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.
Young Adult Kidney Patients Doing PD Dialysis
First day of dialysis
