Tubing question

[Tío Riñon]

Greetings.  I'm going to be staying in a dormitory this summer for my studies.  The ADA Coordinator has been great about figuring out a solution for all of my needs except one...the bathroom.  I use a cycler and we've got a way to get the drain line to a sink in the bathroom.  The problem is how can I reach the commode overnight?  It is further away than the sink (stall setup).  I already have a 12' ext. set with an Easy-Lock connector from the cycler to my catheter.  Can I add another extension? 

When I asked my nurse, she said that she didn't think so, but would look into it.  She was concerned that I might need more fluid for it to work and my bags are dry at the end of a run (NOTE:  I use 4 bags a night so there isn't any more space).  I figured that I'd ask the IHD community and draw from its collective wisdom.  Any thoughts?

Thanks in advance!

[Joe]

If you really have to go, you may have to temporarily disconnect, use the restroom and then reconnect. Your team isn't going to necessarily like that answer, but it is kind of what you have to do. Just ask for some flex caps with your supplies to cap the line end. The other option would be to get a hospital urinal and use that if you have to go during the night. Don't know how much you are still urinating, but that could work.

[Tío Riñon]

Actually, my nurse and I already discussed that possibility.  I have used that technique when my prescription included a day-fill on the cycler.  I had to disconnect until my evening fill and used flex caps.  I still have plenty left over.

I'd rather not go that route, but it is an option if necessary.

Thanks.

[jeannea]

I worried about that on PD but found I hardly ever needed the bathroom overnight. So I would disconnect. Keep it clean and it should be ok.

[papacat]

Hello Tia Rinon,
Someone on another thread suggested putting the cycler on a rolling cart. Then you can unplug the cycler and roll the cart to where you need to go. The cycler is able to maintain the memory of your therapy for quite awhile when it is unplugged. I know my Baxter cycler can be unplugged for at least 10 minutes. The manual says it will maintain the memory for about 2 hours. You just plug the cycler back in and restart where you left off. The post suggested that you unplug during a dwell. Don't know if this will help you but it is worth looking into!
papacat

[Grumpy-1]

I'm confused about the original post and then the replies.  In the original post TIO posted about connecting more than one drain line.  YES you can do it.  Not sure what type of cycler TIO is using but I used one from Frenius (spelling is wrong I'm sure) and I could order drain extension sets (10 to a box).  I have hooked up two drain lines together to reach a bathroom a couple of times.  Now the replies - more of you are talking about disconnecting from the cycler to go to the bathroom.  While that works, if needed, that wasn't what the original question was about.  Grumpy

[Joe]

Grumpy, I think what Tio was asking was how he could get to the bathroom while connected to the cycler. Hence the discussion about disconnecting mid-cycle. My 20' line lets me get there, but just barely.

[Sydnee]

Papacat,
I've only had experience with Ed's cycler which is a Liberty. Ed has his cycler on a cart if the cycler gets bumped and unplugs or gets turned of for even a couple of seconds when it restarts about half the time you have to completely restart everything. Oh and according to the manual it's designed to save the settings also. Although either liberty we've had does so.

[papacat]

Tío Riñon originally wrote:
"I already have a 12' ext. set with an Easy-Lock connector from the cycler to my catheter.  Can I add another extension?"

I know you can use two drain extensions but only one patient line extension on the Baxter. That is why I mentioned the cart and unplugging the power if necessary.

With the Baxter, I press STOP and GO after power is restored to continue therapy from where I stopped it. It could be that older models may do it differently. I have no experience with the Liberty cycler. I discovered this by accident one time when I was moving my cycler cart and the plug fell out of the socket. The manual explained how to restore it after the power failure. It was after that that I read the suggestion on IHD to unplug and move if you needed to. I think the individual said they moved the cycler on a cart so they could watch TV in the living room.
papacat

[Joe]

The Baxter Pro-choice will let you stop during the cycle and start again. You just hit Stop and Go to cycle it. I've had it do this during a power outage. The technician I spoke with at Baxter said the system will hold the program for 2 hours without power, after that you would have to manually drain yourself and start all over (or just forget it for the night  ) Didn't realize the Liberty cycler didn't allow you to do that.

[Tío Riñon]

I appreciate everyone's contributions to this discussion.  I presented them to my nurse and she also followed up with a technician from Baxter (the manufacturer of my cycler).  Here's what I determined are my options:

1.  Disconnect as necessary using FlexCaps & MiniCaps.  The cycler can be stopped and restarted for up to 1 hour at a time.

2.  Put the cycler on a rolling cart and move it closer to bathroom as necessary. 

3.  Use additional extensions while understanding the risks/problems.

The specific recommendations from Baxter are as follows:

I have a pt who wants to use 2 easy lock extension lines on pt end (12 feet isn’t enough); is there any problem w/ that?    
Yes, as long as he is using the 4 prong set, he can add 2 extensions.  If he is using the 3 prong set he can only add one.  Things to keep in mind:  1) Every extension added increases risk of contamination, And 2) the extended length of the line increases the chance that he will have low drain alarms.  If he can get by with doing a walk away exchange (see below), you eliminate those risks.
 
He can’t use the integrated tubing because he needs 4 bag connections.
Also, if he needs to disconnect in a fill or drain and pushes stop, will it alarm after a period of time or stay in pause indefinitely? 
It will alarm after one hour.  He can then hit “go” and then “stop” again, which will keep it quiet for an additional hour.   You can  do this for however long you need to, but depending on why he is stopping and disconnecting, you might want to consider Hi-Dose, in which he can fill and then disconnect without having to stop/go.  The cycler is capable of doing this up to 9 cycles, (although I have no idea why anyone would do 9 walk-away exchanges!)  I can help you with Hi-Dose, if needed.  It is also covered in the trainer manual, the patient manual, and on the Clinician Training DVD.
 
I'll give these options a try and decide which works best in my situation.  Thanks again to everyone for sharing their thoughts on the matter!!