about absorbing the fluid over a long time.
When I first started they had me dwelling overnight and I was gaining weight and
swelling everyday and I figured out from this board what was happening.  The first week
I quit dwelling overnight I lost like 16 lbs.  The clinic should have known.  They do this
all the time, I was new at it. 

[Ohio Buckeye]

By the way, I just wanted to add that this was not a dumb question you asked.
Never have seen any on the site.
Don't ever feel like your questions are dumb.

[Wattle]

Once you get the hang of the manual exchanges you can do them anywhere. I have a travel box with everything I need in it. I have done exchanges in the car, at work, at the beach (in the surf club) etc. Good Luck.  

I've heard this before about doing exchanges in the car etc. isn't that a bit risky infection wise because there would be nowhere to do the 1 minute handwash? You'd be relying entirely on handrub.

Hi Ken,

Along with my "travel box" I take a large tub/bottle of water. I still do a hand wash, with antibacterial soap, standing outside the car. I get someone to help me. Then I use plenty of hand rub. I do the actual exchange sitting in the car. It can be done safely. I did CAPD for six months before I got a cycler. It was summer over that time and my children are involved in life saving here. It was a case of try to travel or sit at home and miss out. I hate to miss out on anything! I am now on APD but still have to do one day exchange. In the two years I have been on Dialysis I have not had any infections (touch wood). I just try to be as careful as I can.   

[Ken Shelmerdine]

Once you get the hang of the manual exchanges you can do them anywhere. I have a travel box with everything I need in it. I have done exchanges in the car, at work, at the beach (in the surf club) etc. Good Luck.  

I've heard this before about doing exchanges in the car etc. isn't that a bit risky infection wise because there would be nowhere to do the 1 minute handwash? You'd be relying entirely on handrub.

Hi Ken,

Along with my "travel box" I take a large tub/bottle of water. I still do a hand wash, with antibacterial soap, standing outside the car. I get someone to help me. Then I use plenty of hand rub. I do the actual exchange sitting in the car. It can be done safely. I did CAPD for six months before I got a cycler. It was summer over that time and my children are involved in life saving here. It was a case of try to travel or sit at home and miss out. I hate to miss out on anything! I am now on APD but still have to do one day exchange. In the two years I have been on Dialysis I have not had any infections (touch wood). I just try to be as careful as I can.   

Hi Wattle
  :thumbup;That's a good idea. Hadn't thought of that. You sound like you've got it down to a fine art. I don't know whether I could be so organised. You mentioned the beach and the surf club. Do you go in the sea? It's just that here in the UK we're told we can use a chlorinated pool but never swim in the sea. 

 

[KT0930]

Ken, I was told I COULD swim in the ocean or in a privately owned pool that I knew to be very well-maintained. Honestly, I don't get to the beach that often, and while I enjoy swimming, it's just not worth risking another peritonitis infection. I've had one, not an experience I'd like to repeat!

[Wattle]

Ken,

I was told the same as KT0930. Swimming was o.k in a very well maintained private pool or a clean ocean beach. I have not gone swimming in a private pool but I have in the sea. The look on my children's faces was worth it. It was an ocean beach that wasn't very busy. I have been taught to do a waterproof dressing over my exit site. Which I did. However, it did come loose and the site got wet (due to the rough surf). I just did an anti-bacterial wash when I got out, by the ca,r using my travel pack. Everything was fine. I have no issue with swimming again.