Priming

[goofynina]

Just me with another question for those on the PD Homechoice Cycler.   When priming your machine and you hook up your patient extension line, do you open the clamp???  i used to open the clamp but when i went to go hook up, the solution would come out of it,  isnt that contaminating it?  I've talked it over with my PD nurse and she said to leave it closed,  but the book shows and tells us to open the line,  WHAT THE HELL AM I SUPPOSED TO DOOOO??? lol   I know they say you need to open it to prime all the bubbles out of it, can someone please advise me.   Thank you.....

p.s.  and even though i drain, i feel like i have fluid in me,  sometimes it is hard to move,  can it be like a great big air bubble accumulating?  OHHHH IF IT IS,  GOD HELP US ALL........

[goofynina]

Well guys,   i got my answer, called Baxter and they explained it to me,  so, just in case anyone else reads this and wants to know,  YOU NEED TO OPEN THE CLAMP ON THE PAITENT LINE,   

[Ginger]

Nina,
For sure you need to open the clamps to prime the air out of the cycler lines before hooking up. I do not always get fluid coming out of the tube when I hook up. If you hold the tube upright and not lower than the cycler, you should get no more than a small drop if any out of the tube. It is sterile fluid so does not cause contamination.

Also, If you still feel like there is fluid in you at the end of the drain cycle at the end of your time, do you set the machine for a manual drain? At the end of my time on the cycler, I arrow down to manual drain, hit enter, and start and get anywhere from 50-450 more fluid out of me.

Ginger

[goofynina]

Hi Ginger,   May i ask what you do if the fluid has not gone all the way through the patient line after it is done priming?  Sometimes it is even hard for me to even tell if there is fluid in there, lol,

[anja]

Hi goofynina,  Do you carry fluid in you during the day?  If so, the first step after the priming and connecting is to drain, so the fluid is coming out and you need not worry about the air nearest you in the patient line .  Yeah, it is rather hard to see where it is.  Now that I have been on the Baxter cycler for a year, they want me to switch to a Fresenius... ???Start training again on the 20th   All has gone well with the Baxter, so I asked, if it ain't broke , why fix it???  But I told them I would try it for a month if that is what they wanted me to do.  (I think I was a guinea pig, for I was the sole patient on the Baxter and I loved it!)  Good luck to you! Baxter was always helpful to me when I called for answers too.  Anja

[goofynina]

Hi Anja,  On a normal day i am empty when i hook up, but thanks to this peritonitis, i have to put a bag in me with antibiotics and let it dwell for 6 hours,  man, am i ever glad i do this while i sleep cuz i just cant function with that fluid in me.  My bags are clear again i just have to complete the 7 days of meds the doc gave me,  we got it early, thank God.  Please keep me updated on the Fresnius.  Why would they want you to change? i dont get it.  Do you think they will eventually have everyone change?  Do you know anything about the machine, like is it supposed to be better, faster, quieter (not that mine is noisy) i am just curious.  Hope to hear from ya soon,

Goofynina

[anja]

Hi again, goofynina!  So sorry that you are experiencing peritonitis~OUCH!  No wonder you are so sensitive to the fluid at this time!  I have 1900 dwelling in me throughout the day.  My best guess as to why the change to Fresenius is since I am the ONLY one in this unit on Baxter maybe they want to drop the contract with them....only a guess on my part.  They said if I were ever hospitalized the nurses would only know how to do operate the other machine, not mine.  I quickly informed them that my other half has been taught how to administer the therapy to me and even give my Epo shots, so he would gladly march into the hospital with my Baxter machine and do my dialysis for me!  The new machine was delivered, unbeknown  to me and set in the garage, where I nearly ran over it when I came home---could have been an expensive encounter....   My supplies for a month arrive on the 6th and I get trained on the 20th and 21st.  Don't know much about the machine yet but it is harder to dismantle and portability will be more difficult on our trips to visit the kids in Chicago and Dayton...  The machine is not supposed to cause 'drain pain' which I thought was just a part of this treatment.  It is to be safer infection-wise (I have had just the one peritonitis from when the cath was placed a year ago plus)  Less time to be open to the air and I wonder if there will be any noise at all.  It is more gravity driven as I understand it so it does need to stand higher.  Time will tell...  I will update you when I know more.  Take care and hope you get over the infection quickly!  Anja

[goofynina]

Hey Anja,  I hope everything works out for you and the transition goes smoothly.   Thank you for your kind words and all your helpful hints and please do keep me posted on this new machine,  now i am worried that they might pull that on me,  and if they do, i want to be one step ahead of the game   lol.   Have a good one my friend...

