What type of PD?

[murf]

I am about to start my PD training and I am wondering whether to use the manual exchange or the nightly machine. I am a terrible sleeper (I find many renal patients suffer this) and a little concerned about using the machine at night. So, I am asking for advice on what type of PD is best.

[bevvy5]

Hubby started on PD in August - manual for a month and on a cycler since mid September.  The hum of the machine doesn't bother him at all, bothers me once in a while.  I don't consider myself to be a super light sleeper.

We both prefer the cycler as it frees up the day completely.  Trying to plan your day around being home for an exchange was difficult. 

No right or wrong answer though.

[paul.karen]

Do you work?

I work fulltime so i went straight to the machine.  I learned how to do manuals just in case i ever need to use it.
I have never been a good sleeper so i am just as much awake and tossing and turning as i was prior to doing PD.
To each there own, but i am glad to be doing PD at night hooking up just once.

Good luck on your decision.

[rookiegirl]

I was only able to tolerate 4 nights on the cycler because I couldn't sleep and had bad drain pain.  I did manual for almost 1.5 years.  I liked it better.

[girliekick]

i also have drain pain, but prefer the cycler. Do the cycler, u should have to train on manuals too. Then u will know what is best for u
girl

[Hanify]

If you have the choice - do them both and see which one you like.
Food luck.

[sico]

I find the cycler so much easier. Did take a while to get used to sleeping with it though.
It was at the side of my bed facing me but now i've moved it to the foot of the bed facing away and i sleep better.
Only did this as it rarely alarms. If it does it'll be 'cause i'm lying on the tube.

[tito]

I, too, started on the cycler, I had to be trained on manual. Occasionally I use a manual bag during the day just to get extra dialysis.

I prefer the cycler. You're asleep while you're full, so you don't notice it much. If you work with the PD nurse in getting the optimal machine settings, you can practically eliminate alarms by using the tidal setting, etc.

I'm going away for the Holidays and not taking the machine - didn't want to carry it, nor did I want to expose it to the changeable Mexican electrical current. Nice to have the manual option.

[peleroja]

Whether you sleep well or not, the cycler is the best type of PD, simply because you only open your end cap once each day.    The more times you do exchanges and open your end cap, the more opportunities there will be for infection.  As for me, I did manual exchanges for 5 years before being forced literally to go on the cycler.  I hated it for a month, and then figured out that with extensions I could put the cycler in the hallway and actually get some sleep in the bedroom.  Seems to work ok for me now.

[jennyc]

I did manuals for my first period on PD as i had a new born and getting up and down at night with him didn't run well with APD (we only get 30 opticaps a month). During that time, using 2.5% at start with 1.5% (when i wasn't passing urine... long story, got some function back as acute failure so i started passing again) but i put on loads of weight. At first i wasn't sure if it was becuase after 4 hours i re-absorb the fluid or not. But doing manuals didn't worry me too much. My Dad, jerry rigged a long pole and welded it to the base of an office chair, put a metal platform at the bottom (for the drain bag to sit on) and had an anchor at the top to hold the fluid bag. I was able to walk around, do the dishes, bathe my son, feed my son, cook dinner... all whilst doing an exchange.

The 2nd time i went on PD i did APD as my son was older and i was working 4 days a week. This time i did 1.5% and extraneal in the day (i have confirmed with my pd clinic it is the higher % glucose bags that cause the lining to fail faster, icodextrin doesnt' affect it becuase it isn't glucose) doing 2 hour dwells and no manuals in the day (7.5 hours a day on machine) i gained no weight, i actually lost almost all the wieght i put on. Now that my peritoneal wall is failing i'm doing more bags and a manual in the arvo and i have to be careful cause my weight is creeping up again (not as fast as before though) so with me (and i know it isn't the case for everyone) i associate manuals and long dwells with weight gain.

I have some trouble sleeping, but i don't think it is to do with the machine. I'm on a benzodiazapine to sleep at night becuase of restless legs and periodic limb movement (i kicked my hubby out of bed the movements were so bad  ). the light annoys me so i cover the machine with a towel or shirt but the noise isn't too bad, you get used to it. I stay awake for the first drain and fill, due to drain pain. When it starts i get up and do a little jig and once i check the drain amount is right i bypass and move onto the fill.

Out here the decision kind of gets almost made for you, with our clinic you really only get a cycler if your working other wise you do manuals. apparently in NSW there is a waiting list for the machines

[mk]

Hi
I started on manuals because my centre's policy is to start there and ensure you know how to do manuals in case of problems or power failure. I found it hard to carry weight of fluid in the dwell period and a hassle to time the manuals in my day. I moved to overnight cycler in 5 weeks and much preferred that. I was able to be dry during the day, not tied down during the days and after about two weeks, I settled into sleeping after I got used to the sound and adjusted the drain so it didn't pull. I'm a bad sleeper too but after the first adjustment, no worse than before on cycler. It was worth it...so much better for me overnight. My centre doesn't let you have extensions so I did cope with disconnecting and connecting again if I had to get up to pee but got used to that too. Hope the adjustment goes well for you. Cheers.

[M3Riddler]

Murf,

I was on PD for 13 years. I first had no option but to start out on the cycler. I absolutely hated it. I was confined to a machine at nite for over 8 hours. During This time, I was in School so I had to be hooked up by 8 or 9pm to finish in time to get up for school the next morning.
I switched to CAPD as soon as I could. I did 4 exchanges a day. I loved this. I had my independence back other than 4 - 20 minute exchanges.  Its up to you what method to pick. Just look at your lifestyle and how each would affect it. Go with whatever fits you better...

///M3R

[-Lady Noir-]

I am about to start my PD training and I am wondering whether to use the manual exchange or the nightly machine. I am a terrible sleeper (I find many renal patients suffer this) and a little concerned about using the machine at night. So, I am asking for advice on what type of PD is best.

Hi there 

My fiance is too a terrible sleeper, and he too got the option to start on the machine too. He didn't like the idea of that at first, so he went with the manual exchanges [which was 4x a day]. I suppose it would all depend if you are working? Or not. And, if they will do an adequacy test [to see if you are a high transporter or a low transporter..] Mike found out he was a high transporter when he was on the manual bags, so he had to change to the night machine, which was dreadful at first, but he got used to it pretty quickly.

Good luck!

[billybags]

CAPD or PD? my husband has tried the over night machine and it drove us spare, he suffers with restless leg syndrome and also has arthritic knees, between the noisy machine and him tossing about allnight we did not get much sleep. Ok it does free you up alot in a day time but he still had to do a manual at tea time. Each to their own. Its nice that you can try this and then go back to manual if it does not work out. Try it!