Officially one year with my hemo catheter

[kristina]

Hello MooseMom,
I better not think about what could or would happen if my cath became wet (and hopefully I never shall find out) but I have heard that an infection etc. could possibly happen and since dialysis in itself is already a life-support, an infection at the cath-site could become life-dangerous, especially since an ESRF-dialysis-body can become a bit weakened over time. But a bit of regular exercise etc. can help a lot to keep the body as fit as is possible for as long as is possible ...
Fortunately my cath-site has never been uncomfortable during the day or night and I can fall asleep in the same way as I have done before dialysis.
What helps me a lot, is, that I always fasten my cath with a medical tape and that keeps the cath securely in its place and when I go for my next dialysis-session the medical tape is carefully taken off and after dialysis the cath is securely fastened with the medical tape again.
To be quite honest, I am very grateful that my cath has given me no problems so far and hopefully it continues like that ...
Best wishes from Kristina.

[lulu836]

What helps me a lot, is, that I always fasten my cath with a medical tape and that keeps the cath securely in its place and when I go for my next dialysis-session the medical tape is carefully taken off and after dialysis the cath is securely fastened with the medical tape again.

You dress your site yourself?  What is "medical tape"?

[Xplantdad]

Thank you Kristina. Holly is doing very well now.

Thank you Xplantdad for the update. I am very pleased to read that Holly is doing very well.
Thanks again and all the best and good-luck-wishes from Kristina.

thank you for asking

[MooseMom]

Thanks for the reply, Kristina!  Very interesting!

[kristina]

Thanks for the reply, Kristina!  Very interesting!

Hello MooseMom,
I do believe that the medical "implementation" and medical "maintenance" etc. of a chest-cath has improved a lot over the years...
Best wishes from Kristina.

[kristina]

Thank you Kristina. Holly is doing very well now.

Thank you Xplantdad for the update. I am very pleased to read that Holly is doing very well.
Thanks again and all the best and good-luck-wishes from Kristina.

thank you for asking

Hello Xplantdad,
Holly has been going through quite a lot and she has always kept up her good spirits and I have been keeping my fingers crossed for her and do hope she is continuing to do well.
Best good-luck-wishes from Kristina.

[kristina]

What helps me a lot, is, that I always fasten my cath with a medical tape and that keeps the cath securely in its place and when I go for my next dialysis-session the medical tape is carefully taken off and after dialysis the cath is securely fastened with the medical tape again.

You dress your site yourself?  What is "medical tape"?

Hello Lulu,
Only nurses dress my cath-site very carefully at both "ends" whilst wearing medical gloves. These medical gloves are completely disinfectant and only worn once and then thrown away ... and the medical tape I have mentioned is non-allergic and well tolerated when it is being used to "tape" the dressed cath-ends (access to dialysis) to the skin, in order to keep it well in place.
Best wishes form Kristina.

[Simon Dog]

The medical gloves are "clean", not "sterile".   Sterile gloves come in sealed individual packs, and there is an extensive ritual to putting them on without contamination.

As to medical tape - several types - paper, paper w/extra sticky adhesive, silk.    The later rips off the top layer of my skin, so I use paper extra sticky (3M Micropore Plus)

[GA_DAWG]

I was told the reason an infection at the catheter sire is dangerous is because the catheter itself leads straight into the heart.

[kristina]

The medical gloves are "clean", not "sterile".   Sterile gloves come in sealed individual packs, and there is an extensive ritual to putting them on without contamination.

As to medical tape - several types - paper, paper w/extra sticky adhesive, silk.    The later rips off the top layer of my skin, so I use paper extra sticky (3M Micropore Plus)

Hello Simon,
the medical gloves all the nurses use at "my" dialysis center are sterile and come in sealed individual packs and you are quite right there is an extensive ritual to putting them on without contamination and all the nurses always disinfect their hands completely and carefully before they proceed to open the individual pack and put the sterile gloves on. It always takes time and I am grateful that the nurses take such great care. If for example the dialysis-machine makes "a noise" and needs to be adjusted, the nurse adjusts the machine slowly and carefully with her/his elbow (which is quite an art in itself !)  ... Let's hope it continues to be so very successful as it has been in the past ...
Best wishes from Kristina.

[kristina]

I was told the reason an infection at the catheter sire is dangerous is because the catheter itself leads straight into the heart.

Hello GA_DAWG, it is quite true that an infection anywhere connected with the catheter is dangerous because the catheter itself leads straight to the heart. Of course it depends on the patient, how they deal with the situation. As for myself, I am much too interested in life to take any risks with my catheter and I am also determined to enjoy as many years in the future as is possible.
All the best from Kristina.

[Simon Dog]

Hello Simon,
the medical gloves all the nurses use at "my" dialysis center are sterile and come in sealed individual packs and you are quite right there is an extensive ritual to putting them on without contamination and all the nurses always disinfect their hands completely and carefully before they proceed to open the individual pack and put the sterile gloves on

I am impressed.

I have been to about a dozen clinics for hemo (I use NxStage at home, but do not haul it on trips), mostly Fresenius but a few DaVita oin various parts of the US, both as a catheter and fistula patient.

I have never seen any clinic use anything other than the bulk packed clean but not sterile gloves.

