Quick PD Cycler question from Newbie

[kickingandscreaming]

Well, today's the day.  My cycler just moved in to my house and we're trying to get used to each other.  I am so nervous that I'm going to make a terrible mistake that I correct that my stomach has been upset all day.

When the Nurse brought over she had me set it up, connect all the bags and attach the extensions and prime it.  That's where I stopped as it was too early to hook myself up then.  But now, it's getting close to that time.

So here's my question: Would there be a problem if I walked the (yet unconnected) patient line into my bathroom where it's easier to shut everything out (including my dog) and where I have a sink and all my connection supplies (that's where I've been connecting the manuals for the past 4 months).  The alternative is to shut bedroom door, and windows, and fan, and dehumidier, etc. for the singular purpose of connecting my transfer set to the patient line.  To me, it seems easier to walk to the bathroom (my extension reaches there with no problem) and connect.  Can anyone see any reason NOT to do it that way?

[Charlie B53]

I don't see any problem.

You have the freedom of tailoring your 'routine' to fit YOU and your needs.   There is no 'one size fits all' method of when, where, and how you set up your Cycler, when and where you connect and disconnect.  What FITS your needs and minimizes risks of infection are the only real engraved in stone requirements.

I can fully understand your worries.  It is perfectly normal to stress over 'new' things that are different from what we are normally accustomed to.   It won't be long and your 'routine' will become just that, routine.   That is the time for concern.   That we do not become so used to our methods that they become mechanical repetition and we fail to pay as close attention to detail as we do initially.  This then poses the risk of cutting corners, not being quite so careful and the always present risk of infection begins to rise.

Your policy of sterilizing with alcavas will greatly minimize risk.   Stay with it.   You will do fine.

[wbdoug]

Keep in mind you still have to follow the same protocol of turning off the fans and closing the doors when you are connecting the bags to the cassette as there is still a possibility of contamination during this process.


Bill

[kickingandscreaming]

Thank you both. 

I managed to survive my first full solo cycler episode with only one alarm (low drain--who knows why) and 2 calls to Baxter. And making several very dumb and obvious mistakes (none lethal, just stupid).  I learned to remember to take the end cap off the drain line extension at the sink (duh).  I learned to remember to open the transfer set before pressing "GO" to start dialysis (duh).  And I learned something from the Baxter tech about priming. During my training, we had the issue where the patient line would fill up and then sink down, and required re-priming several time to get the fluid level up where it should be.  So I now know how to do re-prime the line.  But there's another trick that I didn't learn at the clinic: last night when I primed the line the machine kept telling me to move ahead and I kept noticing that every time I lifted the patient line from the orgainzer that the fluid level dropped more than an inch in the tube.  That concerned me at I was told it should be pretty much at the top of the tube.  So Baxter told me to clamp the patient line after priming and that that would prevent gravity from pulling down the fluid level.  And then just to remember to open the clamp when ready to connect myself.

My program is different from the usual as I am high-average transporter with short dwells, dry days, and  therefore no initial drain and a manual drain at the end. Of course the manual instructs based on the usual CCPD program and not the NIPD program that I am on.

It's the door shutting and window closing and fan and dehumidifier shutting down type of stuff that makes me want to hook up and out in the bathroom where the windows are always closed and my dog is never in there. 

Once summer gets here (if it ever does--it's still in the 40's here) it will be an ordeal to do the open/shutting multiple times as I will probably always set the machine up to the point of Priming several hours before I'm ready to hook up myself and then I would have to go through that all over again when I do hook up.  I'm trying to work around times that my dog will be out of the room.  She spends a lot of time in my bedroom, but no time in my bathroom (which is where I have been performing manual PD connection/disconnecton).  So I'm already set up in the bath for all that and I have a long enough patient line to get there and I have to set up the drain there also.

I'm actually very good at the connection part (my nurses are very impressed with my style).  It's the transitions and the dealing with long tangled tubes that is stressing me out. I realize it's a matter of time until I get a working routine in place. I just hate being so discombobulated in the interim.  Today I am sooooo exhausted from the stress of the transition that I am spending the day in bed along with my old dog who is also stressed out because I have been away at training for so many days (she's used to having me around where I work at home).

Anyone have any good suggestions for managing long tubes without tripping over them or getting them tangled in a blockage?

[Charlie B53]

There should only be two long tubes to deal with as the others are all short connecting to the bags near the machine.   I have my IV pole standing right alongside my Cycler so the second bag and the Ico bag are hanging just high enough the bottoms are only a few inches above the top of the machine.   Thus gravity helps the lines prime easier with relying on the machine pump to move the fluid so much.

The drain hose  goes into a bucket parked at the base of my IV pole so I cut off all the excess hose.  I keeps everything neater.   In your case using the toilet you have to have the line laid out.  I would suggest laying it alongside the wall as much as possible.  This may reduce you catching it with your foot as you pass by.

Much the same with the patient hose.   I un-roll the coil of hose so it won't have any coils or loops that will kink if pulled straight, and lay it out alongside the wall of the hallway, up and back.  Off to the side I am less likely to snag it and I have the freedom to move from my bedroom up the hallway and into two more rooms and back without a problem.

You will soon get used to it.

[beckums70]

After I get my cassette loaded I take off the blue and white paper tabs.  Then, I press "GO" and let the cycler start testing while I uncoil and walk the drain line to the toilet.  After that, I open my bags and set them on/beside the cycler and go ahead and attach the red and white tubes.  When the machine beeps that it's ready to prime, I break the frangibles and press "Go" again.  I let the excess drain line "pool" on the floor next to the table where my cycler sits. After I hook up to the machine, I coil the excess tubing in my hand as I walk around my room or to the bathroom.  Holding and/or coiling the excess tubing is safer than just letting it drag the floor as you move about because when it's on the floor you run the risk of tripping on it or of having it snag on something when you're walking which could make it pull at your exit site.