Skipping Treatments?

[MiSSis]

I'm curious to know if anyone ever skips their nightly PD treatments.  I know I've mentioned before that this is my 2nd time on PD.  The first time (Nov '83- Dec '87), I dialyzed through the University of Iowa.  They allowed patients to skip one night a month.  Their reasoning was it was nice to have the break but also there might be occasions where you were getting home late, didn't feel well from flu or a cold or perhaps had imbibed and it was better not to try and set up.  I used the free night rarely because it sometimes took a couple of days to get rid of the excess fluid I'd built up and I always felt better if I had my treatments on schedule.

Now I dialyze through a different center and they say no nights off.  In 3 1/2 years, I've had two occasions when a night off would have been nice.  One night I went to bed and slept for several hours as I recovered from one margarita too many and the other night we drove straight home from Naples, FL (22 hours straight).  Even then, I set as soon as we got home and went to bed.  Sometimes I'm still dialyzing at noon but that's really not a problem for me. 

What do your centers say?  Are nights off allowed occasionally?

[Chicken Little]

No nights off for me.  The only way I'm going to get a break is if I contaminate my catheter.   

If I had an occasion where I wanted or needed a night off though, I would probably just do manual bags the day of and the day after.   

[KICKSTART]

I do 4 x daily and have been told its ok to skip one if i need to, but like you say ,you just end up working harder to get the fluid off! At one time when i was really down , i was told to take a day off , but thought better of it, i didnt want to feel bad the next day . I think its ok to skip one , if you do daytime like me , its not that hard to catch up again , but not to sure about missing a whole day , i suppose it depends on if you dont mind feeling a bit rough the next day!

[goofynina]

I am going on my 2nd year of PD and i can say i have skipped a treatment 2 times, the first time was a long story but i used two red bags    to help get rid of the excess fluid (which was alot) and the 2nd time, i actually didnt have much to eat or drink and did ok with my normal solution (2 greens and 1 red) the next day)   

[maisha_r]

My clinic has told me that not skipping allowed,  but I do skipp.  Sometimes I feel so tired that even thinking in the set up for my machine makes me avoid it,  I also give myself a break because being hooked up to the cycler at night time would not allow me to sleep.  I enjoy the nights I am not in dialysis,  I sleep great!  and next night i use one 4.25 and 1.5 bag for the toxins build up,  and I do it once a week  i know is not good but it feels so good 

[Wattle]

  No nights off for me either. I also do one manual day exchange (every APD patient in my unit does) ,so I carry fluid ALL the time. After two years it is really starting to get to me and I would love some "time off". I would just like to have one day back... no dialysis for 24hrs... how nice that would be.   

[Ohio Buckeye]

I have missed a couple, not in a row, and I really did not
feel any different.  It is tempting to skip now and then.

[MiSSis]

My husband and I drove down to FL last fall to deliver a car to my parents who had moved there.  In addition to his golf clubs (we never travel without his clubs!) and some of their belongings that had been left at our house, we had our luggage and dialysis stuff to take along.  And we were traveling in a sedan not our usual SUV.  As a result, I decided to try CAPD (which I'd never done before) instead of taking my cycler along.  We just didn't have the room.  While it was convenient for the driving trip down there, I didn't enjoy the daily exchanges so much.  I really like doing all my exchanges at night with the cycler but I will admit that while on CAPD, those nights when I wasn't tethered to the machine were wonderful.  I don't like having fluid in all day.  My clothes just don't fit right!

[Chicken Little]

I'm dry during the day too.  I enjoy my clothes fitting, being able to eat and drink without bloat and not getting congratulated on my pregnancy anymore.  Everyone just assumes women my age with abnormally large bellies are. 

[Ken Shelmerdine]

I skip every week on a Saturday night and also I have just finished a four day vacation and I didn't dialyse at all and had no ill effects. I don't retain fluid and my haemoglobin and potassium levels are normal so I don't get any physical symptoms. I have argued with my clinic that I should still be pre-dialysis but they say not. So I put my faith in our medical system and continue on nightly PD. But I'm dammed if I'm going to mess about dialysing while on vacation. I've not told my clinic that I do this but if they do find out they can like it or lump it.

[KICKSTART]

I skip every week on a Saturday night and also I have just finished a four day vacation and I didn't dialyse at all and had no ill effects. I don't retain fluid and my haemoglobin and potassium levels are normal so I don't get any physical symptoms. I have argued with my clinic that I should still be pre-dialysis but they say not. So I put my faith in our medical system and continue on nightly PD. But I'm dammed if I'm going to mess about dialysing while on vacation. I've not told my clinic that I do this but if they do find out they can like it or lump it.

Wow that was really good! I find that if i miss one i am ok , (manual) but next day seem more bloated . Oh it would be heaven to miss a whole day ....(or two !!!)

[Krowbar]

I've missed my nightly dialysis a couple of times.

The first time I was about to connect myself to the cycler when I noticed the mini-cap had come off sometime during the day so instead of risking peritonitis, I just skipped it for that night and went to my dialysis unit the next day to get it decontaminated. My nurse said I had done the right thing and missing a day now and then won't be too bad and that hemo patients do it 4 times a week. (Makes sense if 1 night of PD is the same as 1 night of hemo but who knows? /shrug.)

The second time, I visited the ER late at night for an infection on my leg and they admitted me for the night to give me IV antibiotics! So I didn't get to do my PD till the next day. Again, same advice from the nurse - fixing the leg infection was more important than missing one nights dialysis.

Other than that I've always done my dialysis every day. Some weekends I've come home late and started at 2AM instead of the usual 10:30 PM though. (Would a 4 hour delay be that bad?)

[Slywalker]

Hmmmm, I just skipped a night.  I went to visit my daughter for one overnight and it seemed like a huge event to have to drag all the dialysis stuff with me - so I did skip and didn't feel any different.  I don't think I would make a habit of it.

Sandyb

[fluffy]

i've skipped before. i used to be in a band and wed play shows and stuff, theyd usually run pretty late and by the time i got home i didnt have the energy to do it. all my bags are in the basement and the cycler is in my room on the second floor of the house and hauling 10 liters up three flights of stairs isnt fun at 3 am.

[VLZS]

No nights off for me.
I actually did try to take a night off last week--I thought I was going to die!  Because I didn't start the cycler until about 3:30 AM, before I could get it set up, my entire dinner came up and then some, I had a splitting headache, and if I'd wanted to take a Pepto-Bismol, I couldn't have, because I didn't feel like I could keep anything down.
By the way, I do the APD (CCPD) at home, and it's every bit the pain people say it is.  Especially in the summer, when the house has to be kept open in order to not be too hot, only keeping it open means flies and mosquitos coming in and getting all around the solution and other supplies---not good.  I'm done with exhaustive three-minute hand washes too.  All that hard work to stay sterile, and there's flies in the house.  I wish I could just stop dialysis completely, due to lack of motivation.

[angela515]

VLZS  Don't give up.. I hope things will look up for you soon.

As for skipping treatments, I have before... not often, because I liked to eat what i want and drink however much I want, so I tried to make sure I hooked up to my cycler everynight just for the fact of that.

[rimbo74]

This was really really bad of me, but I missed two dialysis treatments.  One was I went partying for St Patrick's day with my brother (who gave me my kidney) and I ended up drinking way too much.  Like about 20 drinks all day long (or more).  I ended up passing out while hooking myself up and never got on.  I was hung over the next day but it didn't feel to bad.  The other time was I had to go into work in the middle of the night and decided to skip, I didn't notice any bad effects from doing it.  Your PD nurse will however know that you skipped since there will be a skipped day.