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Author Topic: capd exit site infection  (Read 9968 times)
hephziba
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« on: June 22, 2006, 03:54:31 AM »

Hi, Ive had an exit site infections since I started capd, almost 4 months now, they have tried killing it with antibiotics but it doesnt seem to be responding, they have told me they may need to put in a new line.ahhhhh >:( >:(

In which case they would normally put me back on hemo for a few weeks while the new capd catheter heals. I told them no way and they talked about taking me in for 20 hours of capd with a cycler, and that way I shouldnt need to do hemo over the three weeks of healing time, has anyone here heard of or done twenty hours of dialysis straight ???

 ???
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toad
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« Reply #1 on: June 22, 2006, 04:56:36 AM »

never...i have been on pd for along time and  never have i heard of this....do you use the cream around your exit site..when i started i cleaned it and put the ointment on daily...now clean daily and use the ointment once a week
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kevno
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« Reply #2 on: June 22, 2006, 10:00:16 AM »

It all depends on what the bug is that is causing the infection. The Nurse should have swabbed the exit site. So to know which antibiotics to fights the infection with. I have used the cream on my lines in my neck.

In the UK, when the tube was put in I was on IPD which is before the cycler. 500mls of fluid was drained in, left in for 1 hour then drained out. Day and night for two days. Last time I had that done was 2000 when I had my last tube in. I had a total of 5 tubes in. Then stared on CAPD 1500mls for 1 week then 2000 mls after that. To make sure there are no leaks. Never had to wait for the wound to heal. But the Doctors had no option with me, because of my needle phobia. I would not go on Haemo.

Kevno
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« Reply #3 on: June 22, 2006, 09:04:09 PM »

When exit sites get infected they can get to the point where it just wont heal without removing it. To prevent infection you must shower every day, cleaning it with whatever soap you were told to use, and dry and dress it daily. You can dab it with antiseptic before dressing if needed. If they are wanting to take it out, your better off doing it before the infection gets too bad, as they can get nasty.

I was basically on PD 24hrs a day. Went on the cycler over night, and left a bag in during the day, sometimes doing a bag throughout the day as well. I dont know what cycler they will have you on, but with the one I used you could disconnect during the dwell. You just capped everything off, then when ready to fill and drain again, you just reconnect. Hopefully you will be able to do this! If not it shouldnt be too bad. It would be good if they could hook you up so that you will be on it overnight, so some of the time goes quickly.
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goofynina
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« Reply #4 on: June 22, 2006, 11:16:52 PM »

Hi Amber, This is what was told to me, can you please tell me if it is true,  when you are completed with a fill (i am on the homechoice cycler)  and right when it begins to dwell, when we disconnect, lets say dwell time is an hour (for instance) i understood it that if i disconnected, left and connected when that hour was up, i would still have to dwell an hour on the machine.  thats what i understood,  i would love to disconnect and go about my business while i dwell, but i just didnt want to have to double my dwell time.  Can you please advise me of what is really going on here?? lol,   thanks
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Panda_9
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« Reply #5 on: June 23, 2006, 02:45:58 AM »

Goofinya, your machine should be programmed with the amount of time you need to dwell. If it is an hour, you can disconnect for an hour, hook back up, and drain out then fill again. You dont need to double dwell. That is providing your machine allows you to disconnect. I had special caps that you use to put on the end of the lines, then you put your normal cap on your catheter. What cycler are you using?
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goofynina
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« Reply #6 on: June 23, 2006, 03:02:10 AM »

i am using a homchoice,   i have the caps that you are talking about,  just never thought of using them because of the whole dwell time issue but i think i am going to try it.  Thanks for the info,  i'll keep ya informed, 
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Panda_9
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« Reply #7 on: June 23, 2006, 03:10:24 AM »

Oh your a silly moo goofinya!! By all means use them!!! Your machine will only do the dwell time its been programmed. I usually hooked up a few minutes before it was due to start draining just so there wasnt annoying alarms. Just be careful when putting the caps on the lines and your catheter. It can be tricky as you are holding both ends at once. What I did was have both the caps open ready within reach. Unscrew the line from your catheter and hold both ends in one hand being very careful not to contaminate. Using your free hand, put the caps on. On the machine I had, there were little holders to put the line in while you capped your catheter, but I found I was more likely to contaminate it doing it that way. Let us know how you go and if theres any problems.
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goofynina
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« Reply #8 on: June 23, 2006, 03:20:23 AM »

