Bicarb settings on Hemo Machines

[Hazmat35]

Hello!  Been here for a few years now!  I do In-Center Hemo 3X per week like most.  Ever since I started "D", a few years ago, everything has been fine, as least as fine as it can be while on "D". 

Anyway....3-4 weeks ago, I was moved from one POD in the center to another.  I've had the same 2 or 3 Techs over the past few years, but they moved me to a new Tech that just finished training.  I wasn't to happy w/ it, but I figured what the HECK, give her a chance. 

But, ever since she's been doing the canulating and machine prep, my KT/V has dropped from 1.68 to 1.23.  The Nurses automatilly want me to go for a Fistula-gram, whcih I just had one month ago; they want to add 15 - 30 minutes of additional time to me. 

I had the "normal" Tech that usually does my canualation come look at the set up and see if maybe the newbie is doing something wrong.  Well, first thing she noticed was that the BICARB setting that the doctor ordered was wrong.  It was set @ 35 and should have been 40. 

After she changed it, my KT/V for the day shot up to 1.48; next treatment, same thing, she checked it and again, the Tech didn't set the machine the same way....Bicarb was off from the doctors orders...

I'm not a rocket scientest, so can someone please help me with this....does THAT Paticular setting make that much of a difference?  Apparently it does, but should I push the issue, and get this Tech checked out again on her training. 

[MaryJoe]

If the new tech is not setting the machine as your doctor ordered you should definitely ask that she get some remedial training.  It's affecting the results of your dialysis, and ultimately your health.

[Simon Dog]

What size filter are you using?  An increase in filter size can boost the Kt/V, but is not always eagerly offered since the filter price increases with size.