Line

[jpearce]

I have had a problem with my line since June. The last hour of dialysis sends the machine into a beeping frenzy and ends up adding time. The nurses haven't been able to pull anything from the arterial side since June, the venous side works ok, but while I'm reversed I can feel it pulling and tugging. Even when I'm not hooked up I can feel it pull. The catheter is the same temporary one they put in when all this started 2 years ago. Now I'm trying to figure out if this line is the cause to my fluid gain. Since June I've gone up 7 litres. They put in for 4000mls and I come of 2900mls. They tell me it's b/c their flushing the line. I'm getting frustrated cause I'm telling them it's the line, and their telling me no you've gained body weight. I know what I eat! I know the fluid I drink! Why do they feel they can tell us how we feel? Why won't they listen!!!!!!

[monrein]

jpearce, why do you not have a fistula? 

[jpearce]

I have had a fistula done in my upper arm, a graph and a fistula in my lower arm.None of them took. They did a biopsy of the artery and they was no blood flow in the major artery. They don't want to use the other arm because it might be the same.No one has approached me for any more surgery aside from what will be needed for PD but noone is arranging anything right now, must be the summer holidays.

[monrein]

Right, now I remember you said that.  What a drag.  Can you call your nephrologist and insist they have a look at it and possibly change it?  My first line was exchanged one week later for a second one since the first one was too long!!!  It was curling in the bottom of the atrium and sucking up against the wall.
I'd also have a chat with the charge nurse about feeling that you're not feeling listened to let alone heard.  You should be the person at the center of your team and your concerns ought to quickly become theirs and yours to solve together.
Insist that you are worried about the quality of the dialysis you're receiving with an improperly functioning line.


I've never heard of using 1100mls  to flush a line.  Usually rinseback is added to what needs to come off.

[jpearce]

I go in on Monday, and I'm going to right all the questions down, I get so frustrated when I talk to this one specific Dr., when I requested not to be seen by her. She seems to be the only one on right now.    as the saying goes a squeaky wheel gets the grease.

[aharris2]

This is what they do for us. They ask what my brother weighs. Then they ask what he wants to come off at. They do that math and then add on 0.5 kg for rinseback. Example 97 kg going down to 95 kg = 2 kg, plus 0.5 kg allowed for rinseback = 2.5 kg being removed. We expect to walk out of the clinic weighing 95 kg. If we walked out 1.1 kg heavier, I would be irate and expecting and explanation and corrective action.

If Rolando feels that he is overly "wet" when leaving dialysis, the next time he will challenge himself and ask to go down 0.5 kg lower (94.5 kg)  and slowly but surely continue to do so over a couple of weeks until he feels good and remains good until the next session.

If you have gained body weight and they try to remove 4000ml (4kg) and it is too much YOU will know. You will cramp and your blood pressure will crash and you will feel bad during the treatment. If nothing bad happens during treatment, they should be taking off what you have asked to have removed.

Good luck. You are a competent adult and they MUST listen to a competent adult.

[jpearce]

thank you for your info

[RightSide]

The obvious thing to try is CathFlow, to try to open up any blockages in the catheter.

A CathFlow treatment takes about a half hour.

[Rerun]

Insist on "challenging your dry weight".  If you have that much fluid over load on you it will turn into congestive heart failure.

When your BP drops and you cramp then you will have hit your dry weight.  Not fun but needed.

[jpearce]

I had a wonderful nurse with me yesterday, she agrees that something is not right with the line. She made the Dr. stop by, and stood by me and when the Dr. started on about me creat level, she went right at her. Said my creat always been like that and thet something is definitley wrong with the line.(They've been catflowing it every time for 2 months.) So the Dr. sent me for a X-ray, Hopefully I'll know what's going on tomorrow.