How Long Does it Take for a PD Catheter to Heal?

[mallory]

I got my PD catheter put in on November 15th.  I went to the clinic and they flushed the catheter and changed the dressing on November 17th.  I went back in on the 21st, the nurse told me she was concerned because the catheter was still bleeding.  I told her the surgeon had told my sister that my tissue isn't very good because of all the Prednisone I've been on, and that it might take me longer to heal.

So, she told me to change the dressing every day, and that it should bleed less every day, I should call them if it got worse.  I've changed the dressing every day, and it is still about the same, maybe a tiny bit better.  I'm supposed to go back to the clinic tomorrow to have it checked.  They want me to start on dialysis after Thanksgiving.

Should it take this long for the catheter to heal?  Should I be concerned?  It doesn't look infected or anything, and it doesn't hurt, it just keeps bleeding.  Not to be gross or anything, but it sort of looks like it just bleeding a little and that the rest of it is fluid, not blood.  Is this normal? 

I sure wish it would stop.  It's not a lot, but it pretty much soaks the bandage in 24 hours.  I'm afraid if it doesn't heal, they'll want to start me on hemodialysis, then they said they have to put in another catheter.

Any advice would be appreciated, thanks!

[angieskidney]

Well it is true that Prednisone can hinder in healing but my PD exit site took about 3 weeks to heal completely. Of course mine I had this time around (before switching to HD after Peritonitis) didn't heal as nicely as the one I had in 1990 for some reason.

Do they tell you to use bactroban on it or Betidine?


if it is still bleeding .. is the exit site red or what they call Proud Flesh?


They can't start using the catheter until it fully heals. Don't worry too much as long as there is no pain. But if there is ever any pain tell them RIGHT AWAY! They are just being careful and keeping a good eye on you. Everyone heals differently and at different speeds. Don't worry about trying to be like everyone else

Get as much info on this as possible. If it doesn't heal then it IS a problem. Mine took about 3 weeks.

[Rerun]

They will tell you today if it has progressed to the point that it should have by now.  Even with the prednisone consideration.  I'm sure they can cauterize it or maybe put some healing agent on it.  I'll pray for you today.

Let is know.   OK?     

[Ken Shelmerdine]

Hi Mallory
It is early days yet. As long as it is not infected I wouldn't worry. They didn't change the dressing on mine for a full 10 days after surgery (stand up body washes no showers...shite)  so maybe I didn't see it at its worst. It took about three weeks to heal but even after 3 months I still have some redness round the sight which the PD nurse says is OK. They seem do things quicker where you are cos they didn't flush me till 5 weeks later. I clean the site with Betedine and then a blob of bactrobahn cream then the dressing.

[mallory]

Thanks for the good advice, everyone.  I'm back from the clinic, they said it was okay.  It's still draining more than they would like, but they think it's because of the Prednisone.  They're going to try to wait another week and hope it's healed enough to start dialysis.  They also called in a prescription for some kind of ointment to put on it, but I can't remember the name.

They took my blood today for the lab tests.  She said they'd call tomorrow and give me the results.  I sure do appreciate that.  In the past, my doctor just told me that everything was okay, or that I needed to take Tums, or Aranesp, but he never gave me the results.  Then he seemed unhappy if he thought the levels weren't where they should be.  Well, it will be a lot easier to be compliant when I know what the target is and what my results are!

Thanks again, everyone!

[angieskidney]

If the ointment is Bactroban I found it would dry the area a little while keeping it disinfected! 

[Rerun]

Good!  Just hang in there Mallory!

 

[JerseyGirl]

Mallory my dear take a deep breath and relax!  It takes 3-4 weeks to 2 months for an exit site to heal. Even then there will be redness for months out sometimes.  Your situation is not totally unheard of.  Some new catheters take a longer time to heal. Some catheter sites bleed as well.  Most likely the drainage is not only blood but serosanguinous fluid - colorless but runny - from the surgery. That combination looks like alot of fluid but isn't really that much.  Keep changing the dressing daily - don't forget to wash your hands first, if you have trouble viewing the site use a hand held mirror to help you.  Like your nurse said, keep an eye on it.  The dry dressing will absorb the drainage and keep the actual site dry.  You are ok! This is normal one week post-op.  Some caths bleed more than others, but the bleeding should definitely decrease day by day.  What are you cleaning the site with?  I use SureClens on my brand new catheters - it's like a mild distilled water solution, and finish with Exsept.  As far as the ointment, what is it?  When you use it, use it sparingly.  You don't need alot of it for it to be effective.  Ask the staff to give you some sterile Qtips if they have it, but don't poke around the site, just apply lightly. Work from the inside out like a circle and don't go back. You should be just fine!  The staff are on it, and so are you!  You're on the right track.

