Questions about PD, self cath and infections

[okarol]

Jenna is getting ready to start dialysis and she needs to decide what kind.
One doctor, her nephrologist, recommends hemo, either in-center or home. He say PD will be a problem for Jenna because she often gets bladder infections due to self-cathing her bladder 4 - 5 times a day. He thinks the peritoneum is so close that she may get infections in her abdominal cavity. She also had bladder augmentation surgery several years ago, and he said she probably has scar tissue.
Another doctor, her urologist, is strongly suggesting PD. He says it will help retain some of her kidney function so she will still urinate, and be easier on her system. He says he can look at her abdomen with a scope to see if there is scar tissue. He says longer dwell time bags can keep her from having infections (not sure if I have got that right.)
We are hesitant to use up another vein by creating a fistula as we want to maximize what she's got (and we are actively searching for a donor, so maybe Jenna will get a transplant sooner, although her antibodies are 100%.)
Anyone on PD who does a cath or other urinary exit have an opinion here?
Is there anything else to consider?
It's all so confusing!
Thank you!

[Joe]

Wish I had some input for you Carol, but I don't self-cath. My personal feeling is that if there is any way she can do PD, I'd go for that modality. It has been good to me for the past year, and I hope it will continue to function for me as long as I need it.

Good luck!

[Lillupie]

Ahh I would say get another opinion from another neph if that is possible. Waht are you going to do if she only has one vein left for hemo?? And something happens to that vein?? Then what? I agree with your urologist. Atleast let him look at the scope to see how much scar tissue there is tor a possibility. (Ask Mishy Kats on facebook about doing PD and the self-catherizating, if i remember right, she did this). If she goes to PD, you can ride that out until that very, very last vein has to be used for hemo. One infection doesnt mean another. The peritonits (sp) is with the PD cathether or PD only related, not UTIs or anything else. I have had a yeast infection since PD and that didnt cause a peritontis. She would just have to be extra careful at home with being sterile.
Another thing to remember if its going to be a long wait for a kidney, and she goes on hemo, something can happen to that vein, and then she might not have a choice but to go on PD. That has happened to some. All their access sites are used up, so they end up having to go to PD and only PD. This I believe happened to that Gloria-Ann Moore.

Best of luck. I know its a hard decision, especially when you are hearing so many opinions.
Lisa

[lainiepop]

Hi Karol. I'm similar to Jenna in that I self Cath and get utis. When the nephs told me i'd need dialysis they Said normally they wouldn't consider offering pd to someone with my anatomy but with my family situation (3yr old son and 8 wk baby girl) they'd give it a go BUT i had to have a fistula created at same time in case the pd didn't have adequate clearance due to the bladder surgery which they Said was quite likely. So i decided to go for hemo as i didn't wanna go through all that to have  a fistula anyway. As it happened  my gfr hung on at 8 to 10 for 9mths til my tx So i didn't have either in the end.

how close is jenna to having this done, is there any way dialysis can be avoided for  a while longer? So Sorry i cant offer advice i rembember feeling in a no win regarding pd or hemo . xx

[okarol]

Thanks for the help. 

[okarol]

I updated here http://ihatedialysis.com/forum/index.php?topic=26504.0