PD - Slow Drain

[Charlie B53]

I drain into a bucket and have to empty it daily.  This way I can SEE if, or how much fiberin I pass.  Dangers of using a bucket, SP
ILLS, not sercuring the drain hose well enough.  That will make a mess.   Forgetting to empty the bucket.  DEFINITE mess.

This wasn't me original intention when starting PD, I just didn't want to run the drain all the way down the hall to the bathroom.

[Fabkiwi06]

I've thought about it... but I have my own bathroom and it's really not a huge problem to run the hose.

I'm assuming it's fibrin and not a cath problem. Given that I can do manuals just fine for the most part and that I don't slow drain every night, I kinda think it must not be the cath.

[kickingandscreaming]

I use heparin every third night.  I just inject it into the medicine port on the bag. It's just on more thing....

[Charlie B53]

My body position makes a huge difference in how well I drain.   Vertical, sitting or stand is best, but I lay down to sleep connected to my Cycler.    Sometimes even sitting here using this laptop or reading a book I tend to 'slouch', leaning forwards a bit.  And I can tell when my Cycler is about to give me that 3 beep warning of a slow flow, it's like I can hear it taking a deep breath before screaming out the BEEPs.  If I straighten up soon enough it may only beep once.

I don't doubt much the same thing is happening during my sleep.  Most of the time when it gives those three beeps I am laying flat on my back.   I go to sleep on my right side but once asleep, I don't know how soon, I roll onto my back.   I am told this is normal, that most people do roll onto their back to sleep.  All I know is somehow this restricts flow enough that it takes longer to drain AND fill.  This time causes the machine to recalibrate cycle time so to end treatment within the prescribed time programmed.   If it didn't, who knows how long we would have to stay connected before all the exchanges finished.  Being retired, no job, that may not be a problem.  But for those few that do still work, or have kids and got to get up to take care of business, this could be a major problem.

Perhaps a larger diameter catheter would help, but that would require larger fittings perhaps, at leat another surgery to change out the existing cath.   That would be a PITA.

The heperin may help, but until proven I don't think many Dr's would prescribe it.
As long as my labs stay well within range it isn't a real problem, at least not for my PD Team, only messes with my head.  A puzzl;e that I wold like to solve.

[Charlie B53]

The last cycle dwell this morning was only 9 minutes instead of the  hour programmed.  I must have been real slow draining during the night again.   Called PD Nurse to let her know my suspicions.  She called me back a little later, told me Dr thinks we should try dosing my bags with heperin.

Since I have a Clinic appt tomorrow for repeat labs they will have heperin for me to take home.  I will be given a crash course on dosing bags as I haven't had to do that since my initial training 3 1/2 years ago.   Shouldn't be to tough, just got to be sure to do it correctly so as not to contaminate anything.   It may be days before the total effect occurs.   You can bet I will be watching my dwell times to see any difference.

[Fabkiwi06]

Appointment with my nephrologist yesterday. I brought up my slow drains.  She actually mentioned to me that when your blood pressure is on the lower end, as mine has been lately, sometimes what happens is that because your body is lower on fluids it retains more of the dialysis fluid. Basically it's the reverse osmosis of pulling the water out of your body but instead you're pulling the water out of the dialysis solution.

Don't know if that could apply to your situation or not, but it certainly makes sense in mine because I've been pulling myself slightly dry lately.

[Charlie B53]

My Clinic appt Thursday Nurse gave me everything I needed so I started dosing my bags with heperin.   Hopefully this will make a difference.

I never saw much in my drain, but if it is large enough to cause a restriction then maybe I won't see it until it gets small enough to pass through the cath.

Will find out.

[kickingandscreaming]

How frequently are you supposed to use the heparin?  I started daily and have tapered it to once every third day and that seems to work.

[Charlie B53]

I asked that very question as I had seen your posting.  Nuse doesn't know yet.  Told me to dose every bag every day until I see if it makes a positive difference in my dwell times.

I also asked if this is the same stuff they inject into my jelly roll (belly fat) while in-patient in the hospital to prevent blood clots in the legs.  Nurse says it is.  So I then asked if or how much dosing the bags can affect blood clotting.  Nurse tells me hardly any effect as the heperin in the bags is not absorbed into the blood hardly at all, it merely helps desolve existing fiberin.

Oh.      Three nights done so far.   Dwells have recorded in the 50's.    Far better than the 30's that I have occasionally been seeing.

Monday is my regular Clinic with Dr.  I imagine we will talk about this and maybe come up with a schedule.