PD Users - Describe your therapy..

[GeeWillikers]

As a new PD user, I'm curious what you alll do and how you do it.

How many fills, how much volume, dwells, start and stop times - all the basics.

As I just got my catheter last Tuesday, I'm on an abbreviated schedule to allow me a little time to heal before I go full steam.  I cycle every other day, only three small fills, with about an hour and fifteen minute dwell each time.

I was curious what other regimens look like so I could get an idea of what I might expect as things progress.

I'm already on the Baxter cycler - I did only one manual saline flush before starting with 1.5 solution..

Thanks..

Bob

[-Lady Noir-]

Originally, Mike did 4 manual bags a day, which bought his creatinine down to 700 [7.0?], but they decided to put him on the night time machine since he was a fast transporter.
On the machine, he was on 6 cycles a night, fill of 2000ml, dwell of about 45 mins and dry during the day, which wasn't good for him at all, since he creatinine went from 700 [7.0?] to 1380 [13.8?] in 3-4 months!

So now..
He is wet during the day with 1600ml, and has to do one exchange at around 3pm, which is around 7 hours dwell time. Then he is back on the machine at 10pm. He is filled 4x with 2200ml, 1 hour 45 min dwell, and a 1600ml fill at the end for daytime dwell.
He uses a 1.5% bag and a 2.5% bag, which seems to keep his goal weight.

His creatinine is down to 1080, from 1380 in a month! 

[Jenabcd]

I too, am always wet (belly full of fluid).  I use the cycler, and I set it up about 4 p.m.. I drain and fill with 2000 ml.  At about 11:00 p.m.  I hook back up for the night.  I drain and fill 3 times during the night -- all 2000 ml.  I dwell for 2 1/2 hours each time.  With the dwelling time and drain/fills, I am hooked up (I call it "tethered"  lol) for 9 hours.  My last fill of the morning is 1500 ml.   That's about all that is left in the bag.   That's what I carry until I start over at 4 p.m.  I also use 1 bag of 1.5% and 1 bag of 2.5%.   I put the 1.5% on the heater, so that is the first for my fill.   That's my normal routine, and is used the majority of the time.  If I'm sick and dehydrating, I will use both bags 1.5% so that I don't take off as much fluids.  If I feel I'm holding more fluid or my blood pressure goes up, I will use 2 bags of 2.5%.  That has been much more rare though.  There ya go!

[GeeWillikers]

These are awesome responses - thanks very much - keep 'em coming.

Exactly what I was looking for.   

[Red from Canada]

I am on the Baxter cycler too and love it!  I am wet during the day with 1500 extraneal until I drain it at 11PM and then 5 cycles and 2 bags of 2.5.  Each cycle is 1hr 19 mins, with that final 1500 fill of extraneal.

[paul.karen]

Another Baxter user.

I start at 8PM so i can be off around 5AM to get ready for work.
I fill with 2500 4X a night and i dwell for 1:45 for each fill.  I dint do a day fill  least not yet that may change in the near future.

As for what bags i use i just go with how much i have drank that day and check my weight.  Usually i stick with two 1.5 bags but once a week or so ill use one if not two green bags. 

I also only did one manuel exchange and went straight to the machine due to work. 

[peleroja]

I went from 4 exchanges a day to 5 then to 6 before they literally forced me to use the cycler.  Now I prepare around 7:30, hook up at 9 and get off around 7:15.  I'm wet all day with no midday exchange thanks to Extraneal.  To be blunt, if you don't do some kind of exercise you will start gaining weight due to the dextrose in the solutions.  A while back I posted about how many calories are in each liter of dialysate for each color level.

[suzyq73176]

I must be out of the norm becauase I a dry all day.  I go on about 9 p.m. and cycle 5 times over 11 hours.  I fill with 2400 ml but only about 100 ml for the last fill just for comfort.  I absorb so quickly that if I have any in during the day i gain huge amounts of weight in fluid and my blood pressure goes way up.

