I know im fed up but ..

[KICKSTART]

Ive written another thread in the general section about my struggle at the moment, but i also have a question for people who do PD. I have been doing manual exchanges for about 3 years and only recently gone on to APD. Now since ive gone onto the machine at night ive never felt right. I know my BP has dropped alot and this is why im feeling like this according to my doctor but.. .......Last night i was so fed up, dehydrated etc, i decided not to set my machine up , i just wanted to sleep and to be honest the whole effort of setting up was so exhausting i couldnt face it. So i stuck a manual bag on the heater for today , the plan being i would do some manual exchanges to make up for last night. Now i got up this morning , did a manual exchange and although i cant say ive got any energy , i feel as bright as a button!!! ( if that makes sense)
So i wondered has anyone else gone back on to manuals from APD , did they find the machine didnt suit them?
I cant say its what i wanted but if it makes me feel brighter i might not have a choice . Just to see how i feel im going to switch to manuals over the weekend and see how it goes!!

[kimcanada]

Well I "was" on manual and I "was" on the machine, I personally hated the machine...

I tried so hard to like it, but it didn't seem to do enough dialysis for me.  When I first went back on hemo, I did 5 hours a days till I was back to normal.

I hope you figure out whats best for you Kick, everyone is different, and I even felt guilty that the machine, that does wonders for everyone else made me worst.

Good Luck 

[KICKSTART]

Thanks Kim, i was just wondering if it was me!! I feel very drained when i come off it in the morning and wonder if my body got used to the more gentle spaced out over the day manuals , anyway i will see how i feel over the weekend. Ive just got so many changes going on its difficult to tell whats causing what !

[george40]

Hi Kickstart, you have read some of my posts so you know I was on the machine but after the machine didnt work very well for me I went to manuals. Being that the machine kept me up nightly for hours because of drainig issues I felt miserable every day! On manuals I felt good. I just had surgery to manipulate the cath and untangle the cath from my omentum. So they have me trying the cycler again. A few nights ago I was so messed up from missing sleep that I decided to skip. So, I understand your frustration. Last night I had a good night on the cycler and I felt great this morning! I just got a machine replacement and am hoping the new machine works better than the one that gave me fits. If every treatment was like the one last night that would be wonderful. I know it is frustrating at times. Hang in there.

[Restorer]

On the other side, I fellt absolutely terrible on CAPD. It wasn't just that I felt bad - I was doing really badly, very fluid overloaded, and not dialyzing nearly enough. Once I got on the cycler, it all went away and I felt much much better. I think it really all matters on how your peritoneum works. You say you're dehydrated and your blood pressure is constantly low? Maybe you're taking off too much fluid. What's your ultrafiltration like on the cycler vs. manual? Are you using the lowest concentration bags?

[KICKSTART]

Hi guys , firstly i dont have an issue with the cycler itself , in fact i have never slept better , it doesnt disturb me one bit !!! Also im a high transporter , so perfect for the cycler.
Restorer .. My BP is low after 2 years of running around 230/136 (yes!!!) they put me on a new medication which halved my BP overnight ! But now its in my system, my BP has dropped to below normal, trouble is my doctors are SO pleased with this , that to them its not a problem and they tell me it could take weeks for my body to adjust. We have tried alsorts of regimes on my cycler to get the balance. Ive done Opti choice as well , but no matter what combination of bags i use , i either pull off to much fluid or not enough! Where as with manuals i was fine , never really overloaded , never really dehydrated. I just wonder if my body got used to the gentler manual exchanges every couple of hours , than all in one hit overnight ( i have been doing PD for quite a few years now).

[MiSSis]

Hi Kickstart,

I do think it takes a little while to find the regimen that works best for you when using either the cycler or doing manual exchanges.  I'm considered a low transporter due to several cases of peritonitis in my past.  As a result, what works best for me is longer dwell times.  Currently I'm doing 6 exchanges per night with 1 hr and 30 minutes dwells.  When I see my doctor next month, I'm going to ask to try 5 exchanges and 1 hr and 45 minute dwells.  I'll get about the same amount of total PD dwell time but the entire process will take about 1 1/2 hours less.  For about 3 nights in a row I can use the lowest concentrate of dialysate (1.5%) but around the 3rd or 4th night, I need to up one of my 5L bags to 2.5% just to be sure I'm not retaining any extra fluid.  Most nights I ultrafiltrate anywhere from 500 to 750 cc. 

My husband and I travel 2 or 3 times a year to visit my father in south FL and when driving there, I always switch to manual exchanges for the car trip down.  It's much less hassle not having to mess with setting a machine up in a different hotel each night and I can also do exchanges during the day.  I usually just throw on some sweats or baggy shorts since we'll be riding all day so the extra fluid in my belly isn't as uncomfortable.  However for whatever reason, I don't feel like I get as good as dialysis as I do when using my cycler. 

Lately I've been have tremendous problems with sleeping and sometimes can't get to sleep at night at all.  Usually what happens is I end up skipping dialysis that night but I will hook up in the morning and basically do manual exchanges all day long but using the cycler to keep track of my drains and fills, if that makes any sense to you.  When that happens I tend to extend my dwell times even longer to about 2 to 2 1/2 hours each so it's not quite so disruptive during the day.  It's probably not ideal but until I can figure out this sleep problem (or lack of sleep problem), I figure I'm still getting in the hours of dialysis I need, just not at the times I would normally do it. 

I would think that you've been at this dialysis business long enough now that you're becoming very aware of what is working best for you and there's nothing wrong with choosing manual exchanges over the cycler as long as you feel well and your monthly labs and other tests reflect that you're getting adequate dialysis as well. 

[Hanify]

A friend of mine tried the cycler but it didn't work for him.  He was very slight and there was just no combination that didn't take off too much fluid.  I think you should stick to manual if you are happy with it.  There's no reason to use the cycler unless it suits you if you're getting enough dialysis manually.  Over here (NZ) by the way, we are encouraged to have a 'day off' once a month.  Apparently it does no harm.  It's a strange thing to do though I have to say.  I usually get less sleep, not more.  Just thinking about it...all that fluid going nowhere or something.  The cycler definitely works best for me, but we're all different.