Back on PD, new provider, new clinic, same old tricks.

After 3 successful years on pd, my son started noticing some neurological issues. In a two month period there were 3 ER trips, but the monthly clinic meetings were business as usual. My son knows better than to trust my provider, who rhymes with Biaser Bermanente, and took one of the staffs Monthly PD Interdisciplinary Plan Evaluation packets. He said that all 4 staff members indicate that I am meeting my goals. A couple of weeks after this, my 3rd ER visit puts me in the hospital for what they say is elevated troponin levels. Once again my son asks for the labs and can sse my creatinine has jumped from 7 to almost 11 in 2 months. They want to release me 3 days later, but my son won't tke me until they vouch that the kidney numbers are improving. They say yes. I go home. A week later we get a call from my PD Nurse telling me to start day exchanges. On our last monthly meeting, The nepherologist says I am no longer responding to treatment and that my son should prepare him self (for the end). He calls my primary to see why no Hemo is being offered. The primary calls back and says the nephrologist said that I wouldn't have an adaquit access point due to my small artery diameters. My son asks is this conclusion derived from tests or just professional opinion. The primary calls the nephrologist back, then calls us and says it's opinion. My son request and ultrasound, which revealed 1 artery in my left upper arm. So I get a temp cath in chest (replaced 3 times for clots) and start at Davita Hemo. on the last cath replacement they finally put in the graft and took out my pd cath which had been dry and unflushed for 2 months. A couple of weeks later they start using the graft. It clots 4 times in the 1st month, the 2nd unclotting procedure, I got C-MRSA.

Right at the End off 2011, I'm in hospital for 4 clot. They say they fixed it but put a temp cath back in so I can make it through the Holidays. My son gets suspicious and gets a current EHR and discovers a diagnosis from the date they placed the graft stating 'Mechanical Dysfunction of Peritoneal Dialysis Catheter. So I had been on Hemo for 6 months for no reason and they didn't have the guts to tell me.

We went to a new provider after that. After 6 more months on Hemo, we got back on in Home PD with a Davita unit. It's a nice place but the skill level is not comforting. After a couple of months I start having pains during drain and tell the Davita nurse several times, assuming she'd tell the nephrologist, a month later I start getting pains during fills (which were reported to the davita nurse again) and my son starts to see the same mental ussues creeping back. At our last meeting with the Nephrologist, we mention the pains. He schedules a lapascropy to peek and fix if possible. Soonest slot was this Christmas Eve.

Procedure was finished around noon and went home by 2. We were told to skip dialysis that night. I got up to use the bathroom around 11 pm and apparently lost conscousness and the floor and a few other things before I got there. My son had got up to check on me but just missed me. He thought maybe I needed some clearance and it was a balance issue. So he had a bag already warm. Hooked it up and filled about 200-300 ml and decided to reverse the flow to clear and fibrin. It immediatlely turned thick dark red and didn't stop. Rushed to ER and I started throwing up blood. 3 days later, still in ICU, I have a troponin level of 20. needed 2 units blood. having tachycardia issues and no clue as to where the blood came from. On top of that, PD fluid cultures come back with gram negative rods, eventually turning out to be Serratia Liquefaciens. While I'm out my son is cleaning my room. He lifts the cycler and sees a couple of piles of grreen powder and some moisture spots. He looks underneath the cycler and sees discoloration and a few drops of liquid around the battery door and 4 corroded screws. We've been using this machine for almost 5 months. He called Baxter and looked it up. He comes back saying this is the clinics old machine.

We just assumed, like with our previous provider, that we'd receive a new or at least refurbished unit. Not so. The Davita clinic took our machine and gave us the one the used to train and treat all there new patients.

My only question out of this, is this normal or acceptable procedure?

ShirleyP