PD Training

[Laurie]

Today was my first day of PD Training. I was a little nervous about the first fill and drain, but it went very well. I'm so relieved to have the first one over with. It was a little overwhelming, but I'm sure it will get easier.

[KT0930]

Laurie, it will get easier...to the point you can do it with you eyes closed. Ok, maybe not quite, but it'll sure seem that way! Best of luck with the remainder of your training!

[paris]

Laurie, I had an orientation last Monday to help me decide what type of dialysis to do.  My docs and nurses say that PD is the way I should go. I will be anxious to hear how your training goes.  Please keep posting with all the details!  Hope it goes well for you.

[goofynina]

   YAY, I am so happy to hear that your first day went well, i hope all your days goes as well as today    And remember, if you have any questions, please do not hesitate to ask 

[Wattle]

  The first day is the hardest. Now that it is over, you will find it does get easier. Read all the information they will give you. Have your questions ready to ask and try to relax.

I also found it overwhelming but it all comes together quickly. I am sure you will do great.   

You can PM me with any questions.   

[KICKSTART]

The first time i did it at home on my own was the worst , i was so nervous and shaking !!! Now i can do it with my eyes shut , it becomes second nature. Its like anything else its easy once you know how! Good luck it will be fine .. its just practice!

[Laurie]

Thanks for the replies.

I'm still trying to get used to the length of the catheter. I had it put in the beginning of August, but they left it under the skin until I was ready to start training. I went on Thursday to have it exposed. I could not believe how long it is. I'm having trouble getting the tape to stick to my skin. Any suggestions? I plan on ordering some belts off the internet, but haven't yet. 

[Wattle]

Hi Laurie,

There are a few different tapes you can try. Just ask your nurse/clinic. I use a cloth like tape as the anchor and a Primapore dressing (cloth like patch) to cover the exit site. Fresenius supplied me with a belt to hold the catheter, they aren't too bad.

On the length of the catheter, there are different extension lengths available. They usually give you the longest while you are training so it is a little easier to work with. You can ask for them to change it. I am on the shortest Fresenius extension, which is 30cms from the join. It does take a while to get use to a tube hanging to your knees. Give yourself time and it will all seem second nature.   

[KT0930]

Laurie,

I totally understand. The surgeon went ahead and put the longest extension on mine when it was inserted, then the hospital sent me home a few days later with this THING hanging down to my ankles, and no explanation of how to care for it. Thankfully, the nurse at the neph's office showed me a few days later about looping it around so I only have to use one piece of tape each day.

Ok, back on topic...try different types of tape. Fresenius supplied me with paper tape, but it's pretty much useless on my skin. There are many different types out there, so ask your nurses, buy one roll at at time, whatever you need to do to try them one at a time until you find one that sticks to your skin but not so hard that it tears your skin up when you take it off. I find nylon tape works well.

[Laurie]

Thanks Wattle, I go back on Monday, so I will ask for a different tape. I can't even get the patch that covers the exit site to stick very good. I went to the store and bought some different tape, one will stick, but then it is very hard to pull off.

KT, OMG it really went to your ankles? Mine only goes to my knees, so I guess I shouldn't complain.
I really liked the way it was looped yesturday, but after I changed the dressing today, I can't get it back the way it was 

[Laurie]

Today was my 4th day of training. Only 2 more to go and then I'm on my own. It has been going very well. Today was really boring, going over the same thing over and over. I feel very confident that I am ready to start on my own, but it is required to do 6 days of training.

The only thing that makes me mad is that they have me set up for 5 exchanges in a day. Which means I will be full during the day. I hate it. I have tried to talk them out of it, but they say they start everyone out this way for the first 30 days and maybe after they do the first clearance test, then maybe we can cut out being full during the day. It is so frustrating because I'm not everyone else. I don't have a problem retaining fluid, I'm still feeling pretty good and don't really have any symptoms. I don't understand why I can't try the 4 exchanges for the first 30 days and then if we need to add the 5th, we can. 

Hopefully I won't get too dehydrated 

[goofynina]

Laurie, will they eventually be switching you to a cycler?  That way you can have your days free with no dwelling (hopefully)   

[Laurie]

Laurie, will they eventually be switching you to a cycler? That way you can have your days free with no dwelling (hopefully)

I'm starting out on the cycler, but they still want me full during the day. I will have a total of five exchanges during the day. When I wake up in the morning, I will be full. When I get home from work, I will drain that and then fill and then before I go to bed will drain and fill and then have 3 exchanges during the night. 

[Lulu]

Thanks for the replies.

I'm still trying to get used to the length of the catheter. I had it put in the beginning of August, but they left it under the skin until I was ready to start training. I went on Thursday to have it exposed. I could not believe how long it is. I'm having trouble getting the tape to stick to my skin. Any suggestions? I plan on ordering some belts off the internet, but haven't yet. 