Amber,   I came back to ask you how you use your caps and you had already answered it,  your awesome, thank you,  kinda sounds difficult though,  i have already contaminated myself once, yesss, peritonitis,  dont want to do it again.   When you do your hook up,  do you have the air off and doors and windows closed?   I am just wondering cuz when heph went camping, he did it out in the open,  i dont get it... lol,  i was just wondering if we were all taught the same way...
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« Reply #9 on: June 23, 2006, 04:27:36 AM »

Definitely turn off fans and shut windows if there is wind coming in. Basically anything that is blowing I turned off/shut. I dont think air con is a problem, considering it is on in the hospitals. It does take practise, just take your time and be very careful. You will devise what is easiest for you, that is just the way I found easiest. Good luck!
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angieskidney
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« Reply #10 on: July 07, 2006, 07:48:28 AM »

I had Peritonitis so bad that it was not able to be treated at home as well. They tested for which bug and said there was no growth so it SHOULD have been able to be treated at home but was NOT getting better. When it can't be treated at home assume it is a bad one. i ended up having to be hospitalized for 6 weeks last summer because of this. The ended up telling me it was caused be something internal and NOT by anything I did wrong. Has anyone ever heard of that before? My Peritonitis was the WORST case they had seen in 20 years in my city on top of that!!

Anyway, if they want to take the tube out .. do it. I mean .. I didn't want to go through that but Peritonitis KILLS. They had to take mine out and clean me out. It hurt so much doing drains by this time that I was not able to get a good clearance. I had to change to Hemo. I didn't want to but I had no choice.

At least I am alive.
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hephziba
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« Reply #11 on: July 07, 2006, 08:38:13 AM »

for me Haemo is completly laying down my life. My body just didnt like It in nine months of haemo I had 6 infections all of which put me in hospital for two weeks, I was so weak and sick that my wife had to help me from the car to the house constantly, I couldnt stand to do the washing up so my wife had to do it, which I hated, felt completly useless, had to lay down on the floor at church if I even made it.  capd has meant that I started living again, I am back at some kind of normal and me and my wife are having fun. they say that in england you can only capd for 5 years before having to change back to haemo. so we are fitting as many holidays and special times in as possible, we dont know what will happen in five years. but lets make it worth it. ;)
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goofynina
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« Reply #12 on: July 07, 2006, 12:01:20 PM »

Good for you Heph, i am glad to hear you and your wife are doing well and having fun,  and you keep having fun my friend, til you just cant have fun no more,   ;)
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« Reply #13 on: July 07, 2006, 06:35:16 PM »

angieskidney, both times I had peritonitis they couldnt find what type of bacteria it was. I wasnt bothered about being admitted for treatment, otherwise it meant driving back and forth every day to pick up the bags with the antibiotics in them, as I wasnt allowed to put them in myself. Yet when I had an infected permacath, they put a PIC line in for the antibiotics as I have crap veins, and they let me give myself the ABs through that at home. I had to tell them that I was a nurse, which I hate doing, and they got me to do it a few times before they let me home. Otherwise I would of been in hospital for a month or more as there were no free spots for home IV people to come out and give them to you.
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angieskidney
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« Reply #14 on: July 07, 2006, 11:49:44 PM »

angieskidney, both times I had peritonitis they couldn't find what type of bacteria it was. I wasn't bothered about being admitted for treatment, otherwise it meant driving back and forth every day to pick up the bags with the antibiotics in them, as I wasn't allowed to put them in myself. Yet when I had an infected permacath, they put a PIC line in for the antibiotics as I have crap veins, and they let me give myself the ABs through that at home. I had to tell them that I was a nurse, which I hate doing, and they got me to do it a few times before they let me home. Otherwise I would of been in hospital for a month or more as there were no free spots for home IV people to come out and give them to you.
Wow! Well for me I have never had any infections in my permacath the 11 months I have had it now (I realize how lucky I am) but with that Peritonitis I was annoyed at having to brings bags into clinic for them to medicate since I am 32 (was 31 at the time of this) and I had medicated my bags before when I was 16 (was a false alarm that time however .. was new and overreacted). Finally they gave me the meds (I had to pick up frozen syringes of the medicine and use it over a period of time) to inject into the bags myself after a week of going back and forth. I told them how I did it back in 1990 so I guess they finally decided to let me.