[angieskidney]

You don't need alot of it for it to be effective.  Ask the staff to give you some sterile Qtips if they have it, but don't poke around the site, just apply lightly. Work from the inside out like a circle and don't go back. You should be just fine!  The staff are on it, and so are you!  You're on the right track.

VERY good advice! 

[mallory]

Thanks, everyone for your advice.  And I have good news, my catheter is almost completely healed!  I was really sick over Thanksgiving and while that wasn't good, the silver lining to that cloud is that I was in bed for two days, flat on my back.  I think that must have given the catheter time to heal and by Saturday night, it was so much better.

Jerseygirl, I appreciate your input.  My dialysis nurse (who is very nice and I really like her) kept telling me that most catheters are healed in two weeks.  When mine wasn't, I got concerned.  It was good to hear from you that it isn't abnormal for it to take 3-4 weeks.

Sorry to be such a wimp, everyone.  I get really worried about everything because I'm on all these immunosuppressants and they keep warning me and warning me that I can't get an infection or it will probably kill me.  So, I probably overreact when anything happens.

But, I'm okay!  I'll probably start dialysis this week.  I'll let you all know how it goes.  Thanks again!

[JerseyGirl]

Thank goodness!  But seriously two weeks is an awfully short window.  Good luck with your training - keep us posted!

[angieskidney]

I get really worried about everything because I'm on all these immunosuppressants and they keep warning me and warning me that I can't get an infection or it will probably kill me. 

They shouldn't scare you like that but they probably do because they are used to people not taking them seriously ... even though it is TRUE .. it is not like "oh I got a small infection now I am gonna die!" It does NOT work like that! Just f you have any worries now you know you can come here! 

[Ken Shelmerdine]

Hi Mallory
How did your training go, did you start dialysis this week?

[mallory]

I have my training this week on Wednesday and Thursday.  Do you actually start dialysis when you go to training, or do they just show you how to do it?  My creatinine keeps going up and up, and I'm starting to feel a little sick.  I think the dialysis will help.

[angieskidney]

I have my training this week on Wednesday and Thursday.  Do you actually start dialysis when you go to training, or do they just show you how to do it?  My creatinine keeps going up and up, and I'm starting to feel a little sick.  I think the dialysis will help.

When I trained, they had me actually do exchanges but the dwells were shorter as of course you can't do a whole night in training

So instead of an 8 hr dialysis it would be maybe a 4 hr one. So maybe they will tell you just before bed to do one exchange ... but when you go home after training is all done, you will then do FULL dialysis.

[JerseyGirl]

Usually you'll be doing one or two short exchanges in training - by the third day of training my patients are (usually) dialyzing, baby!  24/7.  Hang in there you are right on track!  You will start feeling better soon.  Have a good day!

[angela515]

When I started my training the first day they did 1 fill and drain to show me how to do it... and then did another fill and sent me home. Then the next time I came, they did the same thing... however, I started retaining fluids because I wasn't doing enough dialysis obviously only 1 exchange isn't enough for anyone, and I was drinking the same amount as when I was on hemo not even thinking of the fact that I wasn't even doing enough dialysis to get that fluid off... so they did a few exchanged on me the follow day and 4.25 strength also... I started feeling sick the first 2 or 3 days on training, but once I started doing the 4 ccpd exchanged per day, and got that fluid and toxins out, I felt better and finally better than I ever did on hemo.

You will get there!

[JerseyGirl]

I don't see much sense in filling if you can't drain - I don't understand why anyone would even do that!?  I will do two short exchanges Day 1 & 2, leaving the patient empty until Day 3 and then have the patient - who has been doing their own exchanges  under my guidance - resume exchanges @ home Day 3 on.  Unless they don't feel comfortable yet, but that's usually not the case.  So in other words, by Day 3 they are doing their four exchanges.  Talking about feeling full-if you were filled Day one and went home full, you must have felt awful that first night!  Plus you'd reabsorb all that glucose plus the solution - not a good scenario.

