I may already have peritonitis!

[Adam_W]

Over the last couple weeks, I've had some pain on the left side of my abdomen, and lately it has been getting worse. Today it's gone from worse to almost intolerable. I can't stand up straight without it hurting, it hurts when I breath, it hurts more when I cough, and God help me if I have to sneeze. My nurse has me doing quick "in and out" low volume flushes to keep my catheter free of fibrin while my leak seals up. I did my flush today, and left the 500cc in for about 15 min, and when I drained it out, the fluid was cloudy. There was also A LOT of fibrin in the drain bag. I'm not running a temp, but I have a very low temp anyway. My nurse wants me to come in tomorrow and do another in and out flush (maybe with a little bit longer dwell time), and she's going to send the effluent for cultures. If it turns out to be peritonitis (even if it's minor), how likely am I to not be able to do PD? I'm scared, and I'm blaming myself because I probably did something wrong and caused it.

Adam

[Romona]

Just offering moral support. 

[mariannas]

I got a very (and I mean very) minor case of peritonitis almost immediately after starting PD (this was after already having the catheter in place for 4 months).  I just did a two week (I think) round of antibiotics.  Basically, I did all the medication administration myself (injecting the antibiotics into the bag) and put it into a dwell that would last at least six hours.  After that I was good as new and haven't had a problem since! 

I think it really depends on how serious of a case you develop as to if you will have a problem continuing PD.  I am very anal and every twinge and minor irregularity gets serious investigation.  Since we caught my peritonitis so early it didn't effect me at all.  Keep on it and insist that a drain bag be analyzed if you think your nurses are dragging their feet.  It's YOUR health and comfort on the line.

I hope you start feeling better soon and make sure to keep us updated!

[MIbarra]

Ugh! How awful for you. Hope everything turns out okay!   

[petey]

Thinking about you, Adam!  Bless your heart!

[Sluff]

I am wishing the best for you Adam.

[willieandwinnie]

Adam,  I'm so sorry. Have you got your NxStage back yet? I hope that things improve for you quickly. I'll be thinking about you. 

[rose1999]

Wishing the best for you Adam 

[peleroja]

Sorry, Adam, what a bummer.  I'm not 100% sure, but I think you have to get peritonitis 4-5 times before they decide to take you off PD.  Most likely they will give you antibiotics for your bags and you'll be right as rain in no time!  Thinking good thoughts for you.

[annabanana]

Hope all goes well for you, Adam.

[Joe Paul]

I am surprised they didnt start you on a oral antibiotic when you first started having pain. I hope they get it sorted out for you, good luck.

[PD Wife]

My husband also always runs a low temp and his temp didn't elevate until he'd had peritonitis for over 24 hours, maybe longer.  He had a pretty bad case and had to be hospitalized but did get over it.  Just be careful if you do get hospitalized and they put you on "broad spectrum" anitbiotics because that can knock out your "good flora" and leave you with a long, recurring bout with a GI bug called c.diff which my husband has had for well over a month now.

[MiSSis]

Just my personal opinion here but if I started seeing fibrin and especially along with cloudy fluid, my doctor would put me on an antibiotic and heparin immediately and then start running the cultures.  Following the results of the culture, he might or might not have to change the antibiotic to something more specific to the bug I've gotten.  We wouldn't be waiting any 24 hours to see if it "might" be peritonitis. 

I'm on my 2nd round of PD.  First was for 4 yrs from Nov '83 to Dec '87.  Now I've been back on it since Oct 2003.  I've have several bouts of peritonitis and 2 pretty significant cases.  Last year in June I developed a serious case of Psuedomonas and was hospitalized for 4 days..  I think that you can continue to do PD as long as you don't develop too much scar tissue as a result of peritonitis.  And this is dependent upon how serious a case you have. 

Peritonitis is nothing to mess around with.  I'd be asking for or demanding some action NOW!  The sooner you start treatment for it, the less damage you should incur. 

Good luck and I hope to hear that it's not anything serious.

[pelagia]

 

[Adam_W]

I had the fluid analyzed today, and the initial cell count indicated that I do have peritonitis. I'm still temporarily on hemo until my leak seals up, so I can't take IP antibiotics right now. I did my treatment at the centre today, and I received two different IV antibiotics. The first was Vancomiacyn (sp?), and I can't remember what the second one was called. The dialysate is being tested for cultures, and my nurse should have the results for me on Monday, and we should know just how serious my case is. The bad thing today was I received the vancomiacyn a little two fast, and actually had an anaphylactic reaction. I promptly received IV Benadryl to reverse the reaction. It appears that this is not an extremely bad case, and I should be able to continue PD, but I'm just so bloody tired of dealing with bad things happening.

Adam

[monrein]

Hope you get a break really soon Adam and everything sorts itself out.

[twirl]

 
thinking about you with care and love
hope things get better

[Mimi]

Adam, I know you are bloody tired of it.  You will be in my prayers.

Love, Mimi

 

[CatEars]

In my first year, I'm a pro at a year and a half now, I've had two confirmed cases of peritonitis and two holes in my cather.  My nurse said that I'm the type of person who has to do everything wrong in the first go just test it out.  I would argue but my mother says the same thing.

