One of my lines isnt working

[SweetyPie]

So you know in a cvc line there are two lines that come from it. One is red and one is blue. For about 2 weeks one of the lines hasnt been pulling any blood so they have been reversing the line. Let me remind you all, I got this new line in August just last month. The nurse gave me an order to go to the vascular center. I dont have time to go being in school an all and also dont think its an emergency being the fact that I am still receiving dialysis.

[Michael Murphy]

It becomes a emergency if your clearance numbers are low.  In US minimum clearance is 1.2 and Fresinius aims for 1.4 or higher.
Check with your lab results if you are below 1.4 not good if you are below 1.2 bad.

[lulu836]

I had that same problem on my first catheter.  I was not taking a blood thinner at the time.  That one was replaced about 2 years ago.  Then I  had a couple of strokes.  Plavix was prescribed.  I have always run reversed - That's not a big deal.  Sometimes one of the lines will suck up to the vessel and cause it not to run straight which is why it does not aspirate nor does it function as it normally should.  There is an immediate solution that works most of the time.  In my clinic it is called a "cath-wash".  tPA "major clot buster" AKA Tissue Plasminogen Activator.  It is put in the two lines which are clamped off so that it does not enter your bloodstream.  The wash lasts for about 40 to 45 minutes.  When time is up the two lines that held the tPA are thoroughly washed .  After that your treatment will begin. 

There are two types of problems that interfere with blood flow through the cath.  One is positional and the other is clotting.  Positional normally means that one side or the other has attached itself to the wall of the vessel.  I have spells of ventricular tachycardia which I can stop by doing a "I am Sparta" thump a couple of times on my chest, take a deep cough and it's over.   The cath-wash plus Plavix have, so far, been successful.

[Charlie B53]

I had a cath my first year on Hemo waiting, working on my fistula before it decided to play.

Twice, months apart, the clinic had to fill my lines after treatment with something other than the normal heparin they usually use.  Sorry that I do not remember the name of the med, but it was sort of an industrial strength heparin, almost a clod dissolving agent.

Worked for me as my cath flowed fine for months again.

Reversing lines is very common as a first step whenever the flow numbers reduce.

I really recommend you make it in to see that Dr.  Perhaps talk with one or more of your instructors to see if they will make some allowance for you to miss those couple of class necessary to get needed medical attention.

I bet they will.

[SweetyPie]

I appreciate the advice but I dont see the emergency in going. They have reversed the lines many times and it works just as good. I dont have pain besides the fact that my suture ripped out but other than that tip top.

[Paul]

I had a similar problem to the one you describe. The hospital did nothing. Eventually it became impossible to dialyse me without my blood pressure dropping, the machine alarming several times a minute, and me eventually loosing consciousness.

They had to put an emergency line in my groin, which hurt. It also meant that for the next few dialysis sessions (until they fixed the main line) I was dialysing with my pants round my knees. Humiliating.

In other words: I would advise you to visit the vascular centre BEFORE it becomes an emergency, it will be a lot worse if you wait. Plus, if you end up needing hospital treatment, you will loose even more school!

[SweetyPie]

Oh my goodness that sounds awful!! Ill see when I can go. Gosh, just more stress on me what else is new.

[GA_DAWG]

It is almost ALWAYS beneficial to attend to a problem before it becomes an emergency. Not only does it tend to be an easier fix, emrgencies tend to take far more of your time than the fix would have.

[SweetyPie]

Today didnt go that well. I came in very fluid overloaded like 2.7 kilo over. The beginning of dislysis i couldnt take it. Very short of breath, my fingers I could see turned pale and dizzy. Why? I was so overloaded with fluid and the thing is the nurse only tried to remove 2.1. I couldnt even do that I only removed 1.3. I think what paul was talking about might be happening to me. I know i gotta get checked out. Theres absolutely no blood return in one of the lines. I am home my arms and legs dont have strength.
I reallly have to watch my drinking. Basically i can probably drink a glass or two this whole weekend. Has anyone ever had this happen? Do you thibk perphaps something was done incorrectly which is why I couldnt take off much today and almost passed out?

