Today was my second visit to the dialysis clinic for a dressing change which basically followed the exact procedure listed above with just a few additional tweaks, and this week the PD nurse did a "flush" of my PD catheter.
In addition to all the sanitary procedure steps outlined in week two, the PD nurse was going to use an iv bag type pole to hold the PD solution for the flush, so she used a cleaning solution (KidneyCoach said the name is Alcavis) to wash down the entire bag stand except for the bottom where the wheels attach. This cleaning liquid isn't as powerful as the ExCept that was used to clean my skin. The cleaning with Alcavis included the little adaptor that was about 2/3rds down the pole where the tube from the dialysis bag connects to the tube leading into my stomach and out to the drain bag. Think of it as a three way valve type thing with inlet for the PD solution, outlet to my tummy, and outlet to the drain bag. A valve that she turns directs the flow. So all of that had to be cleaned before use.
In addition to containing the valve to directly the fluid flow, the connection device has "ports" where each tube connects. The nurse took new "tips" out of sealed packages and inserted (using gauze moistened with the same sterilizing liquid (ExCept) that she used on my stomach around the tube before replacing the dressing to hold it with ad cover the end with until it was time to hook my catheter tube to it. She first connected the 2 liter bag of solution and hung it on the pole. Then connected the tube from the bag to one of those sterile connectors with the valve in the "off" position. Then she hooked up the drain bag to another connector, then last she quickly took off the sterile gause from the port where my catheter connects, and connected my catheter to that new sterile "tip" that was already in the valve port. Then she proceeded to turn the valve, allowing 500ml of solution to enter my peritoneal cavity. The fluid had been pre-warmed. I was very much surprised that I didn't feel a thing until it was almost all in and then just felt a little "fullness" for lack of a better term. I had been very afraid that having that warm fluid go in would cause me to pee myself or something from the pressure, but alas, my fears were unfounded in this event.
The fluid had only been in for a few minutes when she began to drain it. It is very difficult to describe the sensation that gave. Like a "fluttering"? It wasn't what I would call painful. I've had gas pains that have been a LOT worse than that experience. And she was very talkative through the entire process which actually helped me keep my mind off the draining. So after just a few minutes, she said, Ok, we're going to do that again with another 500 ml. I said, you mean that was it? I was surprised that it was over already. Was it a tiny bit uncomfortable during the drain. Yes, but just a little and it was a breeze compared to having that Foley catheter put in in the ER after my surgery! Oh my gosh. I would compare it more to light gas discomfort and only lasted for a minute or so. So then she proceeded to fill me again with another 500ml, and drain, and then fill me with a third 500 ml and drain. And that was the end of that!
Once the final drain was done, she removed my catheter connector from the port in the valve, wrapped it around into about a 4 inch circle over my incision and taped it to me. And that was the end of that. She said that I would "officially" become a dialysis patient next week once I start training, that these first two weeks were done "gratis" by the dialysis center, before I actually became a patient. So next week I need to come prepared to fill out a TON of paperwork!
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RonZone
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Yeah, to be honest, it was WAY better than I thought it would be. Now let's see what the full blown training event feels like next week. I'll report after that and you might hear me whining and complaining'!
Ron I can't thank you enough for these accounts and the detail you provide. It' gives me a ton of questions to ask my neph before starting any of this.
Was probably "ExCept" or Alcavis(sp). Glad it went so well. I absolutely loved PD. I wish I had been allowed to start my dialysis career with PD. Sadly it didn't last for me. I hope your PD journey is a smooth uneventful one. Blessings
Ahhh, you have a much better memory than I do. Alcavis is what she used to clean the iv pole, and ExCept is what she used to put on the gauze she used to clean my tummy around the catheter, and the first few inches of the catheter. Thanks for remembering that!
The hard parts over...now just a bunch of learning techniques...She gave you 500 ml...but your regular dialysis fill will most likely be more...but it will feel the same , just fuller...Sound like she is taking excellent care of you
If you have not done so already, my dialysis place had me take some tests to make sure I learned everything there is to know about PD Dialysis and its uses. So you might be taking some quizzes (a lot actually). But maybe that is just my clinic (DaVita).
Hope not. But the older I get, the harder it is to remember stuff. I'll definitely have to go over this multiple times till I get all the steps carved into long term memory. I learn better by doing than watching, so hopefully they will make my training a hands on experience after the first day, but under their watchful eye so i don't mess up something too bad like scratching my nose after cleaning my hands. Some of those kinds of things I had trouble with during the pandemic when folks said not to touch your face while you are in a store or whatever. Some of those actions are sorta on automatic pilot. I'll have to train myself to watch myself to keep me from touching stuff I ain't supposed to. Cause my normal mode of operation is "If it itches, it's gonna get scratched"
My PD nurses showed us, reviewed the paperwork, I took notes, would come home and tell my husband about the days he didn't attend (as my support person), and the second week of training we did most of the setup and they watched.
Ahh, so you got two weeks. My pd nurse has only mentioned one week, 4 days in clinic, one (Friday) at my house. Guess we'll see if the extend it if I'm struggling to remember stuff. Hopefully they will let me take the time to take notes. I might ask if I can just make short video's of each step. One of the reasons I recorded all that stuff o here is to help me remember what they did. Typing it helped me remember it. I'll probably do the same thing during my training days if folks on here will bear with me. Those that get bored with it can ignore it.
Tell us more about your DaVita experience when you get a chance sometime. I'm using a Fresenius center. Be interesting to know if there's any huge differences.