[tinyspiko]

I just started PD. They are working me up to 10,000ml with 4-5 exchanges a night. I first started at 10 hrs, 8500 total vol , 1200 ther vol and 7 exchanges on tidal. Tonight I am switching to 9 hrs, 8500 tot vol, 1400ml per exchange and 90% tidal. I am still having a lot of drain pain. I was wondering if anyone's effluent is yellow? I thought it was supposed to be, but mine is just clear. Worried it's not taking off any toxins. I have felt worse than ever the first 3 days of PD. I go dry during the day. Which I am hoping to hold on to for a long time. What is everyone's avg dwell time at night?

[Restorer]

I started with manual bags, 500 ml per exchange, a week after the surgery. 4 exchanges a day at 9 AM, 2 PM, 7 PM, and 12 AM (I stay up late). I worked up to 1000 ml per fill over several weeks. I wasn't doing well on CAPD, and I felt like I couldn't bring my volume up over 1000 ml, so that's what I was on for several months.

When I finally got switched to the cycler (which I had wanted from the start), I started with an almost 11 hr treatment, 1200 ml per fill (just under an hour per dwell, as I recall), a total around 8400 ml, and dry during the day. After a little while, I pushed that up to 1400 ml, with one fewer fill.

A few months later, I moved, switched to the new cycler model, and started increasing my fill volumes. I settled on 2000 ml fills, 1 hour 25 minutes per dwell, and dry during the day - but with that volume, going from 2000 ml to 0 in the morning left me with bad pains, so I started doing 1900 ml fills with 500 ml in all day, just to keep me wet and avoid the pains of my peritoneum trying to go back to its regular size.

[*kana*]

I used to do 5 manuls a day until I tore my pertineal wall.  Now I have to do all my treatments lying down at night on the cycler.  I still work full time so I normally do 7 (45min dwell) exchanges per night, 2900ml of solution and on tidal settings, which takes about 9hrs.  When I have the weekend off I do 9 exchanges which takes about 12 hours. 

 

[jeannea]

I do overnight.  Each fill is 1500 mL and I do 6 fill/dwell/drains.  Then in the morning I get 500 mL as the last fill to carry around all day.  Treatment time is scheduled for 8 1/2 hrs but sometimes takes 9 hours.  But I'm not very tall.  I understand bigger people need more volume.  I didn't really "work up to it" though.  I did 2 days of training and then did a regular overnight.  I use 2 5000 mL bags of fluid, usually the 2.5% solution.  I think everyone's is a little different.

[murf]

As my clearance is not good. they have put me on the following regime: 1 x 1.5% @ 2000ml in the morning, 1 x 2.3% @ 2000ml at lunch, 1 x 2.3% @ 2500mL at dinner time and 1 x 2.3% @ 2500ml @ bed time. I am taking off a huge amount of fluid with this schedule - up to 2500ml daily but that does mean I have almost no restriction on my fluid input.

[billybags]

5 cycles over 7 hours. Average dwell 45 min.

1 green    2.27 5000mil
1 yellow   1.35 5000mil
1 green   2.27 5000ml
and last fill extraneal 2000ml

tea time manual 1 green 2000 ml

It takes all his strength in a morning to lift the drain bags to empty them, they are huge and blood** heavy. Can not use extension lines or should I say dare not use them in case he gets peritonitis again.Them little bugs are every where.

[GeeWillikers]

I just started PD. They are working me up to 10,000ml with 4-5 exchanges a night. I first started at 10 hrs, 8500 total vol , 1200 ther vol and 7 exchanges on tidal. Tonight I am switching to 9 hrs, 8500 tot vol, 1400ml per exchange and 90% tidal. I am still having a lot of drain pain. I was wondering if anyone's effluent is yellow? I thought it was supposed to be, but mine is just clear. Worried it's not taking off any toxins. I have felt worse than ever the first 3 days of PD. I go dry during the day. Which I am hoping to hold on to for a long time. What is everyone's avg dwell time at night?