[GA_DAWG]

You may have to run consecutive days or a longer time in order to get it off. I have seen this happen to one lady in particular who comes in barely able to breathe, but then says she cramps before they can get the fluid off. She usually winds up in the hospital where they run her consecutive days until they get the excess off. Of course, she learns nothing and then starts the entire process over.

[lulu836]

You absolutely must learn to control how much you eat and  drink. Anything that becomes a liquid at room temperature must be counted as fluid content.  Gravy, jello, ice cream.  If you eat salads you need to know that lettuce is 90% water.  Canned drinks are usually 16 oz of fluid.  A coffee cup is 9 0z, a mug is 12.  Do you see where I'm going with this?  The nurses' assignment is to get you to the dry weight your doctor ordered.

[SweetyPie]

Trust me I am very strict with my fluid. If im not I suffer because my legs are heavy and i cant breathe properly im fairly small so a little overload affects me. I usually come to dialysis with 1.5 over. During my treatments my blood pressure drops to 70s despite me feeling good so the techs turn off the fluid. I hate when they do that, if im feeling fine why turn it off? And at the end they add lots if saline again when i feel fine. This makes my weight go up its like i drank a qhole bottle of water when i leave there because they pump me with all thst fluid. My dry weight is 42kg and i left at 43.3kg.

[lulu836]

Ok dear, I'm out.  You said in a previous post that you arrived at dialysis at 2.7.  This post seems to place the blame for the overage on your nurses.  So........I wish you all the best but, well, I'm out of this conversation too.

[SweetyPie]

No sure you read my post clearly, i said during dialysis the nurses stop the pulling of fluid due to my blood pressure and at the end add even more saline. This adds to my weight. Im doing my job and really watching my fluid intake its their job to not stop the fluid pulling if im not symptomatic. When they stop the pulling it leaves me higher than my dry weight obviously.

[Michael Murphy]

 Are they giving you saline to flush the lines, that’s about .5 liters or a half a kilo of fluid.  That flush back is done to every one.  If your BP is low they give you more saline.   If you are 2 kilos above dry weight they should remove 2.5 kilos to reach dry weight.  Two plus a half to equal two over plus a half to account for flushing the lines.

[SweetyPie]

I know about the .5 after dialysis. They give me more, because while doing that they are checking my blood pressure and majority of the time I am signing an ama to leave the clinic. I feel sometimes its a waste of dialysis when I leave still overloaded.  At the same time although overloaded I dont think its right to deprive my body of water. It cant be healthy.

[Paul]

I think what paul was talking about might be happening to me.

Yes, sorry, that does sound like the early stage of what I went through. The only advice I can give is get those lines sorted out ASAP.

[Paul]

I feel sometimes its a waste of dialysis when I leave still overloaded.

I used to think that, especially when it got to the point where they were dialising me but taking off no liquid whatsoever. However the nurses pointed out that even without liquid removal, toxins are removed. Without it your urea, potassium, and phosphorus would build up and kill you.

[SweetyPie]

Im gonna email my teacher for an extension on my assingments, so i can make an appointment.

[SweetyPie]

I made an appointment for tomorrow. You guys can pretty much guess how treatment went today. I couldnt take off anyhting it was terrible. Despite them stopping the pulling of fluid I continued to feel worse. I vomitted and almost fainted. I asked to get off early. I am upset, sad full of emotions. I have a hole in my right side from my previous catheter. Can they go there again? I dont know if i can get it in my groin i just can't

[Paul]

I dont know if i can get it in my groin i just can't

The groin is only done if it is an emergency, or cannot be done elsewhere. Only a very small chance they will have to go in the groin, several other locations are possible.

[SweetyPie]

You have given me some hope Paul. Keep me in your prayers. I need them

[Paul]

Having reread my first post in this thread I realise I was not clear on one thing: The catheter in my groin was only a temporary thing. I am now back to using a catheter in my shoulder to chest.

[SweetyPie]

Thats what I have one in my shoulder/collarbone/chest. I had an infection august. This catheter was on the right side. They took it out and placed one on my left. I only know these three places they can go. Shoulders or groin.

[GA_DAWG]

In one post, you say you are usually signing an AMA, and in a later one you mention again signing out early. That is absolutely the worst thing you can do, especially if it is on a regular basis. As Paul noted, even if they are not pulling fluid, they are filtering your blood for potassium, Phosporus, and urea.