Peritoneal or Hemo?

[angieskidney]

I worry about travelling because they said I could travel easier with PD, but it doesn't seem easy (and Geoff's experience backs that up!) and that's important to me.

I found it VERY easy to travel on PD myself (and I am talking out of my country (Canada) to the States!! I didn't have to worry about American coverage or anything like I do with HD.) With Hemo I can NOT travel .. unless I go out and buy outter country insurance coverage with my pre-exsisting medical condition 

Of course it is different for everyone and also dependent on your own personal situation and where you are in the world

[geoffcamp]

I am not sure how your insurance works in your country Angie but I find it much easier to travel on hemo!  I just tell my social worker where I am going and she makes the arrangements.  I have been out of the country more then once and had no problems at all.  They even have cruises now with dialysis on board so you can get treatments while on the boat!  No supplies to lug along or have sent to where ever you are going just go and show up at the center at the time the social worker set up!

[Panda_9]

Ya I myself didn't get it in my feet so much. Even at just 2L (3L??? How could you handle that? 2L was a lot for me!) I looked pregnant and then the drextrose!

I am just glad I got my stomach back after getting off PD even though it DID work for me!

The needles aren't so bad once you get used to them .. but I too had a HUGE fear of the needles. Damn I STILL do! lol (Epoman's been trying to calm me down about self-cannulating lol)

Beleive me it wasnt comfortable!!! When I first started 3L it was rather painful, I just felt like my belly was going to burst. It affected my appetite as well (along with the severe nausea), as once you had all that fluid in you, there wasnt much room for food or drink! When Im due for dialysis now I still tend to look pregnant as all the fluid accumulates in the abdomen. It is a real pain as my clothes dont fit me the day before dialysis, but they fit me the day after!

Oh that brings up a very important point and memory for me!! On PD I couldn't go to the bathroom as well because it was pushing on everything. So when I drained initially I would disconnect and go to the washroom and do my thing. When doing CAPD I would bring it in the washroom with me so I didn't have to disconnect. It was easier to do that. Had you found similar problems?

I was quite the opposite. As soon as I started running the bag in I would have to run to the toilet (which was outside in the laundry) carrying the full drain bag and mostly full fill bag lol I had mild colitis (which wasnt supposed to cause any problems), but I constantly had to run to the toilet, especially if the bag was a bit on the cold side. Then when I started on the cycler it was very difficult as I would have to disconnect quickly trying not to contaminate the lines meanwhile hopping around like an idoit trying to hold it in. For the first few months I still urinated as well, and it was getting increasingly urgent, so that was a double problem.
Since being on hemo I rarely get it, and I dont have to pee!

[angieskidney]

I am not sure how your insurance works in your country Angie but I find it much easier to travel on hemo!  I just tell my social worker where I am going and she makes the arrangements.  I have been out of the country more then once and had no problems at all.  They even have cruises now with dialysis on board so you can get treatments while on the boat!  No supplies to lug along or have sent to where ever you are going just go and show up at the center at the time the social worker set up!

The difference is I am poor

[Panda_9]

I guess thats why alot of foreigners come over here. Everything is free here, except medications which are pretty cheap anyway. No offense but Im getting a bit annoyed with the abundance of foreigners at the hospital who obviously are here just for the health care, and cant speak a word of english.

[Black]

"...Researchers at Johns Hopkins have found that in people with end-stage kidney disease (ESRD), choosing peritoneal dialysis over hemodialysis increases their risk of dying by 50 percent.  ..."

http://www.hopkinsmedicine.org/Press_releases/2005/08_01_05.html

[geoffcamp]

WOW that is a hell of an eye opening number!