My current dwell time setting is now 6 hours (4 cycles @ 1.5 hours, 1800ml 1st fill, then 1710ml on the next 3 (tidal setting is 95%).  I expect to increase volume to 2000ml per fill on Monday, and will likely increase dwell to at least 7 hours (4 X 1:45:00)

My averge dwell is between 1:27:00 and 1:32:00 - I've actually had a few sessions where I've "gained dwell time" vice "lost dwell."  Still have to research and see how that's possible - my guess is that the tidal setting is allowing me to complete the drains faster than the computer thinks the average "factored dwell" should be, thus allowing me to be "full" longer than the projected 6 hours.

I'm also dry during the day.

My biggest problem is drain pain that rivals childbirth..  Can't seem to get away from mit even on tidal - the last drain of the therapy is usually a killer.

[Henry P Snicklesnorter]

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[murf]

Midday: Second exchange while having lunch or, while driving if I don't stop for lunch.

Henry P, could you please explain how you would dialyse whilst driving. TIA.

[Henry P Snicklesnorter]

Midday: Second exchange while having lunch or, while driving if I don't stop for lunch.

Henry P, could you please explain how you would dialyse whilst driving. TIA.

G'day Murf, (I see you're a fellow Sandgroper    )

I do exchanges in the car and in my truck. I made a small wire hook that I hang off the coat hanger hook on the rear of the truck cab or on the hanger immediately behind the drivers seat in the car. I hang the new bag off this. I carry two exchanges in the travel pack that Fresenius supplied.
Basically, It goes like this: Pull over to the side of the road, sterilise hands with Aquium gel, open package, hang full bag on hook, arrange lines comfortably Very carefully hook up and start to drain. After 15 minutes or so, when drained, I switch over to refill (without stopping, ) and complete the exchange. Pull over, use the Aquium and very carefully disconnect. I don't use the organiser when doing this.
I even did some roadside exchanges on a solo motorbike trip to Kalgoorlie and back, just pulled over and hung the bag on the windscreen and sat on the bike had a sandwich and cup of tea while I did the exchange. - it was a little slower than usual, but I was in no hurry.     I've since made up a pole for the bike so I can raise the bag higher and increase the flow rate for future trips.

[murf]

I do exchanges in the car and in my truck

Wow. That is impressive. I have enough trouble coordinating my exchange at home.

[Henry P Snicklesnorter]

.

[Sax-O-Trix]

Henry P. - You give me hope!  I lead a very busy life being the only parent of two, working FT and traveling alot by car.  If I end up on PD, I now will know it is possible to keep up with most of my current activities, even it it means hooking up in the car!!!  I can see myself sitting in the car doing an exchange while waiting for one of my daughters to get out of dance or music classes.   Is your doctor aware that you do your exchanges in this manner?

[Henry P Snicklesnorter]

.

[RainingRoses]

I only use 1.5%.  I'm on the machine for 9 hours each night.  4 fills of 2.0 L.  Last one is 1.5 L during the day.

My creatine keeps creeping up.  Last was 10.92 so neph said tiime for KT/V and adjust the cycler settings.

[Dex]

I'm at 5 fills of 2300mL (1.5% or 2.5% depending on BP/Weight), with a last fill of 1000mL. My average UF is about 700, and my machine runs for an average of 8 hours(some nights I move it down to a 6 or 6.5 hour night). Almost all of my dialysis is completed while sleeping, while about a half hour or so I read in the morning, while I wait for it to finish the last drain(the big one!)

Total volume is 12 500 mL or 12.5 L.

[gothiclovemonkey]

Im pretty new here, so my terms might not be right... and some of the things ive read are actually weird to me...
i get up at 7am, I drain, fill 2500m 1.5 dex, dwell
12pm: 2500m 2.5dex, 
5pm 2500m 1.5 dex, and
10pm 2500m 2.5 dex, dwell over night, repeat at 7am