[Ginger]

Goofynina,
Sorry I am so late answering your question. (Went to the lake for the weekend.)
The couple of times that I forgot to open the clamps when I set the cycler up and it did not prime, I just reset the cycles over again so that it did another prime cycle. Of course this only happens on nights that I have to be up early.  If you compare the empty lines to the patient line after priming you should be able to see the difference if it is primed.
Ginger

[goofynina]

OK, let me get this right?  If my machine is set up for an Initial Drain before my first fill, it's ALLRIGHT if there is still air in the patient extension line? 

[Ginger]

Goofynina,
Depends on the amount of air! An inch or so I would not worry about. 2 feet, I would probably reprime before setting to the initial drain otherwise you will have the dreaded 'shoulder pain'. When you set it up with the patient extension line, do you put the end of it in the cassette like the other one was? If the end of the extension line is lined up in the cassette it should prime to the end as if there were no extension there.       Ginger

[goofynina]

Hi Ginger,  yep, once i connect the extension line i put it back and it never is primed and there is usually about 2 or more feet that has air in it,  So i should reprime it again?  I will do that tonight, maaaaan, if its not one thing its another huh?  aye yi yi
thanks for your help, it is very much appreciated

[Ginger]

Goofynina,
You are not hooking more than 1 extension line are you? Or forgetting to open the clamp? Anytime I have used the patient extension, I have never had a problem with it priming to the end of the tube unless I forgot to open the clamp. (You know, that memory loss!)   Ginger

[goofynina]

Nope,  i am just adding the one extension line.  Last night i even primed it twice and it still didnt prime all the way,  i hooked up anyways    I just dont get what i am doing wrong...

[jdat]

I used to always clamp the line that connects to the patient despite the fact you are supposed to unclamp it!

I know I'm a bad boy but it always ended up leaking out a little bit or I would spill some while connecting myself and being my lazy self I try go keep clean up to a minimum.


I don't really think it matters that much anyhow or does it when you are draining when you plug yourself in!?!

[goofynina]

Hey Jdat,  I am just soooo afraid of getting air in me again,  that is the most painful and uncomfortable thing i went through and i just dont want or i dont think i can handle going through that again,,,   you've never had that problem?  and yes, i do drain before my first fill.

[Ginger]

Goofynina,
Do you drain enough in the initial drain to completely clear the line? If so, the 2ft of air probably would not be a problem. I would also check with Baxter about the air in the line after priming as maybe there is something wrong with the priming mechanism of the machine, because it should fill it all the way!  Hope this clears up for you soon.   

[goofynina]

Hi all,  Last night i had to prime my lines 3 times in order to get the fluid all the way to the top,  when i have my initial drain it is a very small amount,  usually under 20ml,  do you think that is enough?  i am not too sure, i just know one thing, i dont want that feeling again.....

[Ginger]

Goofynina,
20ml is not enough initial drainage to clear the lines before your fill. I would call Baxter as it should not take more than 1 prime to fill the tubes! It definitely should not take 3 times to prime all the way. You may need a new machine, or they may have some suggestions.

[jdat]

goofynina are you empty during the day?

because 20 ml sounds like you're empty!


And no I never had any air apart from maybe a bubble or two get in because my initial drain used to be around 1800/2400 ml so that cleared all the air out.

[goofynina]

Yep, i am dry during the day.  I do a manual drain 2 hours after the end of my therapy on the cycler that is why my initial drain is so low.  I am just so worried about that extension not priming...