PD Dialysis - Week 5 day 1 - training begins - Kidney Dialysis

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PD Dialysis - Week 5 day 1 - training begins

RonZone profile image
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So today, I drove to the Fresenius dialysis clinic for my first day of PD training. Last Wednesday, since my training had been put off a week waiting for Baxter supplies to come in, my PD nurse had given me an iPod with the PD training modules pre-loaded. But I discovered that after I had logged into the Fresenius patient "hub/portal", I could access the training modules on my home computer and even on my phone, so I didn't need the iPad they provided (couldn't use it to watch netflix anyway :-) Upon arrival, I had a bit more paperwork to fill out and sign and the nurse drew blood for labs and gave me a TB test. Then once that was done, we reviewed the process for changing my bandage over my pd catheter exit site as I had a few questions. Found out that I did not have to do the extreme hand washing just to change the bandage after taking a shower, that the extreme hand washing was only for connecting and disconnecting when doing manual exchanges. Then she went through the process of layout out all the supplies, doing the extreme hand washing, and connecting me up to a PD solution bag and put 800 ml of 2.5 solution in me. I had asked last wednesday if they could do the amount in progression instead of dumping all 2000 ml in my tummy the first day. She said the doc said it would be fine since I was not in a state of emergency. So we're doing 800 today, 1200 tomorrow then 1500, then 1800, then 2000, increasing every day.

While I was "dwelling from about 10:45 am till 1:45, she went over the entire process very slowly with me again using a pamphlet provided by Baxter that outlined the entire exchange process. She added a few notes on it that Baxter had not included, and I added a couple of notes myself and moved one of the extreme hand washing events down one step in the process, and she agreed that's where it should be. I'll do another post outlining all these steps in another post, probably tomorrow. During her demonstration she actually showed me a PD catheter. The tube coming out of the stomach with the end that connects to the Baxter "transfer set" (that's the adapter that goes between the pd catheter and has the end on it that connects to the Baxter manual bags and the Baxter cycler). Then the "cuff" that your skin grows over that prevents germs from getting inside of you when you shower etc. followed by the "tunnel" part that is about 2 inches long part of the tube that goes just beneath your skin but outside your abdomen, then another cuff where the tube goes into your peritoneal cavity. Then the long part of the tube than ends with the curled around tail like a chameleon tail. The last 2 inches of the tub and the curly tail have small holes all around the tube through which the PD fluid enters the peritoneal cavity and where the fluid drains out. And the end of the tub has an ice pick sized hole in it to deliver and pick up fluid. I found out that drain pain is caused by those small holes messing with the nerve endings in your peritoneal wall. For some people the nerve endings are more sensitive than others or the tube is positioned where it agitates the nerve endings more and has to be moved by body position or through surgery. She also allowed me to take videos of each step as we went along with my phone, so I could refer back to the videos to make notes and refresh my memory as to what we had done when I got home and went "duh". So that will be extremely helpful I think. I can download the videos on my computer and watch them as I do my own exchange, which will be at my home workstation for the most part. I'll do that until I get it all memorized and can do it blindfolded (well almost). Tomorrow, she has a "practice dummy" that she will use and let me go through all the steps using notes I'm making today to do an exchange on the dummy. I'll do that several times tomorrow while I "dwell" with the 1200ml inside.

I'll write more details tomorrow. I have printed out a lot of the information that was on the training tutorials which i will also use for reference. I've created a notebook with tab dividers for each "section" of the exchange process, drain, flush, and fill, along with other topics contained in the tutorials that I will list in future posts, like adding medicine to the PD solution etc.

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RonZone
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Blackmidnight profile image
Blackmidnight

Ron

This section: The tube coming out of the stomach with the end that connects to the Baxter "transfer set" (that's the adapter that goes between the pd catheter and has the end on it that connects to the Baxter manual bags and the Baxter cycler). Then the "cuff" that your skin grows over that prevents germs from getting inside of you when you shower etc. followed by the "tunnel" part that is about 2 inches long part of the tube that goes just beneath your skin but outside your abdomen, then another cuff where the tube goes into your peritoneal cavity. Then the long part of the tube than ends with the curled around tail like a chameleon tail. The last 2 inches of the tub and the curly tail have small holes all around the tube through which the PD fluid enters the peritoneal cavity and where the fluid drains out. And the end of the tub has an ice pick sized hole in it to deliver and pick up fluid. I found out that drain pain is caused by those small holes messing with the nerve endings in your peritoneal wall.

Could you please send me pictures the you took? I haven't seen this.

Thanks

Renee

RonZone profile image
RonZone in reply toBlackmidnight

Pictures. You really want to see photos of my tummy??? Not a pretty site. Let me find some on the internet that are good representations and add those :-) I'll see if the PD nurse will let me take a photo of that PD tube end with the holes that she showed me.

Blackmidnight profile image
Blackmidnight in reply toRonZone

thanks, no I don't want to see your tummy. I do want to see the cuff and the pd tube and catheter

RonZone profile image
RonZone in reply toBlackmidnight

Ok, I'll see if I can get those images for you today during training :-)

rabbit01 profile image
rabbit01

Very interesting. Pleased for you that it's going well.

RonZone profile image
RonZone in reply torabbit01

Yeah, hasn't been bad at all. Just a lot to add into my daily schedule :-) more on that in a bit.

Bassetmommer profile image
Bassetmommer

This journey should be published, and you should get paid for doing this. You make it sound so much less traumatizing than I imagined. How did it feel to have the fluid in your gut? Did you feel bloated? Did you get that pain when they drained you?

How tired are you from all this? Did they tell you about limiting your activities or having to change your diet?

You have no idea how beneficial this diary of yours has been.

Thank you for doing it,

RonZone profile image
RonZone in reply toBassetmommer

Published, Uh, I AM publishing it on here, ha! :-) And it's available from other sources I'm sure somewhere, just finding it is the hard part. Like my posts will be a year from now. The fluid going in was not a problem at all, just started to feel a tad "full" with just 1200ml in me. Now once they get me up to 2000ml, that might be a different story. I'll report on that then. I didn't get "pain" when they drained me, just a bit of a discomfort feeling like someone was pinching me inside. Again, I've had much worse gas pains before! Now for men it's a tad worse cause the pd catheter goes a bit deeper in us, so as it get's toward the bottom it makes your butt pucker a tad :-)

I wasn't tired from it at all. Just sitting there in that nice comfy chair all that time while we went over things. No limit to activities were mentioned, though since the surgery I really try not to pick up anything heavy. I've not talked with them about any kind of exercise program yet. I'll do that later this week or next week.

Well if anybody get's anything out of my rambling, I'll be happy! You are very welcome. It helps me to write about it.

Bassetmommer profile image
Bassetmommer in reply toRonZone

Butt puckered..... too funny. The image was like a comic where a person is being deflated.....

RonZone profile image
RonZone in reply toBassetmommer

It's the truth! :-)

horsie63 profile image
horsie63

Another exciting installment in the "Ron Diaries". Thanks so much for all this. How do you feel afterward? My neph says since I'm so small that I may not need a lot of the fluid but that's on my list of questions. You've actually posed many and provided answers that I will run by my neph in Sept when my next appt is.

RonZone profile image
RonZone in reply tohorsie63

I feel fine afterwards. Not a big deal. Yeah, you will probably not use as much fluid. Ask your team to work with you to find the optimal amount that will get the job done without making you feel miserable walking around with it. Yeah, make a good list of questions to ask when you see your doc. Your situation will be specific to you.

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