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Author Topic: Do you prefer using the cycler?  (Read 390 times)
Angiepkd
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« on: January 15, 2017, 08:29:18 PM »

Working on getting my PD catheter placed and was curious about what method you all prefer. I have heard the cycler is harder on your peritoneum.  It is a tempting option for me, so I can have my days free. I can do the CAPD, and certainly will if it allows me to stay on PD longer. Another transplant is not in the cards any time soon.  Any thoughts are greatly appreciated!  Thanks.
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PKD diagnosis at 17
Cancer May 2011, surgery and no further treatment but placed on 2 year wait for transplant
October 2011 first fistula in left wrist
April 2012 second fistula in upper arm, disconnect of wrist
January 2013, stage 5 ESRD
March 2013 training with NxStage home hemo
April 2013 at home with NxStage
April 2013 fistula revision to reduce flow
May 2013 advised to have double nephrectomy, liver cyst ablation and hernia repair. Awaiting insurance approval to begin transplant testing. Surgery in June.
June 2013 bilateral nephrectomy.
August 2013 finishing testing for transplant, 4 potential donors being tissue typed.
January 2014 husband approved to donate kidney for me
March 4th 2014 received transplant from awesome hubby. Named the new bean FK (fat kidney) lol!  So far we are doing great!
cassandra
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When all else fails run in circles, shout loudly

« Reply #1 on: January 16, 2017, 12:41:09 AM »

Hi Angie, I was nowhere near as informed as you are now. When I lost dad's kidney I was informed that I had to do hemo again. The fistula that was created infiltrated so badly that hemo was not poss anymore. PD had been excluded before because of all the abdominal surgeries I had had in a previous life  ;D
But turned out it worked smoothly.
I started with capd as there was no choice back than. As I was still working, and young I was offered APD Baxter.

Pro CAPD: 1. you can do exchanges anywhere where there's a socket, and hand-wash/cleaning facilities.
Con.           1. It's hassle to exchange on a schedule 3/4/5/6 times a day.

Pro APD. 1. Your days are free whether 'dry' or 'wet'.
                2. You can always do some emergency CAPD exchanges in case you don't/can't sleep next to your machine.
Con.         1. Your nights will be connected to a filling emptying machine which I had to get used to, and had to start using Diazepam to actually sleep so I could                           function during the day. Hubby never had a problem with his sleep.

Thinking about it again (long time ago) I preferred APD

Luck and wisdom on your choice, love, Cas
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I started out with nothing and I still have most of it left

1983 high proteinloss in urine, chemo, stroke,coma, dialysis
1984 double nephrectomy
1985 transplant from dad
1998 lost dads kidney, start PD
2003 peritineum burst, back to hemo
2012 start Nxstage home hemo
       still on waitinglist, still ok I think
kickingandscreaming
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« Reply #2 on: January 16, 2017, 04:44:52 AM »

No one ever mentioned that the cycler was harder on my peritoneum.  I hope you're wrong about that.  The cycler is infinitely more freeing to your lifestyle than doing manual exchanges all day long.  In my case, because of the nature of my peritoneum, I need to do many short exchanges (1.5 hours each).  When I had to do that manually, I was a prisoner to the process and constantly interuping everything.  Now, it does its thing while I sleep.  The other thing about the cycler is that it requires many fewer hookups and hence less exposure to the danger points for infection.  That's important to the peritoneum too.
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Diagnosed with Stage 2 ESRD 2009
Pneumonia 11/15
Began Hemo 11/15 @6%
Began PD 1/16 (manual)
Began PD (Cycler) 5/16
Charlie B53
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« Reply #3 on: January 16, 2017, 06:03:46 AM »


K&S makes a great point about the number of connections increasing the chances for error and infection.

I did manuals for my first year on PD.  We had three dogs and two cats inside the house and they all thought I was the designated door opener.  When each one wanted out they came to me..I wished they would agree on times and all go together, but it worked that way.

Being sort of active and getting outside daily, I stayed busy getting my hands dirty constantly.  Stopping, cleaning up, coming in doing and exchange interrupted my work greatly.  Only after losing two dogs and a cat to old age and infirmities I switched to using the Cycler.  It was a major change NOT being interupted during the day.  Granted, an 11 hour program did shorten my evenings considerabley.  But I soon learned I could cap off, roam free, and return to connect before my Dwell time expired.  My Nurse wasn't too happy with this arrangement, telling me I was increasing my risk of infection.  But I remained quite careful and thought I was doing fine.

