Is it bad

[paul.karen]

Last Tuesday i had my Cath flushed with 1.5 dialysis solution.  This was the first time my access had been used.  They put in 5ooML and drained it four times.  The final drain when the weighed the bag there was 400ML of solution that never came out.
My concern question is-- is this bad form people?  I wont be going back to train on the cycler until the 28th.  What happened to the fluid is it still there if absuerdr is this bad for us?  Why didnt it all drain out of me?
Is the cycler better cause it will suck it out?
I thought i was lucky cause i had no drain pain.  Only to find out i didnt totally drain...

[KICKSTART]

Sometimes it varies between what goes in and what comes out. When you get going properly you should as a rule pull more fluid off than you put in but there are times when this doesnt happen. If you go over your exchange times or have a long dwell for instance you can absorb some of the fluid. I wouldnt worry to much as you are just starting out and not doing proper exchanges yet. Sometimes 'fibrin' gets in the way and stops a complete drain as does constipation! Best thing to do is keep an eye on yourself , if you start to show signs of fluid overload have a word with the doctor.

[paul.karen]

Thx as usual Kickstart.

Once i start going for real in the next month or so i still pee plenty (for now) so with this in mind should i still pull off more liquid then goes in.
I realize i will learn all this from my techs (who are nice so far) but i like to go in with some knowledge.  I have surprised them thus far ..
They even have some comics hanging on the wall they pulled from IHD.

[KICKSTART]

Ah thats probably why you got less out , if you measured your urine output as well and added that to what you pull off from dialysis that would be your total , so i wouldnt be to worried !

[CCStan]

Paul, sorry to hear about your problem.  Many of the reasons for your negative UF ( less out,than in)  can be related to what Kickstart mentioned.  But, unfortunately this is how my husband started back in December.  The nurse flushed with heparin and did get a fair amt of fibrin out, then hubby twisted and danced and still nothing coming out or very litlle .  After an x-ray it was noted that the catherer tip was pointing up.  He had to go back to hosp/surg. to have it re-postioned. Although before the surg. it got to the point of nothing returning.  So hopefully you just have some fibrin or constipation issues going wish you the best !!!  If not an x-ray (flat plate of the abdoment) would be in order.  A simple way to make sure it is not a cath prob.

[twirl]

paul-karen
I do not understand any of this but I am praying for you and you are always on my mind.

[dh514]

On my initial flush the same amount that went in came out, but I had a lot of drain pain to get it out. They had the bag on the scales and did not stop until it was out.

I would not worry yet, you will probably be fine when you start training.

[Restorer]

I was told by my PD nurse that sometimes on the very first flush when you start on PD, the peritoneum is "dry" and it tends to absorb some of the fluid right away, and not give it back. 400ml out of 2000 sounds like a lot to lose due to that, but I wouldn't rule it out. I spend the day dry, and every night, my first exchange ultrafiltrates much less than all my others, because my peritoneum has gotten dry over the day and wants to hold onto a bit of the fluid.

If it hasn't been absorbed, and it's just sitting in there and the catheter can't get to it, it shouldn't be a problem, especially if you have remaining kidney function. It should all get absorbed in a day or two, and then you'll pee out that extra fluid (though you get to keep all the sugar - but don't worry, 400ml of 1.5% is only the equivalent of two packets of sugar).

[Rerun]

If you need to take a shit you get some "Smooth Move" tea.  Great stuff.... it is the BOMB literilly!

                                         

[george40]

Hi PK, were they trying to drain it all out? When I was in training the pd nurse would leave fluid in to float the catheter. Once you start exchanges the goal will definitely be to get more off than you put in. To ease your mind, perhaps ask your nurse if they left fluid in purposely or if there is any reason for concern.

[paul.karen]

Thank you all for your input.

I start training this Thursday so i will be asking a few of the points pointed out to me here.
They did try to get it all out far as i know.
All else seems to be ok.  Will update after Thursday.
P&K