PD and Drainage

[Poppylicious]

I realise this has been asked before, but I wanted to just get responses to our own personal dilemma ...

Blokey has been on PD since Saturday night (using a Baxter machine).  Whilst he was training they noticed that it wasn't draining as well as it should be so they advised him not to go on it, and after another week of haemodialysis they x-rayed his belly and stated that the tube was correctly placed inside and he was just constipated.

Well, although he had a couple of good drains on Saturday and Sunday night, Monday and last night were absolute nightmares.  He's draining out a lot less than he's putting in and he's put 6kg on in weight since Friday (2kg since yesterday).  When he did his manual exchange last night it took 25 minutes to drain just 300g.  He's absolutely shattered because he can't sleep for worrying, poor thing.

Is this normal at first?! 

He's now convinced (after only a few days) that PD isn't for him and he may as well go back on haemo and have the dreaded fistula (which he really doesn't want).  To make it worse, he's pretty sure that 'they don't care'.  I don't know what to advise or say to him, but it breaks my heart to see him so sad and disillusioned.

[paul.karen]

Is there any Fibrin that you can see in the lines or in the drain bag?
This can cause people not to drain right but it is easily fixed with a shot or two of heparin straight into his PD solution.
Also when he is draining try to lie in different positions.  I know on my last drain of the night that for me i do best if i stand up for the last five minutes or so to fully empty out.

Im sorry to hear this is happening.  I hope they can figure out what the problem is. 

[Red from Canada]

Poppylicious,   It is waaay too soon for him to give up.  There are always bumps in the road at the beginning.  Has the nurse impressed upon him the importance of daily stool softeners to avoid even a bit of constipation?  Also, I put Heparin in my bags EVERY night, so that fibrin is never a problem.  Tell him to cheer up, there are lots of us who had rocky starts and now would rather be on PD than Hemo.  It DOES get easier.

[billybags]

Poppylicious, As with any thing PD will take awhile to sort out, there are things that may need to be adjusted or should we say "tweaked" Tell him not to give up on this it will work out ok and he will get use to it. We have been told that Alan needs to go back on the machine and they are sorting out another training session for us soon, I remember the last time about 11 months ago we went through the same thing, nursie kept adding bags, tweaking times but it was ok in the end. Constipation does play a big part. So lets talk about sh**. My husband thought he was ok, went regular, once a day didn't take any laxatives, never needed too, but they said he was constipated, did x-rays to prove it. He is now on 2 senna and lactose twice a day. I get through loads of loo paper. It does make a difference to how you drain.  Another question is, is he still peeing? I dont know why I asked that, just being nosey. Please tell Blokey to stick with it and just keep reporting if his weight goes up.

[Poppylicious]

Thanks for your replies.  Blokey went to the hospital today and they gave him an x-ray which showed the catheter inside had moved again and wasn't in the correct position.  The x-ray also showed that he wasn't bunged up, but they have given him some powerful medication which means he'll take the day off work tomorrow so he doesn't have to spend every five mins apologising for running to the loo!  He'll then try a manual exchange in the evening.  However, the likelihood is that he'll probably have to have the catheter tweaked. 

On the upside, he has had haemo today so he now weighs four kg less than he did this morning!  He seems much happier than he was this morning, much more positive so I know he'll stick with it.  It's just the disappointment.

Another question is, is he still peeing? I dont know why I asked that, just being nosey.

*chuckles* ... No.  He hasn't pee'd since the Neph sent him home with a big bucket thing to do a 24 hour urine test back in September!

[peleroja]

In addition to what others have said, which color bag is he using?  When I use the yellow (lowest), I never get any extra fluid out and usually end up as a negative. 

[rookiegirl]

I'm glad he had an X-ray done.  I had the same issue where I couldn't drain at all.  So they did an X-ray to find out a was constipated.  They prescribed me Sorbitol (very sweet syrup med).  Made me go to the bathroom aka "Loo".

I have never had problems with constipation until I was on PD.  It's very important to avoid constipation because the other HUGE issue with constipation is that I had my first & only Peritonitis.  Not fun at all.  I always took Colace (stool softener) or if needed Dulcolax (laxative).

But with all that I liked PD.  It gave me so much freedom to do pretty much everything.