SWITCH FROM PD to HEMO

[Whamo]

I'm switching from PD (after 6 years) back to hemodialysis.  Right now, I have a line near my chest and catheter for my PD.  Has anyone gone through this?  Any advice?












Sp mod Cas

[cassandra]

Hi Whamo, I went from PD to hemo in ‘03. It’s hard as in in-centre versus home. Independent v dependent. Diet change I found very hard, but than someone like CharlieB found it much easier and actually prefers it.




NB if the independence is your ‘big deal’ too, look into home hemo with Nxstage (less invasive in the home)




Good luck, Cas

[kristina]

Hello Whamo,
I only ever had a chest-cath-access and only ever used a dialysis-centre for four years and I had no complaints and no problem at all.
It seems that with a chest-cath to make sure no-water whatsoever is allowed at the site is the most important "thing" to take care of, i.e. no shower above the hips and only careful washing with a washing-towel, which is not even allowed to be wet either  -  and unfortunately not the luxury of a bath whatsoever.
That was my rule during those four years and there was no problem and no infection whatsoever and I feel extremely lucky about it.
I know it can be hard and I wish you the best of luck from Kristina.

[GA_DAWG]

Whamo, I have only ever done hemo in center. A part of that is because I wanted a clear dfintion between dialysis and the rest of my life. I do not want to see a pile of supplies and a machine every time I walk in my bedroom or bathroom. As it is, I do my four hours on the machine, then leave it behind to go live the rest of my life. Hope that makes sense for you.

[Riki]

I switched from PD to Hemo in 2008.  I had had a very bad peritonitis infection, and after having time to heal from the infection, it was discovered that I could no longer do PD.

First thing I did was take steps to rid myself of the chest cath.  I hated it, and I wanted it gone.  I had a fistula placed in November of 2009, and after months of trial and error, the fistula was being used independently from the cath by May of 2010.  I got that cath removed and never looked back.

I wanted to live as normal a life as I could, and I couldn't do that with a chest cath.  I can now shower, swim, travel without worry of infection.

[Charlie B53]

3 1/2 years on PD were great in that I could eat and drink as much and of whatever I wanted.  Total dietary and fluid freedom.  It was wonderful.

The Cons?  TIME.  Manuals my first year.  My phone has multiple alarms going off reminding me it was time to stop whatever I was doing (outside, in the yard or garden).  Get cleaned up and go do an exchange.  Three major interruptions to my day, EVERY Day.

Switching to the Cycler was sort of a relief, no more interruptions to my days..  But I lost my Evenings, setting up and connecting so to get my 10 hour run.  I cheated, Nurses didn't like it, but I'm a Smoker.  During Dwells I would cap off and go out in the garage to smoke, or BBQ on the porch, fix dinner in the kitchen.  But within the hour that machine alarm would go off telling me that I was late to reconnect for the next Cycle Exchange.

I had to have rushed a hahir to quickly during my set up as one night I developed Drain Pain, that kept getting worse.  After too many hours I finally admitted something was seriously WRONG.  Drained a sample to look at and sure enough, I was clouded.  By then I could barelyl breathe because the pain was so great.  Fast forward 3 months, the infection would not die, my PD Cath came out and a Blood Cath went in and I immediately started Hemo.

The sudden dietary and fluid restrictions were the hardest.  It ain't easy limiting myself to a single liter of fluid a day, so I am often over, but not by much. Food limitations are tough, but with the fluid in food plus my liter plus I manage to keep my treatment take-off under 3.  If I get outside and sweat I can even come in UNDER, and Trust me, that is a feat as I keep a water bottle by the faucet at the Barn and have chugged most a bottle 3, even 4 times in a day while outside.  Those are really good days when I can drink big!

The time difference between PD and Hemo is huge and greatly contributes to me remaining on Hemo.  Plus it is only three times each week.  I have one of their earliest seat times which works well, I am an early riser so I get in and get done.  Free the rest of treatments days.  Now If I could just find the energy to stay out of bed after treatmments maybe I could get something done.

[SweetyPie]

I did pd for 6 years starting age 15 then after an infection I had to go to hemo. Personally I like hd better. I got a break to sum it up. I dont have to worry about setting or the clean up. Hd techs do everything. I read some people said the fluid restriction is tough. What you need to pay attention is the diet. Control your salt intake it will go a long way. If you are able make everything at home so you know what is going in your food. My only concern is I know it will take some time for your body to adjust to hemo again. I suffered a little in the beginning but got used to it. Just pay attention to your dry weight. I wish you good luck.

[Simon Dog]

If you do PD ask you MD for a set of emergency antibiotics for peritonitis.   Save a drain bag, call the dialysis RN to get clearance to use the antibiotics, rinse out your gut with a few bags, mix the drugs in the final bag, fill then go to the ER with the cloudy bag for the lab.  That way if you are stuck waiting hours, your treatment has already started before you even get to the hospital.

[Simon Dog]

Shower above the hips and only careful washing with a washing-towel, which is not even allowed to be wet either  -  and unfortunately not the luxury of a bath whatsoever.

https://korshield.com/

[Riki]

If you do PD ask you MD for a set of emergency antibiotics for peritonitis.   Save a drain bag, call the dialysis RN to get clearance to use the antibiotics, rinse out your gut with a few bags, mix the drugs in the final bag, fill then go to the ER with the cloudy bag for the lab.  That way if you are stuck waiting hours, your treatment has already started before you even get to the hospital.

When I was on PD, that was part of the training, and they gave you the meds when you went home.  Because of my vision issues, my mom did that part, but we were still sent home with a couple of doses, just in case something happened.  I'm not sure why, probably insurance related, but the home dialysis nurses are not allowed to give the first dose of antibiotic if peritonitis is suspected.  You have to do that yourself, and the nurses can give any subsequent doses.