PD for the.....ahem.....larger gentleman

[Stu]

G'day, I'm scheduled to have the Tenckhoff catheter surgery on the 6th of January, then will start the training etc. (I did haemo for six years before my transplant, which lasted 5 years).

I'm what you might call a rather "large" guy (5' 9", 110kg (240lb)), I was just wondering whether there were any others here of my kind of size, and what your experiences were with PD?

I'm planning on doing manual exchanges, as I'm a pretty adventurous sleeper (I toss and turn a lot and sleepwalk from time to time).

So, any advice for a fat bastard about to start PD?

[lmunchkin]

There are other heavier people on here that do PD and have great success with it.  Long as you are doing it and are in control of your health.  You might lose some weight.  Just do it the way you are trained and you should be fine!

Good luck, Stu, hope it works for you!

lmunchkin
 

[Stu]

Thanks lmunchkin, that sets my mind at ease a bit!

  You might lose some weight.  Just do it the way you are trained and you should be fine!

LOL, here's hoping! 

[Joe]

I wouldn't consider myself a larger guy Stu (6'0" or ~ 2m) and 175lbs, but as lilmunchkin said, just follow the clinic's directions and you should be fine. Not sure what to tell you about sleep walking, but if you're good with CAPD I wouldn't worry about it.
Good luck and let us know how you are doing.

[justjen321]

Hey Stu,

Groovy icon.

My husband is 6'2 and 330, so he has some size on you.

He is also diabetic, so some of the experiences we had may not apply to you.

We are currently preparing to switch from CAPD (Cycler style) to Home Hemo Extended (or Nocturnal, however you wanna say it).

For us, we've found that the sugars are getting more and more difficult to control for hubby, because we use reds in everytime we set up the cycler. (Greens alone will not remove enough fluid, and we don't EVER use yellows cause he'd swell up like a balloon).

The second issue is weight. He's non weight bearing right now, so you have to factor that in as well, however, PD solution contains glucose, and it WILL add calories into your day without you putting a thing in your mouth. If you have to get your weight down for a transplant, it's absolutely something to consider.

As for the cycler, if you sleep walk, I'm thinking it's mebbe not the best solution for you. It'd be pretty sucky to wake up because you just walked your cath tube outta your belly.

Jen

[Stu]

Thanks Joe, yeah, everything I've read points back to keeping everything clean!

Thanks JustJen, yeah, it's interesting, some people have told me I'll probably lose weight when on dialysis (I've enjoyed the finer things in life since having my transplant, let's just say I didn't cope too well with the restrictions of haemo when I did it), and others have said to watch calorie intake of I'll gain more weight.

Did your husband have any trouble with the catheter? Clothing? Did he have the catheter put in above or below the waistline? What did he use to keep the catheter in place during day to day living?

I really appreciate the advice to date, thanks!

[justjen321]

I can see where it could indeed go either way. I'd wager some people feel 'fuller' with fluid in.

He hated the cath surgery, simply because they have to push some air into the abdomen, which has no way to get out. So he had some shoulder pain for a few days. His Neph and Surgeon told him Tylenol would be plenty to help the pain, but it wasn't. So, push for a back up pain med. Also, he slept in a recliner for a few days which helped with the air discomfort. (I'm not trying to be scary, just honest.)

His is above his waistline, because it was the best placement for him. He wore a PD belt for awhile, which I thought was brilliant, but he hated. We taped his tube up for awhile, but the tape tore his skin to shreds. The method he has used the longest is pretty simple. I clean and apply Gent cream, cover his exit site with 2x2's using paper tape to affix it. I then create an 'anchor' tape, where I leave some play in the tube, and tape about 3 inches from his site. This gives some leeway in case there's a tug on the tube. It has to get past the 'anchor' tape first. (I use plastic for that because it seems stronger to me) Then, he tucks the remaining tube into his pants. Maybe not ideal, but the most comfy for him.

Jen

[Atooraya]

The only caution I give is that you get 500 calories a day from PD. You should watch your calorie intake like a hawk.

[Poppylicious]

My Blokey is a bit taller than you and weighs a teeny bit less, but he (or his body) didn't take to PD at all (tried for about two months but had to return to haemoD and get a dreaded fistula).  Whether that was because of his weight or other factors, we never really knew.  In good news, he didn't find the catheter a hindrance at all and just let it dangle (it was just above his waistline).

Good luck with the surgery!

 

[Joe]

Stu, my catheter is just below my waistline. That way I can keep my pants belt above it when I'm dressed. It also lets me wear a bathing suit if I want to.

[Stu]

Thanks guys, appreciate your input!

[Ravenwolf]

 I'm 6'3" tall and weigh 280 lbs. I have been on APD for two years. I toss and turn in my sleep as evidenced by, never being in the same spot or position on awakening. I use a 12 foot extension giving me 24 feet to work with. I find if I place it just right entering bed, I have no problems. I'm not a sleepwalker so, that problem I don't have. Depending on my diet I have gained and lost weight. If you want to lose weight, try exercising the extra calories off. I used to walk a mile and a half a day and It kept me stable weight-wise. Also there are several different styles of PD belts to secure your catheter so, investigate a few of them. Some are even paid for by Medicare. No cost to the patient. Just hang in there and study all you can about the technique. Education will always arm you for the times ahead. Good luck and God be with you. 

[lmunchkin]

My hubby just reminded me how we did his Catheter. We cleaned the site and taped the area, then we bought Baby socks (yes, you read correctly) to stuff the long tube in and paper taped it just to the side of the site.

Im surprised he remembered that.  NOW WHICH ONE OF US HAS THE MEMORY PROBLEMS?  Lol....

lmunchkin
 

[Wildrose]

The only caution I give is that you get 500 calories a day from PD. You should watch your calorie intake like a hawk.

I was told by a nurse who has worked at a local dialysis clinic for 30 years that its an additional 100 calories per day. I thought that seemed low and wondered what all the fuss was about then... but since you say 500 it really makes me wonder which is more accurate!

[mcclane]

The only caution I give is that you get 500 calories a day from PD. You should watch your calorie intake like a hawk.

I was told by a nurse who has worked at a local dialysis clinic for 30 years that its an additional 100 calories per day. I thought that seemed low and wondered what all the fuss was about then... but since you say 500 it really makes me wonder which is more accurate!

probably depends on what bag strength you use