Until I became infected.  But 3 1/2 years clean, I don't think it was my disconnects.  I am SURE I made contact during set-up, causing a 'dry contamination'.  So much for hurrying to get set up.   That ain't ever going to happen again.

As for damage to the membrane.  I never heard of this except as a result of using the red bags with the highest concentration of sugar.  As long as you are able to use only green and Yellow you should remain fine.  Unless you are that rare person that has tumerous growths caused by PD.  These may be tested for with an ultrasound.  Perhaps you should voice that concern with your Neph and decide an an annual test.

PD works best while the sugar concentration is higher than the blood sugar.  Dwell time can be dependant on the concentration ised, a lower concentration should not be swelled too long as the sugar tends to balance out then re absorption is possible.  Dwell times up to one and a half hour prevent this.

4 hour manual drains may be too long using Yello bags.  Fine with Green.  Be aware of this if doing manuals.  If using Yellow and your drains are NOT measuring much of a positive uF perhaps those dwells are too long and need to be shortened to only 2 hours.

Hope this all makes sense.  It can be a lot of information for a beginner.

Take Care,

Charlie B53
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Tío Riñon
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« Reply #4 on: January 25, 2017, 07:32:08 AM »

I prefer using the cycler for dialysis.  It provides me with more freedom and flexibility.  As others have stated above, you connect before bed and disconnect the following morning.  I have used this technique for 5.5 years and will continue to do so as long as possible.  Yes, I have heard that the peritoneum can wear out, but I will take my chances.

Due to the cycler, I was able to work for a number of years.  I have also studied at a university in another state and traveled extensively around the US and other countries (including a cruise).  I am not limited in living my life as I choose.  I can visit friends and family and have the solution shipped to the location where I am staying for free in the US.  The machine is portable enough to carry in a car or via a bus, train, plane, or ship.  If I were on HD, I would need to contact facilities in advance to request a spot and schedule my trip around their availability.

Manual bags are always available as a back-up.  However, if there is a problem with my cycler, Baxter usually gets a replacement to me in 24 hours.

If you have further questions or concerns, please feel free to ask.

 
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Simon Dog
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« Reply #5 on: January 25, 2017, 12:02:41 PM »

Quote
I never heard of this except as a result of using the red bags with the highest concentration of sugar
It is common over a number of years, even with the yellow and green bags.
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OneForTheBirds
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« Reply #6 on: January 25, 2017, 05:00:10 PM »

I decided to return to CAPD after 2 months on the cycler.

I like to go to sleep and wake up when I feel like it and the cycler was really cramping my style.

I don't think the cycler does that good a job draining.  Whenever I hear the drain sounds I wake up, and sit up, otherwise the drain is incomplete.

I also don't like to spend 14 hours a day with the Extraneal, I am not as comfortable with it as I am with the Physioneal.

I don't mind the exchanges after lunch and supper, my hook is right next to the computer so time passes quickly.
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Angiepkd
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« Reply #7 on: January 30, 2017, 08:11:13 AM »

Wow!  Thanks everyone. It is a lot to think about. I guess I will see what the doc recommends and go from there. Thanks again!
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PKD diagnosis at 17
Cancer May 2011, surgery and no further treatment but placed on 2 year wait for transplant
October 2011 first fistula in left wrist
April 2012 second fistula in upper arm, disconnect of wrist
January 2013, stage 5 ESRD
March 2013 training with NxStage home hemo
April 2013 at home with NxStage
April 2013 fistula revision to reduce flow
May 2013 advised to have double nephrectomy, liver cyst ablation and hernia repair. Awaiting insurance approval to begin transplant testing. Surgery in June.
June 2013 bilateral nephrectomy.
August 2013 finishing testing for transplant, 4 potential donors being tissue typed.
January 2014 husband approved to donate kidney for me
March 4th 2014 received transplant from awesome hubby. Named the new bean FK (fat kidney) lol!  So far we are doing great!
KBC300
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« Reply #8 on: March 13, 2017, 03:07:27 PM »

I have been using the Liberty Cycler since November. I should say I am now using my 4th Liberty Cycler since November. I am quite frustrated with not being able to trust that the machine will work consistently & correctly for more than a month at a time. The last one only lasted two weeks!  Otherwise, I enjoy the freedom that using the Cycler gives me.  Has anyone elated had this kind of luck with Fresenius?
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KBC300😽
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