It still wasn't helping to clean it up even though there was no "growth". But I remember I was in so much pain that I could not even stand up to cook myself food and my friend Dave had to cook for me. It was a pain for him because he had no car.
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« Reply #15 on: July 08, 2006, 07:59:46 PM »

The two times I had peritonitis it wasnt real painful as I got treatment as soon as I noticed a cloudy bag. I had a bit of pain, which made it hard to sleep, but I can imagine how painful it must be if you dont get treatment asap. I think my permacath got infected because it got wet a few times because the dressings were shithouse. So the second time I got a permacath, I devised my own dressing, and it didnt get a drop of water on it. I just used 2 large tegaderm, and stuck it on as close to the caps as I could. It worked quite well. I had spare ones at home and if it was starting to peel off I just redressed it myself using a dressing pack and chlorhex after scrubbing my hands.
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goofynina
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« Reply #16 on: July 08, 2006, 08:08:54 PM »

hi amber,  i know this is a stupid question but it has been bugging me,    how the heck do you get the sticky glue off of your skin after you remove the tape?  It is driving me crazy, my stomach looks like a friggin road map, lol,   any suggestions anyone?
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mmmmdeedee
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« Reply #17 on: July 08, 2006, 10:16:57 PM »

Hi there:

Most effective way to take off the sticky stuff is WD40. It actually comes in little wipes also. Very handy. They use it at my dialysis center also.

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kitkatz
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« Reply #18 on: July 08, 2006, 10:18:14 PM »

Nail polish remover might work too.
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« Reply #19 on: July 08, 2006, 10:24:39 PM »

Awesome,  i will try the nail polish remover, i dont think i have WD-40, but it is good to know,  Thank you...
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angieskidney
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« Reply #20 on: July 09, 2006, 12:35:02 AM »

The two times I had peritonitis it wasn't real painful as I got treatment as soon as I noticed a cloudy bag. I had a bit of pain, which made it hard to sleep, but I can imagine how painful it must be if you don't get treatment asap. I think my permacath got infected because it got wet a few times because the dressings were shithouse. So the second time I got a permacath, I devised my own dressing, and it didn't get a drop of water on it. I just used 2 large tegaderm, and stuck it on as close to the caps as I could. It worked quite well. I had spare ones at home and if it was starting to peel off I just redressed it myself using a dressing pack and chlorhex after scrubbing my hands.
That is great :) I don't know how they do it there but here I am allowed to get it wet and have had mine now for a year just about (by 2 more weeks it will be exactly a year) which I know is normally too long but they had such troubles with my fistula. They are talking about taking my permcath out finally though since my fistula is just starting to be used and so far there are no troubles. But the thing about when I had Peritonitis is that my bags were not cloudy at first so I didn't realize and I thought the pains were cramps from .. well .. you know .. anyway ... I didn't know at first. I mean .. I had never had Peritonitis before and after 4 1/2 years of PD and no problems you kinda don't think about it as much.
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« Reply #21 on: July 09, 2006, 01:16:41 AM »

I dont know why they would say its ok to get a permacath wet since water is a huge carrier of germs. If you get it wet, do you clean it with antiseptic and redress it? That is a long time to have one without getting an infection!
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« Reply #22 on: July 09, 2006, 01:52:33 AM »

About the sticky stuff, I usually left it on for a couple of days til it hardened a bit, then I just rolled it off with my fingers after I got out of the shower and before I did the dressing. I tried the sticky remover wipes but they were useless and just stung my skin.
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« Reply #23 on: July 09, 2006, 06:56:15 AM »

Goofynina,

Heph uses the alcohol wipes they send him to clean his surface and exit site. They work really well. Don't know if you use alcowipes over there though.  ;)
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« Reply #24 on: July 09, 2006, 11:16:46 AM »

Yep, we sure do (just never thought of using them on that)  but you better believe i am going to try it now....Thank you
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