Nope, no shower yet, sink bath only while my incision heals. Feeling pretty grungy these days But no one is holding their nose when i come in the door, so guess I'm not too stinkyi yet. Hopefully they will give me the "go" on getting a shower in a week or so. I know they make some waterproof bandages to cover the catheter exit site. I may order some of those once I find a good source if the clinic doesn't provide them.
I used those water proof covers and they worked well. I also took showers with my detachable shower head to take a "half shower" covering just the lower half of my body below the catheter site. I used a washcloth on my arm pits. Not great but made me feel better.
Hey, if you have a source for those waterproof covers. Share the link. Love to order a few if the clinic doesn't provide those, or if I find I have to pay for them even though clinic provided. Yeah, I shoulda added a detachable shower head in my shower, just haven't got around to it yet. Guess I'll wait at this point and see if I'll need it once I can start using those waterproof covers and a lanyard to hold the catheter tube.
The waterproof dressings are referred to as waterproof "Shower Shields" or "Aqua Guard" moisture barriers, etc. They're available in various sizes from online sites such as Amazon. They're also in drug stores but with less choice and at a higher cost. Before spending money on anything, ask your PD nurse for a few samples. Hubby didn't find them very effective.
I wasn't allowed to shower until a week after all my training. As for the exit site, mine is still an open area so I can't shower without something covering the exit site. Did yours close?
Anazon makes a waterproof bandage to cover new tatoos while swimming...It is a great product and alot cheaper than the Kidney Shields... I have been on PD for 18 months now and I still use it for every shower...probably always will...
Waterproof covers aren't needed if the catheter site heals well. My hubby initially used waterproof covers and then later tried using the lanyard while showering from head to toe (baths not permitted). He was most happy just letting the catheter dangle freely while showering. He commented that the lanyard was just another contraption to sanitize and it, too, allowed the catheter to dangle. Anyway, he rinsed off really well after every shower. Your PD nurse will let you know when the site is completely healed and give you the greenlight for showering. (Some PD nurses have more rules in place for showering than other, there isn't any consistency that I know of so keep that in mind.) During the time my hubby was on PD, he never caught any infections.
Ok, that's good to know that the waterproof covers aren't needed during shower once healed. (I can't WAIT to have a shower!) And he's right, having one more thing to sanitize would be a pain since you have to sanitize every day. Freely dangling sounds like a very good option And yeah, I've had two different PD nurses in the initial two bandage changes and they both did things a tad different. I'm sure I'll add my own creative twists to all of this as time goes on and I get bored doing it one way and will want to try something else for a while. Really glad your husband never got an infection. That's totally my plan as well!
I wasn't allowed to shower until a week after all my training. As for the exit site, mine is still an open area so I can't shower without something covering the exit site. Did yours close?
For me, so that would be two more weeks of no shower since I start training next week. My exit site is looking closed, meaning that the skin is tight around the catheter tube where it comes out of me from what I could tell in the brief moments I saw it when the PD nurse was going through the cleaning ritual before applying new bandage this past monday. Hopefully yours will heal up soon! How long has it been since your surgery?
My hubby doesn't quite remember the specifics but says he thinks it was within a month or so after surgery, at which point his nurse said he could simply take showers as usual, just no tugging or twisting the catheter, etc. We're aware that some PD nurses may not be that accommodating. So I researched and couldn't find any standard rules about it. The guidance is apparently left to the nurse in charge. I hope you're allowed to shower unrestricted as well.
Yeah, I've got two PD nurses that I've seen so far, I think the one I had the first week will be more accommodating than the second one. Guess I'll find out who's really in charge of me starting next week with the training. I've actually asked if I could slowly transition into the full amount of PD solution as training progresses. Start with 750ml, then go to 1000ml the next day, 1250 the next day, 1500 the next day, 1750 the next day, then 2 liters the final day. Crossing my fingers that it's allowed. There doesn't seem to be any medical reason why I couldn't use that progression so my body could get used to it gradually rather than them just dumping 2 liters in me the first day. I'm waiting for their response. Medical people don't normally like things to be any anyone's convenience other than their own, so we'll see what they say. I mean I'm doing "zero" right now, it's not like I need the full 2 liters immediately for any medical reason, it would only be cause that's what they "say" I have to do. Am I being "non-compliant".... maybe
Lol....I did have some "training" in this when I was in the Army and we'd go to the field and there was no shower available. Lots and lots of wet wipes and I kept my hair short. I guess I'll need to do that again.
Spent 4 years in all in Germany. My dad was retired AF (he died in 2020); my husband is retired AF, my brother was in the AF for 10 years and my SIL was in the AF for a little over 3 years. I was deemed "too small" by the AF but the Army was happy enough to take me. Since I grew up "military" and my mom is German I had NO problem dealing with the Army or all the associated "stuff" that goes with being military. It might be why none of this really phases me... it's all just learning to deal with a new situation. Just a matter of identifying and overcoming challenges in life.
Ahh, well your background will serve you well in dealing with all this. Thank you and your family for your service! My aunt was German. My uncle met her when he was in service in Germany, then they came back to Alabama when he came back. Man did I love to go to their house to eat!
Yep my dad met my mom when he was stationed in Germany and brought her back. She still has an accent and the food growing up was fantastic. I miss her fried chicken and mashed potatoes. There's a German restaurant in Tulsa that we used to go to but haven't been since Covid and with my diet restrictions I doubt there's anything I could eat there.
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Film at 11. But sure, np. Helps me too. 
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