[angela515]

I don't see much sense in filling if you can't drain - I don't understand why anyone would even do that!?  I will do two short exchanges Day 1 & 2, leaving the patient empty until Day 3 and then have the patient - who has been doing their own exchanges  under my guidance - resume exchanges @ home Day 3 on.  Unless they don't feel comfortable yet, but that's usually not the case.  So in other words, by Day 3 they are doing their four exchanges.  Talking about feeling full-if you were filled Day one and went home full, you must have felt awful that first night!  Plus you'd reabsorb all that glucose plus the solution - not a good scenario.

Ohh yah, I totally agree.. i also got peritonitis the very first day of training... so it sucked all around for me. The center I go to now is great though...  too bad I didnt move here before I changed to PD lol

[angieskidney]

I don't see much sense in filling if you can't drain - I don't understand why anyone would even do that!?  I will do two short exchanges Day 1 & 2, leaving the patient empty until Day 3 and then have the patient - who has been doing their own exchanges  under my guidance - resume exchanges @ home Day 3 on.  Unless they don't feel comfortable yet, but that's usually not the case.  So in other words, by Day 3 they are doing their four exchanges.  Talking about feeling full-if you were filled Day one and went home full, you must have felt awful that first night!  Plus you'd reabsorb all that glucose plus the solution - not a good scenario.

See for me I was already doing CAPD for a few months before they trained me on CCPD so I was able to do a drain at home easily just manually.

[angela515]

I don't see much sense in filling if you can't drain - I don't understand why anyone would even do that!?  I will do two short exchanges Day 1 & 2, leaving the patient empty until Day 3 and then have the patient - who has been doing their own exchanges  under my guidance - resume exchanges @ home Day 3 on.  Unless they don't feel comfortable yet, but that's usually not the case.  So in other words, by Day 3 they are doing their four exchanges.  Talking about feeling full-if you were filled Day one and went home full, you must have felt awful that first night!  Plus you'd reabsorb all that glucose plus the solution - not a good scenario.

See for me I was already doing CAPD for a few months before they trained me on CCPD so I was able to do a drain at home easily just manually.

I only traind for CAPD, and then I switched to CCPD after 1 week of training on CAPD, and I had the nurse come out to my house and show me how to set the machine up and disconnect and yada yada... I told the dr before I switched to PD that I had read all about PD and I have decided I want to do my 1 week of training on CAPD and then i want to switch to the machine right away... because they were telling me at first I would have to do CAPD for a month or 2 before switching.. I said, No, I will not, I cannot (at the time my 2 kids werent in school yet and im a single mommy so I couldnt do no 4 daytime echanges!!) lol... now they are in Pre-K and K so if I had to do CAPD i could but i love ccpd.

[shay_pcb]

My catheter took a couple of months to fully heal, but they didn't wait for it to heal for me to start dialysis. In fact, they didn't even wait a day! As soon as they externalized my catheter I was doing exchanges in the hospital. My exit site still bleeds a little every once in a while, and it has been 8 months since I got it externalized. I guess it's bc I'm on coumadin. I haven't had any infection or drainage other than a tiny bit of blood every once in a while, so I guess I'm good! LOL

[mallory]

That's good to hear, shay_pcb.  My catheter has still been bleeding the tiniest bit, and I wasn't sure if i should be worried.  But I've only had mine about two months.  So, I'm not going to worry, and I guess we are good!

[shay_pcb]

Glad I helped somebody, finally!! I feel like I've just been making a mess of everything since I've been here! 

[melshell]

My exit site is still a bit tender, and VERY positional! I never had any bleeding other than on the initial surgical bandage-I'm nearly 8wks post-op and was started on dialysis right at 2wks post-op. They still haven't given me the go ahead for showers, but I figured 8wks was ample healing time, and I was close enough to that date to risk it!! I position myself in the shower to avoid direct water flow into/around the catheter, and shield as much as possible. Is everyone else being told not to shower for a certain amount of time? -Just curious, my PD Nurse advised me that no matter what the surgeon told me, I shouldn't shower until the exit site healed completely to avoid tunnel infections.