I Hate Dialysis Message Board
Dialysis Discussion => Dialysis: General Discussion => Topic started by: Annig83 on July 25, 2012, 10:40:09 PM
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Okay, so you know the little cusp that holds the catheter in place... it's like directly under the catheter exit site? I already asked my doctor about this, and he didn't seem too concerned, but I'm very uncomfortable still. If I push, lean, or my son crawls over me, I get pain just in that spot where the cusp is... there's no redness, no fever, some oozing...but it like scabs over *I use Gentamicin antibiotic cream everyday* I also have some fibrin in the tubing, but nothing massive...just the normal for me. I've been using Heparin 1-2 weekly to get rid of it. Has anyone else had this issue? I had pain a few weeks after initially getting the catheter in and the cusp was bothering me then... but it's now well over a year...why is this still bothering me? Should I get a second opinion?? Could it be the start of perotinitis? I've never had it... would I already be feeling pain everywhere?
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Annie
It's unlikely to be the start of peritonitis. Peritonitis hits you with a bang!
I never had any discomfort with mine. I use an antibiotic ointment too, but I have been told to only use it for five days in a row each month (or if it starts looking red) so that any bugs are less likely to work up a resistance.
I don't remember any oozing though. Our renal unit works on the theory that if anything can ooze out, infection can get in. Maybe a second opinion would be wise.
Good luck
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It may be just at the edge of your skin, and starting to extrude. I had a partially extruded cuff for over a year, until it finally worked its way all the out ("fully extruded"). While it's partially extruded, it's at a greater risk for exit site infections. Ask your PD nurse and nephrologist how to keep it as clean as possible. I washed it well in the shower, then scrubbed the cuff with hydrogen peroxide (to break up any gunk stuck in it) and Betadine (to keep it sanitary), and I kept the exit site and cuff covered with a dressing and sometimes gentamicin cream.
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I haven't had that exact issue, but I do get occasional redness around my exit site. I would think if you are having oozing from the site, you may have a mild infection. If your Neph and PD team think it's ok, I'd look for a second opinion.
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Don't worry about the crusting as long as it is red or sore, leaking serous fluid or pus. If your doctor can't answer this for you ask ( and there is a strong likelihood that he doesn't know the answer), for a referral to a vascular surgeon ( they are the ones who put in PD caths. For their opinion.
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Anne
It's unlikely to be the start of peritonitis. Peritonitis starts down inside your stomach area, not at the exit site. For the oozing - you do need to have that checked out. It could be the start of an infection. Grumpy
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After a year and a half, I often have small scabs around my exit site and occasionally a little blood but I've never had an infection. The built-up "cusp" of skin around the cath still gets irritated and if scabs form they will "stick" me a bit and that hurts sort of like a needle stick. In my case I exercise hard at least 3 times per week and I think that causes a bit of strain on the cath. In all cases though, even when exercising, I always tuck my cath into a Stickman belt rather than use tape (which causes severe rashes). I also get a bit of reaction if the tubing touches my skin and I get a small welt that itches like crazy so I try to move it around a bit.
Here: I can't imagine not having these... Stickman Belt (http://www.kidneystuff.com/belts.html). :2thumbsup;
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Willis, you ate right. I have described what you see when there is a problem and where there isn't. I am not saying that you shouldn't run it by your nurse, but a little crusting does not mean the start of an infection. If it is oozing, red, puffy sore - be concerned. Otherwise, clean it as you are and you will be fine. I didn't even apply anything to mi e, I just used soap and water when showering and then made sure that I dried it well. I was on PD for a total of nine and a half years and never had an exit site infection but a little crusting was very common so what I am saying comes from a lot of experience of dealing with a PD catheter. Be vigilant, but don't over angst about crusting.
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Thanks guys!! Like I said, no fever, or reddness. I think it's possibly what Restorer has mentioned with the extruding. I see a small section of pink skin (almost looks a bit like a hernia) near the exit site. I've had so many belly surgeries too. Willis mentioned the scabbing too. I guess it's more of the scabbing over than the oozing. I will ask my nurse and see what she thinks. :thx;
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I'm with Willis on the Stickman belt! I use mine all the time.