"voluntarily" doing an extra exchange

[Deanne]

My weight is up, my BP is up. My UFs have been down. I'm considering doing a manual exchange today, probably filling at noon, draining after work. I know I'm carrying extra fluid. I didn't order enough extra green bags to start doing two greens most nights. I'll order better next time. I do have several boxes of manual bags, so I'm thinking about putting them to work as needed to pull off this fluid. Grrrrr. I was trying to avoid manual exchanges, but I got myself into this by not ordering more green cycler bags and I don't want this to get out of control.

[cassandra]

Good plan, and good luck

Love, Cas

[Joe]

That is a good plan Deanne. I did that occasionally  when my weight would spike.

[Deanne]

I think the Liberty cycler doesn't always drain completely. I drained off 700 mL before I did a fill even though I'm supposedly dry during the day. I pulled off another 300 mL after a 2.5 hour dwell. I feel thinner now.

[okarol]

Good solution!

[Joe]

I didn't connect that you were using a cycler. With my Baxter, I typically didn't get everything off through the regular cycler final drain and had to do a manual drain at the end of the cycle. I would typically get another 800-1000 ml off. Not familiar with the Liberty cycler, do you have a manual drain setting you can use before you disconnect? That would likely clean you up.

[Deanne]

The Liberty doesn't seem have an option to do a manual drain. I don't think I often have an issue with it not draining everything off. I did another manual this afternoon and it barely drained anything before I did the fill, and the drain about 2.5 hours later only pulled off about 200 mL using a green bag. That wasn't really enough to be worth the time for doing the manual exchange,but my BP and weight are still higher than I'd expect them to be. Is it possible I still have fluid that isn't being pulled off, even though I still urinate quite a bit? I have "high" nights when my UF is ~1200, but also "low" nights when it might only be ~600. It's very inconsistent.

[Joe]

If you're not getting anything off with the drain before you fill, you are likely doing ok and not retaining. The difference in your UFs may be a combination of how much you are taking in during the day and the fact that you are still peeing. Talk with your team and see what they say, but I'd guess you are doing ok.

[Deanne]

Thanks! That's reassuring. I see my nurse next week and my neph in a couple of weeks.

[Whamo]

I recently began a high-dose therapy.  It takes me almost an hour to fix up my cycler, drain, fill, and get to the dwell.  I detach, go about my day for about four hours, and hook up for ten more.  I'm feeling a lot better.  I'd been hospitalized twice because my ten hours wasn't working.  I was suffering from chronic constipation, and feeling intense "discomfort" from too much fluid at night.  The pain was excruciating.  On the worst night I cramped for a few hours, and then felt like throwing up, heaving dry, for a few more.  I was freaking out.  I stopped therapy.  My blood got dirty, and my mind started losing it.  I endured enemas in the hospital.  I started a cranberry juice/lacalose cocktail that I drank every few hours.  Finally, my stomach cleared out, and things began to improve.  I still get an upset stomach, but not as heavy, and after I eat the wrong food.  For some reason jello with fruit in it upsets my system.  A root beer from a fast food place didn't seem to help either.  I keep learning how to cope with these incidents, but it seems like something else always pops up once a problem is solved. 

[Fox_nc]

May be too late to help, but you might see if your clinic has some of the concentration that you need until your order.

[Whamo]

    Ever since I started doing a mid-day drain and fill, plus the regular hours at night, my dialysis has been getting better and better.  I love it when a plan comes together.

[Shaks24]

Deanne, is there one more level of solution above green? I don't remember the colors but I think there is 1.5, 2 and 4% I think. Have you tried that? All I use to this point is the 1.5.

[Joe]

The colors go yellow, green, red for the 1.5, 2.0 and 4%.