Have you seen the PD band? It is custom made for each person. It look awesome. I am getting one when I get my catheter in. Here is the link.
http://www.patientspride.com/pdsecurityband.html

[Amanda From OZ]

Wishing you all the best with your training, and hoping things go smoothly. 

Amanda
xxoo

[Ken Shelmerdine]

Laurie, I had an orientation last Monday to help me decide what type of dialysis to do.  My docs and nurses say that PD is the way I should go. I will be anxious to hear how your training goes.  Please keep posting with all the details!  Hope it goes well for you.

Hi Paris
I didn't realise you are still pre-dialysis. I can recommend PD particularly with a cycler. You can carry on life as normal with complete freedom 'cause it's all done while you sleep at night. Most people experience early problems but in the main the problems soon sort themselves out.

As far as the surgery is concerned I know someone who had a local anaesthetic and wishes he gone for the full because though he didn't feel much pain he said he could feel the sergeon sort of tugging and pulling and he said it wasn't pleasant so I opted for full anaesthetic. I was in hospital for a week because I got a slight infection in the surgery wound otherwise I would have been out in two days. The wound itself wasn't very painful and normal painkillers like paracetamal kept it at bay.

The worst pain was the god awful mother of a sore throat I woke up with fromt he tube they put down your throat.
Best of Luck 

[MyssAnne]

Definitely, PD is the way to go, especially the cycler! I love mine!!!  I have to be full during the day, which irks me as well, but they won't change it, they say it's necessary. Ugh. OH well.  I remember my training, I was so nervous, then after I'd been on it for a week at home, I thought, why the heck was I so nervous? This is cool!!!

[Laurie]

MyssAnne, did it take you a while to get used to the cycler? I wake up in pain every time it drains. Right now, I really hate the cycler. I'm full during the day too, which I hate. I haven't ate much since Thursday night. My back is killing me.
I have a call in to my nurse to see if there is anything that can be done. I'm miserable. 

[MyssAnne]

Laurie, how much are you putting in?? That sounds like a major part of it. there shoudl be NO pain whatsoever.  My guess is you're putting too much in at one time. You can control the amounts put in. THey don't like it, but when I had a new tube put in, I didn't put much in to begin, but worked up to it, gradually. VERY gradually.

[Laurie]

I was putting in 1500. Today they changed it to 1250 which feels better, but I still have pain during the drains. They are thinking maybe the catheter has moved or is too long and may need to be replaced. The pain gets so bad I have to bypass the drain and go on to the fill.

[Wattle]

I'm starting out on the cycler, but they still want me full during the day. I will have a total of five exchanges during the day. When I wake up in the morning, I will be full. When I get home from work, I will drain that and then fill and then before I go to bed will drain and fill and then have 3 exchanges during the night. 

Hi Laurie,
I am on the same routine. You will get use to it. I was going crazy on the manual bags. You just seem to do dialysis all day long. Now I do one exchange in the afternoon and the cycler at night. Each exchange is 1600 fills.
It takes a while to get use to carrying the fluid. I felt like I was going to be sick for the first couple of weeks but it did get better.
Try changing positions with draining to see if the pain gets any better. I find I drain better lying on my right side. 

Hang in there   

[KT0930]

Unfortunately, the pain is something that happens occasionally. Usually the cycler is trying to pull off more fluid than is in there. Picture a kid's CapriSun drink pouch (the silver ones that you stick the straw in). When you get to the bottom and are trying to get that last little bit of drink out, it collapses the bag. That's essentially what's happening inside. At least, that's how it was explained to me. And that's the reason for the pain. As wattle mentioned, try changing positions. My cath is on my right side, and I find it doesn't hurt as much to drain while laying on that side. Also, what percentage solution are you using? I find I don't have as much pain with the drains when I use a higher percentage (2.5% vs 1.5%). Just be careful not to dehydrate yourself using the higher solution.

[MyssAnne]

KT is right, I like the CapriSun analogy.  Do be careful with the higher percentages, as she says, it does dehydrate you, and I speak from experience!!!  Try positioning yourself once the pain starts. Try the other side, try your back. It very well may be the tube is too long.
Also, you could just go ahead and bypass it at that point, if enough fluid has been drawn out, just go ahead and go to fill. I've done that too,
if I've pulled off not only what I put in, but a little extra.

[Red from Canada]

I am on the Baxter cycler and love it.  But when I started I was having severe pain with draining, so they put me on a tidal program for a while.  I have now been on more than 6 months and seldom have pain at all.  I may go off tidal and on regular program since I am now up to 90% with no ill effects.  One other thing that can cause pain is not being regular.  Take your stool softeners and make sure you don't get stopped up.

[Laurie]

But when I started I was having severe pain with draining, so they put me on a tidal program for a while.

I've never heard of a tidal program, what is it?