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kickingandscreaming
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« on: March 27, 2017, 07:15:15 PM »

I've been doing PD on the cycler for a little over a year.  At first it was uneventful.  Then, at some point (don't remember when) I found myself waking up many time/night unable to breathe.  I think it was always during a dwell after UF had built up.  It's a horrible feeling, and it has wrought havoc with my sleep.

Recently, I was hospitalized for flu/asthma/brochitis when I couldn't breathe for about a week.  Part of my treatment is to use a nebulizer with albuterol.  What I discovered by chance is that on nights that I nebulized right before bed, I didn't have the problem in the night. Which makes me think that the pressure from the fluid in my peritoneum is somehow affecting my breathing apparatus or is somehow triggering an asthmatic situation.

Any ideas?
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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
MooseMom
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« Reply #1 on: March 27, 2017, 08:21:50 PM »

I haven't a clue, but it sounds bewildering.  I hope you find some answers because you've piqued my curiosity!
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"Eggs are so inadequate, don't you think?  I mean, they ought to be able to become anything, but instead you always get a chicken.  Or a duck.  Or whatever they're programmed to be.  You never get anything interesting, like regret, or the middle of last week."
Charlie B53
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« Reply #2 on: March 28, 2017, 03:31:05 AM »


Key word :   Nebulizer

I suspect your issue is NOT PD but rather a condition with your lungs needing attention.

The Nebulizer treatment opens passageways that are otherwise closing or leaking fluids during sleep causing you to lose lung capacity.  This condition may be due to seasonal alergies and may possibly be increased a bit if your 'dry weight' is slightly too high.  Double check your hydration level before bed by pressing on the front center of your shin to see if it 'dents'.

Pay close attention to your resting heart rate.  Dr's fail to advise us of the early symptoms of congestive heart failure which is basically water over-loading of the body, reducing lung capacity and also filling the heart sac, taking up the space the heart needs to fully fill and pump blood efficiently.  When this begins the heart rate starts speeding up in attemt to pump the same volume of blood.  It is these extreme heart rates that cause the heart to become overly tired, cramp, seize, and the patient die.

Seasonal allergies can mimic many of these symptoms and may trigger the onset of the real CHF.

Eucalyptus oil added to the water tank of my CPAP helps to keep me clear.  No more than 2 drops.  A few drops in a vaporizer in the room can make a difference. A drop on an OFF light bulb before it is turned on can create the vapor.  Warning;  This costs.  The quart I found thru a local pharmacy was $72, I figure it should last well past my life time. Unless I live to be a very really old Guy.  Hope?

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cassandra
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« Reply #3 on: March 28, 2017, 11:00:42 AM »

Sorry KaS, I agree with Charlie here, is it poss you are overloaded?

Good luck and 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
Whamo
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« Reply #4 on: April 08, 2017, 06:23:49 AM »

I used to get overloaded with fluid and it's horrible.   Thank God those days are over.
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kickingandscreaming
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« Reply #5 on: April 08, 2017, 08:27:26 AM »

I'm not overloaded.  But my full peritoneum triggers my asthma in the night--unless I pre-medicate with albuterol nebulizer.  When I nebulize i can get through my PD script without any breathing issues.  I'm not fluid overloaded.  My weight is as low as it ever has been (on PD) and my BP is actually quite low.

Now, I may have congestive heart failure (I hope not), but I should know more about that after my cardiology appointment next week.
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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
PrimeTimer
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« Reply #6 on: April 08, 2017, 10:36:37 PM »

Sometimes sugary things trigger my asthma. I can eat bananas, which are very sugary but no problems. Eat some sweet chocolate cake and the wheezing and choking start up. It's weird. Certain hard candies will do it to me too. Wonder if your PD solution has anything to do with it. I sleep propped up on 3 pillows and lay to one side all nite. Sleeping on my back sometimes chokes me up.
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Husband has ESRD with Type I Diabetes -Insulin Dependent.
I was his carepartner for home hemodialysis using Nxstage December 2013-July 2016.
He went back to doing in-center July 2016.
Charlie B53
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« Reply #7 on: April 09, 2017, 04:07:25 AM »


CHF is evidence of excessive fluid, most often accompanied by fluid accumulation in the lungs.

Do you ever 'pinch' the back of a hand then watch to see how long it takes to fall flat again?  This is a very tellilng test use to determine if a person is dehydrated as normal hydration that crease will drop, disappearing within a second or less.   I do not think you are anywhere near dehydrated, but your 'dry weight' may still be slightly too high, leaving sufficient excess fluid that may be contributing to your problems.

My second thougoht is your fill volumes are still too large.  This will be placing too much 'pressure' on the bottomside of the diaphragm, making it more difficult to breath while laing down in bed.  You may breath fine while vertical, but the pressure changes with the hoerizontal position in bed.  You need to present this to your PD Nurse and talk about reducing your fill volume further and increasing the number of fills.  The dwell times can be adjusted, shortened to factor the increased exchanges within your scheduled treatment time.

Reducing the pressure on your diaphragm may give you easier breathing, however seaonal allergies, acting up can still require your nebulizer.  We fail to realize how enclosed spaces of a home, or a bedroom, the air quality can create issues with allergies.

Do you have some sort of air filtration system?  Some with allergies report great success with a couple of commercially available systems that rid the air of allergenic particles.

Lastly, are you aware if you snore, or have sleep apnea?  Either of these also contribute to undefined problems sleeping and can be very difficult to determine by a person living alone.

I know I snored.  Wife told me of my apnea and refused to ever sleep in the same room, expecting me to die next to her.  I've since worn out two CPAP machines and working on my third.  It DOES make a difference.
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