What center do you use, and what company runs it?   It is interesting to see one exercising this extra level of care.

[lulu836]

I have never seen any clinic use anything other than the bulk packed clean but not sterile gloves.

Same here.  Sounds more like a tape and gauze cover than Tegaderm. 

[GA_DAWG]

Our clinic uses the same gloves you can buy at Sam's. As often as they change them, they would spend all day going through a ritual with sterile gloves. They do use lots of hand disinfectant though. Of late, they have been using the regular paper tape, then for the last layer, a sterile band-aid. Still haven't figured out the band-aid, unless someone owns stock in the company.

[kristina]

Hello Simon,
the medical gloves all the nurses use at "my" dialysis center are sterile and come in sealed individual packs and you are quite right there is an extensive ritual to putting them on without contamination and all the nurses always disinfect their hands completely and carefully before they proceed to open the individual pack and put the sterile gloves on

I am impressed.

I have been to about a dozen clinics for hemo (I use NxStage at home, but do not haul it on trips), mostly Fresenius but a few DaVita oin various parts of the US, both as a catheter and fistula patient.

I have never seen any clinic use anything other than the bulk packed clean but not sterile gloves.

What center do you use, and what company runs it?   It is interesting to see one exercising this extra level of care.

Hello Simon,
Whilst I am posting my experiences and thoughts here on IHD, I have to say that I don’t report on all the catastrophies that I come across at my dialysis center and what I hear second hand – like for example when patients pull their chest-catheter-lines out and injure themselves falling due to low blood pressure. All patients are different and whilst I struggle to try and do my best I am only too aware of the very serious problems which can arise, no matter how hard one tries. There is no perfect center for dialysis, there is no perfect way of having dialysis, it is down to experience and a huge amount of luck and one has to be diligent at all times and this is difficult when one feels very much under the weather. It is a question of: it is easily said but difficult to do.
Best wishes from Kristina.

[SweetyPie]

My center doesn't use sterlie gloves is that something I should be concerned about?  I have been on hemo for 1 year no infection thanks to God. I know all aboit sterile gloves and how they have to put it on. That would take forever of they always had to use it though

[Simon Dog]

Kristina - who runs the clinic that used genuine sterile glove?   I'm wondering because I have never seen that at Fresenius or DaVita.

[cassandra]

NHS runs clinics and wards and only use sterile gloves on catheters and lines

[Simon Dog]

NHS runs clinics and wards and only use sterile gloves on catheters and lines

Are you talking about the real, individually packed sterile gloves that must be laid out on a sterile field and applied using the sterile glove ritual?

[lulu836]

NHS runs clinics and wards and only use sterile gloves on catheters and lines

Are you talking about the real, individually packed sterile gloves that must be laid out on a sterile field and applied using the sterile glove ritual?

There's a ritual?  That's so funny.  My clinic uses the boxed, clean gloves also.

[cassandra]

NHS runs clinics and wards and only use sterile gloves on catheters and lines

Are you talking about the real, individually packed sterile gloves that must be laid out on a sterile field and applied using the sterile glove ritual?

Yes, per pair (left/right) wrapped, but I only saw them use those withe catheters/lines, not fistulas.

[Simon Dog]

There's a ritual?  That's so funny.  My clinic uses the boxed, sterile gloves also.

As a matter of fact, there is.

The packaged is opened in a matter that the package itself is used as a sterile field.   The gloves come folded (not bunched up like the gloves in bulk boxes), and there is a very particular procedure used to put on the gloves without touching any of the outside surfaces of the gloves.   Gregorian chanting is optional.   A video of the ritual is posted at https://www.youtube.com/watch?v=jqi6HD645oU.    If this procedure is properly followed, the outside surfaces of the gloves have not been touched by anything other than a sterile glove surface during the process.   Anyone not using this method is probably not following proper sterile procedure.

The gloves (often blue nitrile) that are bulk packed in boxes of 100 and dispensed like tissues and not individually wrapped are clean, but not sterile.  My clinic uses these for everything - catheters, fistula, touching the dialysis machine, etc.   I was asking because people often mistake those for "sterile" gloves.

[Paul]

In Britain the rule tends to be: Use the wrapped, sterile gloves when touching wounds, catheter's, kneedling, etc to prevent your germs infecting the patient. All other time use the boxed (non sterile) gloves to touch patients to stop them infecting you!

[Simon Dog]

In Britain the rule tends to be: Use the wrapped, sterile gloves when touching wounds, catheter's, kneedling, etc to prevent your germs infecting the patient. All other time use the boxed (non sterile) gloves to touch patients to stop them infecting you!

That's on up on the US clinics.    I've been to a lot of them, and never seen true sterile gloves.

[GA_DAWG]

MooseMom, I know that while I had a catheter, they made it very clear I was not to sleep on my stomach, and of course went into great detail over the need to keep it dry and how if it became infected, the infection has a direct path to your heart. They first attempted a fistula with me, but it did not take, so they went to a graft. One thing I can say, from my experience, is it is much less draining than with a catheter. I was told that would be the case before the graft was done, and was pleasantly surprised at the truth in it. Another thing that really bothered me was the fact that where the catheter was placed, I could not drive because the seat belt harness came directly over the catheter.