Burying the Cathether & hemodialysis access at the same time

[RCA]

My mother will need dialysis soon and we are choosing PD.  We just go back from a meeting with the dialysis nurse (SUPER SUPER NICE!).  Here are some questions I have:

1.  The Nurse said that even if we don't need PD right away, we can get the surgery done.  The PD Catheter would be buried beneath the skin and then release when she needs to start PD.  Anyone have the catheter buried under the skin until time of use?

2.  In case something happens (e.g. recurrent infection, other illness) and she needs to stop PD, the nurse said that we can get the hemodialysis access surgery done at the same time as when they put in the PD catheter.  We would only need to use the HD access during emergency situations.  Anyone have PD catheter and HD access surgeries done at the same time?   

3.  The nurse mentioned a new cycler from Fresenius...Liberty.  I think it will be available this month.  Does anyone know the advantages of this new cycler (vs. the Newton IQ)?

[Rerun]

NO!  Why get the PD access until you need it.  It only needs about 3 weeks to heal and if they are watching her there won't be an emergency situation.  Also, NO on the hemo dialysis access.  Why put her through any unnecessary surgery only for an emergency!  If PD gets infected and the cath must be pulled they can insert a catheter in her chest (Permacath) and do Hemo dialysis immediately that same day. 

Why don't we just give the entire population a fistual just in cast they may need dialysis "some day"!  GEEZ

[okarol]

I agree with Rerun. Each access opens her to infection, which is unnecessary, in my opinion. Why put her through all that?

[karen547]

 When I had the surgery the surgeon recommended I get both accesses done at the same time as well. I said no thanks. But when I had the fistula surgery my pd cath was removed then

[Wallyz]

I am going to disagree, because most PD patients eventually need some hemodialysis, and catheters have a much higher rate of infection than fistulas.  I would only recommend against it if your mother has weak veins and problems with bleeding already.

Waiting until you have a serious infection to have emergency vascular surgery is an invitation to die early.

One of the issues with Dialysis patients is a shortage of medical services, so demanding two separate surgeries (PD port, then Cath and fistula when you have an infection) without a good medical reason is  a bit uncaring of other patients needs.

[RCA]

Thank you for all of your comments!  I'll let you know what the doctor says and what we ultimately decide to do : ) 

[Joe Paul]

Thank you for all of your comments!  I'll let you know what the doctor says and what we ultimately decide to do : ) 

Any updates?

[RCA]

No updates yet.  I'm applying for insurance for her that's sponsored by the state (high risk group).  Once she gets the insurance, I'll make an appointment with the nephrologist. 

[Joe Paul]

No updates yet.  I'm applying for insurance for her that's sponsored by the state (high risk group).  Once she gets the insurance, I'll make an appointment with the nephrologist. 

Good luck, hope all goes smoothly for you.