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  • Drainage Problems with PD access

    Hi,

    I've been hanging around reading the many posts for about a year now but it's time for me to tap into the experience of others now. My husband was diagnosed with stage 4 kidney disease in May of 2011 and shortly after contacted a staph infection that hospitalized him from Oct. until mid Jan. 2012. Very long story and I'll skip that for now but suffice it to say that after losing 70 lbs. and being bedfast for months that he has fought hard to get away from in center hemo (hates, hates it!!) and start peritoneal.

    Had the access places about a month ago and the first flush a week later seemed to go fine. The second flush the next week left about 500 units of fluid and so we were sent for an xray. PD doctor was not happy with location and sent Terry to a interventional radiologist to attempt to flip the cath into a better position. Still didn't drain properly. Had another surgery 2 weeks ago to reposition the same cath laproscopically. Seems that has only made things worse. 1600 units in, 550 units out. Sent for another xray and PD would tell us nothing other than they have made an appt. with same surgeon for this morning. When he repositioned the cath he told me that if that didn't work that hubby would just be one of those people who could not do PD and the cath would be removed. I have heard of others with this same problem who had the cath removed and another one inserted with success. Does anyone have experience with this problem or now of someone who has?

  • #2
    Yes.

    After I was on PD for about a year I got a dreaded infection in my stomach and the catherter. It was indeed painful when it did not drain. My doctors, which were my kidney doctor (nephrologist) and the vascular surgeon that put my catherter in, immediately decided that the infection warranted that it must be removed immediately.

    To my dismay they had to put me on hemodialysis until my catherter sight, my stomach, had time to heal properly. I just plain hated it on hemodialysis!!! But it was a LONG wait. I ended up on hemo for over three months! When my stomach was healed enough the vascular surgeon put in a new catherter! But the new one was put on the OPPOSITE side of my stomach to avoid the infected side. I still had to wait a few more weeks before I could go back to my good old PD (periodontal) treatments.

    It has been about a year and a half since that happened and I am extra careful changing my transfer sets from now on!!!

    Brian

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    • #3
      I began dialysis on Sept. 22, 2012 in the hospital. After a 5 day stay and 3 dialysis treatments, I began clinic dialysis using a temp. cath the day after being released from the hospital. I had my PD cath put in on Oct. 29, 2012. First flush was tried on Nov. 7th at the dialysis clinic and it wouldn't drain. They made an appt. with the surgeron who put the cath in for the following week to see if his staff could get it to drain. They couldn't get it to work either. Had surgery on Nov. 27th to reposition and clean the cath. The dialysis clinic nurse tried again on Dec. 3rd to flush and this time the fluid wouldn't even go in. Back to the surgeon again the following week and he said maybe I'm just one of those patients who can't do PD and his only suggestion was to put in a fistula for hemo dialysis and did a sonograham of my arms and suggested we talk to his nurse to set up an appt. for this surgery. We did not make an appt. for more surgery. I talked to the manager of the clinic the next day and told her of my disappointment of going through surgery twice with no results. She was quite surprised by the suggestion of the surgeon as she had sent us back to him for fixing the PD cath not to discuss hemo. I now have an appt. tomorrow with another surgeon to see if he can help get the PD cath working. Hoping for the best. Wish me luck as I really want to try the PD dialysis at home. Has anyone had similar problems getting started with home PD?

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      • #4
        Originally posted by NCPat View Post
        Hi,

        I've been hanging around reading the many posts for about a year now but it's time for me to tap into the experience of others now. My husband was diagnosed with stage 4 kidney disease in May of 2011 and shortly after contacted a staph infection that hospitalized him from Oct. until mid Jan. 2012. Very long story and I'll skip that for now but suffice it to say that after losing 70 lbs. and being bedfast for months that he has fought hard to get away from in center hemo (hates, hates it!!) and start peritoneal.

        Had the access places about a month ago and the first flush a week later seemed to go fine. The second flush the next week left about 500 units of fluid and so we were sent for an xray. PD doctor was not happy with location and sent Terry to a interventional radiologist to attempt to flip the cath into a better position. Still didn't drain properly. Had another surgery 2 weeks ago to reposition the same cath laproscopically. Seems that has only made things worse. 1600 units in, 550 units out. Sent for another xray and PD would tell us nothing other than they have made an appt. with same surgeon for this morning. When he repositioned the cath he told me that if that didn't work that hubby would just be one of those people who could not do PD and the cath would be removed. I have heard of others with this same problem who had the cath removed and another one inserted with success. Does anyone have experience with this problem or now of someone who has?
        NCPat,

        Have you thought about getting a second opinion ?
        ______________________________
        PD - 13 Years
        3 Transplants
        In-Center Hemo - 6 Months
        NxStage - Since April - 06
        Facebook: Dialysis Discussion Uncensored

        ________________________________

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        • #5
          Just a quick update from my last post. Ok. We had the cath inserted, attempted flip by radiologist, repositioning by same surgeon (who actually did not reposition) and then after fighting with the center and having to call hubby's origingal neph we were given another appt. with another surgeon but it was in the same practice which I wanted to avoid since I feared that he would not want to "show up" another surgeon in his practice. Sooo....new doc. removes original cath and inserts a new one on the same side but a little higher. The tubing could be felt under the skin and it twisted back and forth like the line at McDonald's. No surprise that this one didn't drain either. Actually it did drain 1 day and it was like someone had broken a dam. The PD nurse said that in 20 years she had never heard the gushing sound come from anyone else.

          Well, had to have 2nd cath removed and we are now at home after a month of training doing NxStage hemo. It is not something I would recommend unless you are willing to take on a 5 hour a day job. They will tell you 3-4 but they don't count the labs and inventory and restocking and cleaning and loading the machine and waiting 15 minutes for it to prine and on and on. If you don't want to be a nurse and don't want to devote your day to hemo then steer clear.

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