[kimcanada]

I hope all is well Adam, don't blame yourself 

[angela515]

I had peritonitis 3 times while on PD. The first time as the very first day of PD training and they said it was dormant in me and the fluid activated it. The other two times were within 6 months after that and I did everything right so I don't blame myself at all.

However, your supposed to be put on heparin and antibiotics at the first sign/symptom/thought of peritonitis.... So I'm shocked they didn't do that and they are messing with your peritonium and the chance to continue doing PD.

[ReneeP]

Ugg....   5 months of peritoneal dialysis....    One small child, two cats, a husband who doesn't know what a towel is and I haven't had peritonitis.   Until this morning when I woke up with my cycler beeping holy hell at me...something about system error 2400.   Who knows it was 3 am and I just turned it off.  Come to find out that my 5 year old let the cats in the room in the wee hours of the night and as soon as a drain or fill started (don't know which one)  the cats attacked the line like there was a mouse running through it.   Fluid all over my rug.  AGAIN.   Except this time they bit and clawed through the line that was attached to my transfer set.   SOB!!!    I manually emptied, I prayed.  Come noon, I felt like I had put alot of air in my abdomen   Come 1 pm I called the doc. 
Went in and they changed my transfer set (don't know why, oh well) and put me on amoxicillin 500 mg for a week.  My fluid's were not cloudy yet.   Guess what, I was at Walmart with Kaley and I thought I was going to pass out.  Felt like menstrual cramps times 100.   For all you guys...  Kidney stones.  (I don't know what that feels like but I've heard)   Got home.  called again and they asked me my bp which was amazingly 117/75 and just told me to drink some chicken broth.  Okay, just checked, yep, you guessed it.  Cloudy.   But the cramps are almost gone. 

Do you think the amoxicillin is working?

I'm going to call in the morning.  It's getting late.  Man I  hope that isn't a stupid move.

Kids got to get to school ya know.  (Yes, I've been told my priorities are messed up)
 
Renee

[MiSSis]

Don't wait.  Make the call.  About 1 yr. ago, I suspected peritonitis.  Fluid wasn't cloudy yet but I had some fribrin in my first drain and my belly hurt.  I just felt like something was wrong.  Called the doctor and he told me to add some heparin to my bags and to call the office in the morning.  I had my husband call him back about an hour later as I was really starting to feel badly.  He said to go to the ER.  I went in with fluid in my belly and took along a CAPD drain set so that I could drain fluid there for them to test.  By the time we got to the ER and drained out some fluid, my husband said the fluid was really cloudy and almost orange in color.  To make a long story short, I ended up spending almost 1 week in the hospital with a pseudomonas bug and come home with a PIC line.  My husband had to give me IV antibiotic treatments daily for two more weeks.  Peritonitis is nothing to mess with.  IMO, oral antibiotic is not going to do the job for you.  I think you'll be much better off to get things checked out now and hopefully prevent a more serious infection that could put you completely out of commission for your family. 

Have you ever considered doing manual exchanges instead of using a cycler.  I know it's a little more intrusive in your daily schedule but you wouldn't have to worry about your cats attacking your lines during the night.  I'm lucky in that my cat doesn't mess with my lines but not wanting to tempt him too much, I don't drain into the toilet at night.  Instead I drain into a drain set of four bags which I've placed in a large plastic container.  In the morning I drain them into the toilet when I can keep my eye on things better. 

I hope things work out for you and that you find you don't have an infection but I do really feel it's something you need to have checked out immediately.  Call a friend or relative if your hubby isn't available and have them help with your kids.  This really should come first!

[ReneeP]

MiSSis,

Doing better...  that was horrible, I can't imagine having a full blown case.   Bless anyone who has.

As far as the manuel exchanges, I did that for about 10 weeks before I started the cycler.  I absolutely hated it.  I felt like the dialysis was running my life and I like to keep some sort of control over my life.  Know what I mean?  I'm currently trying to just keep the cats locked out of my room and training my 5 year old to keep my door closed too.  Problem with her is that when Daddy is on the road (truck driver) she likes to crawl into bed with me (still)  in the middle of the night when she's half asleep and doesn't think about the door.

You drain into a set of four bags?  Hmm,  I know there's the huge drain bag I use when keeping fluid for a test at the clinic...   That's definately something to think about.  I wonder if they would put those on my prescription instead of the drain lines.  So stupid you need a script for this stuff.  All about the cost right.

Thanks for the tips!

Renee

[Adam_W]

Are you on the Baxter or Fresenius cycler? I'm pretty sure the Fresenius uses the drain bags, but I'm not sure if you can get drain bags and eliminate the drain line on the Baxter machine or not. I haven't had any experience with the cycler yet, and it looks like it's going to be a long time before I do get to use it. I'm still on hemo because of a stupid hernia, and my doctor just said it will probably be another four to six weeks before I can even restart CAPD. Sheesh, my peritonitis was minor, but it just wouldn't be normal if something didn't go wrong with me. Hmm, I think I just hijacked my own thread!

Adam