[meadowlandsnj]

****My opinions and experiences ONLY!!****
I did both PD on the cycler and Hemo.  I absolutely HATED PD!!!  I could not do anything!  My RX for PD was 11 hours EVERY night on the machine and 1 exchange during the day. 
Geoff

I had almost the same experience--I was 9 hours on the machine at night plus 2 exchanges during the day,  I hated it also!!  I was also given the whole song and dance how about how much better PD was.  It sucked!!  Plus the supplies took over my apartment!  I was living with dialysis 24 hours a day 7 days a week.  Time to hook up, time to do an exchange.. it got to me after a while.  This was in 1993.  I was on PD for 9 months I think.  I gained so much weight from the solutions.  It was like 50 pounds and it was a royal pain taking it off again after I got off PD in 1994.  But soem people like PD and this was only MY experience...........

[anja]

I have been on PD for 16 months and so glad I found this site which directly impacted my decision.  Without it, my Dr. would have had me on in-center, with no discussion.  So glad I lurked here and learned all I could.  I have never regretted my decision !  I watch my father on in-center hemo. and realize how very lucky I am to be able to do PD and have such good labs.  Dad bottoms out often with his blood pressure,  goes home wiped out, and his voice is a raspy whisper after hemo.  This is just our experience and everyone's situation has different variables.  Best of luck on your decision making.     Anja

[goofynina]

My experience with PD has been great, i am so glad i am able to do it,  i think i gained more weight while in-center due to my constant gaining of 5 - 7 kilos between each session,  it kept creeping up and up and up,  i have been at the same weight while i am on PD,  matter of fact i lost 3 kilos on the last visit, dont know how that happend but i was happy it did.  So all in all, i have been very pleased with being on PD,  yes, it is uncomfortable and yes, the supplies do take a bit of room but i dont mind 

[angieskidney]

I still gotta read that article but as soon as I saw what you quoted black I was like, "WHAT??!" I mean I was on PD for over 4 yrs. I would think HD would be more risky considering how easy it is to get a blood clot. Too bad I can't do PD anymore since the Peritonitis I got was so bad

[Ohio Buckeye]

I'm very glad I chose PD.  It was not a hard decision for me to make.
I went to a class that told about each method and I left the class knowing
I'd choose PD.  Started CAPD then changed to CCPD.
Using the cycler at night is not a problem for me.
Doesn't take long to set up.  Dragging heavy bags around is an annoyance but
I tell myself, get used to this, you have to do it.  I haven't had any nausea or problems.
Diet and drinks is not quite as restricted.  I'm so grateful that there was that option
for me and I pray that I NEVER have to go on hemo.  At least if you start out
on one, if it doesn't work for you, then you could go to the other.
I'm a widow, maybe that makes a difference also.  Some people wouldn't want the tube hanging from their stomach or would not want to be "hooked up" at night.  I prefer it to sitting in a chair for
hours with needles hanging from me.  There are supplies, but they are delivered, rotated,
and stacked by the deliveryman and I keep them in my smallest bedroom and keep the door
closed except for when I need something to set up.  It has not taken over my life. not at all.
Most people don't even know that I am on dialysis.  There is one lady who broke her elbow
and they made her do hemo for a while. I broke my hand but I managed to keep going so I did not have to do hemo.  Had to have a friend help me set up for a while.  PD, so far, for me, has just
been an inconvenience, hoping it stays that way.

[angieskidney]

I prefer it to sitting in a chair for
hours with needles hanging from me.  There are supplies, but they are delivered, rotated,
and stacked by the deliveryman and I keep them in my smallest bedroom and keep the door
closed except for when I need something to set up.  It has not taken over my life. not at all.
Most people don't even know that I am on dialysis. 

Ya my delivery guy was real nice and rotated them for me as well. He didn't always know the right order so I had to tell him but he was real nice and always asking how I am doing healthwise. Sometimes he even brought me things. Very nice guy Deliveries would come every month and I would keep the spare bedroom door closed.

[Triker]

Just my two cents worth:
I've been doing dialysis for a little over 6 years. My kidneys failed due to untreated high blood pressure. I started out with a hemo catheter, and used it until my PD catheter was ready. I used PD with a cycler for about four years until it got to be too much work, and requiring too much time. All the inventory, trips to take out the trash, dumping the 10 gallon bucket with used solution everyday from one end of the house to the other, it stinks, they kept increasing my volume until I looked like I was pregnant, to spend a weekend away involved loading a pickup truckbed full of supplies and machine, the final straw was when they wanted to increase my time from 8 hours to 10 hours nightly, not including the daily manual exchange, it was just too much for me. I had a spare bedroom full of supplies! I went back to a hemo catheter, until my fistula was good to go. Now I can take off on my motorcycle trike on a Friday afternoon and not worry about a thing until Monday morning. The down side is that I have a terrible time restricting my fluid intake. Regularly, I have to get an extra treatment after the weekend to takeoff the extra fluid. The local clinic is only open on Mon., Weds., & Fri. I have to go about 30 miles to the next closest one, and if they're full up, the next option is a two hour or better drive. On PD I was able to drink pretty much all I wanted. I also, felt better on PD. Some of the technicians aren't properly trained, I'd be better off sticking myself. LOL!!! I don't have a good relationship with one of the charge nurses. All I want is for her to do what she gets paid to do. I guess sometimes we disagree what that is. I'm happy to still be here, but that's not to say that I'm always happy. I was just reading in the forum about Nxstage. I have never been told about it. I don't know if it's an option for me or not, but I want to check into it.

Just a rant off the subject: I used to feel that one of the charge nurses used to try to threaten me about my fluid overload by telling me that she didn't know if she could get me in at the clinic 30 miles away, and that she might have to send me to one over two hours away for an extra treatment. Once, she told me that they were too full, and I managed to get around her. When I got there, there were three empty chairs after I was hooked up. She doesn't threaten me now. Another interesting thing, I asked why I couldn't go to a clinic 30 miles in another direction for my treatment rather than driving over 2 hours away? It was because it wasn't Davita. Medicare doesn't care, they would pay all the same. The provider's red tape makes it nearly possible to do this. This tells me that they are more interested in the money, than providing for the patients. Of course, they will tell you that the quality of care may not be the same. Sorry about the rant. I hope that I could help you with your decision. Best wishes, however you decide.
Triker

[angieskidney]

That was a very good and informative post Triker! Thanks! 

[angela515]

I just wanted to comment on something that was said. I don't know how long ago you did PD, but, you said you had to dump a 10 gallon bucket of used solution everyday... i'm not sure why, but that's not how it works, now at least. You have a drain line... and in the morning when your done you hook the drain line up to your used bags and the other end of the drain line goes in the toilet, or sink, and you walk away do whatever it is you o... come back later and unhook the drain line and your bags are now empty, you didnt have to lift a thing.

[angieskidney]

I just wanted to comment on something that was said. I don't know how long ago you did PD, but, you said you had to dump a 10 gallon bucket of used solution everyday... i'm not sure why, but that's not how it works, now at least. You have a drain line... and in the morning when your done you hook the drain line up to your used bags and the other end of the drain line goes in the toilet, or sink, and you walk away do whatever it is you o... come back later and unhook the drain line and your bags are now empty, you didnt have to lift a thing.

I know there are different types of CCPD depending on if you are through Fresenius or Baxter (are there others besides those?).

Mine was very similar to this (this pic only shows 2 5L bags but I also had a 3rd that was an additional 2L):

[angela515]

That looks like Baxter products... I dont know much about Baxter, but I know 1 person on PD with baxter and they also use a drain line... I use Fresenius, and I use 5L bags, 3 of them, each night. Luckily I only have to lift them once to setup my machine, and I hook them up to a drain line when im done so the next time I pick them up they are empty bags.. lol.

Weird 

[angieskidney]

That looks like Baxter products... I dont know much about Baxter, but I know 1 person on PD with baxter and they also use a drain line... I use Fresenius, and I use 5L bags, 3 of them, each night. Luckily I only have to lift them once to setup my machine, and I hook them up to a drain line when im done so the next time I pick them up they are empty bags.. lol.

Weird 

Ya that pic does look like Baxter from the connector. I was on Fresenius myself but didn't get any pics of the drain bags (I kinda thought I would still be doing PD ...) for CCPD. I only have 1 pic of me on CAPD (Fresenius):

[mallory]

So do any of you on PD have Baxter?  I think that's what my clinic uses.  They gave me a book about PD, and it was from Baxter.  Is it okay, or is Fresenius better?

My catheter is still bleeding a little and I'm a little freaked out today about this whole thing.  I sure hope I haven't made a mistake, maybe I should have chosen HD.

[goofynina]

Hi Mallory,   I have Baxter and i love it,  dont worry, things will work out for you.  Are you currently on hemo?  Please address all PD questions in the Home Dialysis thread   see ya there

[Rerun]

Mallory, Don't worry if PD doesn't work out you can always try hemo.  You've got to start somewhere and PD is a place to start.  I've done both and I would love to be back on PD but too much scarring has made it impossible.

[anja]

Oh, Mallory, I wish you weren't so worried, but that's normal, so was I.  I have been on both Baxter   and Fresenius  and by far prefer the Baxter machine. In my opinion,Baxter is less sensitive( so fewer alarms) because it does not work on the scale system, much easier and quicker to set up, has longer tubing, can be disconnected as many times as needed(unlike F, which you can do only once), it can drain into a bucket or stool or tub (Fresenius drains into bags hanging on the machine that you must struggle to unhook and carry to dispense of), there is less waste(tubing, containers and wrappers)  with Baxter(hence, less garbage to get rid of),  the connecter attached to you has shorter tubing to contend with.  I could go on and on, as I did with my dialysis unit when they wanted me to switch - recounting each and every positive and negative.  The only positive I found that the Fresenius had was that it was somewhat quieter, except when it switched over - that was a loud clicking noise.  Now that I have moved my machine to the hallway I sleep more peacefully and have no problems or alarms- whoever said it had to be next to your head or even beside your bed?  It does not!  Best wishes for your introduction into the world of dialysis- you are LUCKY if you are able to do PD!  Thinking of you,  Anja

[Panda_9]

I was on gambro and had to carry 15-20L out to the bathroom (which was outside) every night.

[angela515]

Oh, Mallory, I wish you weren't so worried, but that's normal, so was I.  I have been on both Baxter   and Fresenius  and by far prefer the Baxter machine. In my opinion,Baxter is less sensitive( so fewer alarms) because it does not work on the scale system, much easier and quicker to set up, has longer tubing, can be disconnected as many times as needed(unlike F, which you can do only once), it can drain into a bucket or stool or tub (Fresenius drains into bags hanging on the machine that you must struggle to unhook and carry to dispense of), there is less waste(tubing, containers and wrappers)  with Baxter(hence, less garbage to get rid of),  the connecter attached to you has shorter tubing to contend with.  I could go on and on, as I did with my dialysis unit when they wanted me to switch - recounting each and every positive and negative.  The only positive I found that the Fresenius had was that it was somewhat quieter, except when it switched over - that was a loud clicking noise.  Now that I have moved my machine to the hallway I sleep more peacefully and have no problems or alarms- whoever said it had to be next to your head or even beside your bed?  It does not!  Best wishes for your introduction into the world of dialysis- you are LUCKY if you are able to do PD!  Thinking of you,  Anja

I just needed to correct a few things beause I am on Fresenius and you make it sound so bad.  You say youcan only disconnect from a Fresenius machine one-time, and thats not true... I disconnct as many times as I want too... I have snap-disconnect and have many many disconnect's if I need them and need to be unhooked from the machine. I also do not have to carry my bags to drain them, I just hook up a drain line and put the other end of it in the toilet and come back in an hour or 2 and its empty. Also my machine makes no noise at all, not even switching from drains to dwells and fills... only sound is if I alarm, obviously. So, there are lots of positives to Fresenius also... not just negatives as you pointed out.Maybe you sed a different machine for Fresenius, idunno.. I use Freedom Cycler PD+ IQCard. I used Baxter for a week in the hospital and was glad I didn't have to use it at home.. I didn't like it at all, so you see, everyone has a prefrencce, and mine is Fresenius 

You will have to try and see for yourself what works for you.