Today, my PD nurse hooked me up and filled me with 1200ml of PD solution 2.5 today and I was to "Dwell" for 4 hours. She checked the TB test she did yesterday and it is looking ok. She also had me to bring my vaccination and immunization records that I keep on a card at home as well as my Covid immunization card so they could record all that. I have not had the pneumonia vaccination so she said they would provide that there, in addition to any other vaccinations I needed including the new Covid vaccine due out in Sept. One stop shopping, I like that.
Oh, before I forget. To prevent constipation (a big no-no for PD as all of you already know), she had recommended I take Ducolax. So I popped one tiny little pill this morning at 8am with my other medicines and figured it would start working later today since the box said "overnight relieve". Well let me tell you, about 10:30 I had to race to the bathroom. That stuff hit like Hurricane Helen. Good thing she had postponed my training until 12:30 because of doctor rounds today. Whew. I'll know to take that stuff about 5 in the afternoon from now on. A little earlier once I'm on the cycler. And she said it was safe for me to take every day if I want. But I'm not sure I want that experience every day.
So back to the training. While I was "dwelling" she got the renal dietitian to come speak to me for a moment, but she basically told me she was leaving and was going to be replaced in about a month. She gave me a few handouts that were fairly generic. No mention of the nutritional protein benefit from such Southern staples as frog legs, alligator tail and rattlesnake meat. Hopefully I'll get a few specific questions out of her through email, if not, I'll have to wait till the next dietitian comes on board.
Next the social worker came in. Not sure what I'm supposed to do with her. Maybe she's the complaint dept? I guess I'll find out as we go along. She didn't spend but about 3 minutes in there.
After that, my PD nurse came back and she actually had me to go through the entire manual dialysis process from beginning to end twice as she read from the notes from the pamphlet including some additions and modifications we had made to it yesterday. We used an empty solution bag as my peritoneal cavity so I could see it filling and emptying, though it didn't have a real catheter in it, just a regular hose connection. I felt pretty good about it once we got through the second part. I may detail the entire process in another post, but it's going to be slightly different for folks not using the Baxter system. Meaning the hookup part will be different. After that, she disconnected me and I was on my way. She would've let me disconnect myself, but I ask her to give me one more day of practice before I gave myself a huge infection by dropping something. Speaking of dropping something, when I was cleaning the tray table that the supplies were put on I though I would pick it up so I could clean the legs. Little did I know that the top was not anchored to the legs and the metal top fell with a huge bang and clatter on the floor. I know everyone in the building wondered what the hell was going on in that room. I told her yesterday to expect me to screw up some stuff, and today I proved me right 
She was very forgiving. I said "charge it to medicare, I've been paying taxes all these 50 something years!"
Ok, next. I promised Black midnight I would post some photos of the actual pd catheter part that goes inside of me. (Well not of the one in me, but one just like it used for demonstration purposes). So look for those photos below.
Oh and I'm going to list all the steps of the bandage change procedure I do along with my shower each morning. I know some folks don't cover theirs any more at this point, but I just don't feel good about leaving it exposed to dirt and stuff while cutting grass etc. So here are those procedure steps, my version anyway. Let us know how yours is different:
Gather supplies.
Clean bottles of ExSept, hand sanitizer with 100:1 bleach solution
Get clean wash cloth and towel
Cut fingernails
Clean shower head with bleach (at least once a week)
Remove old bandage
Shower using antibiotic pump soap and shampoo
Dry exit site with fresh wash cloth (optional-my choice for now)
Dry rest of body using fresh towel
Clean table with 100:1 bleach solution
Remove top of ExSept solution
Take out eight 2 x 2 gauze
Liberally apply ExSept solution on three 2 x 2 gauze in ExSept bottle top and let soak
Tear seven pieces of tape 6 inches long. Put one on edge of table and stick end of other 6 to it.
USE HAND SANITIZER HERE
(Remove old bandage here if not taking a shower)
Be sure catheter cap is tight
Wash around exit site in circular motion from center outward about 3 inches using gauze soaked in ExSept solution
Repeat with second gauze soaked in Except solution
Use third gauze soaked in Except solution to clean tube coming from exit site
Dry with first dry gauze
Dry with second dry gauze
Dry tube with third dry gauze
USE HAND SANITIZER HERE
Make take 4 corners of fourth dry gauze and fold to make a point. Apply Mupirocin (if desired) to the skin at the base of the tube where it comes through the skin.
Fold fourth 2x2 gauze in half and make a "pillow" to position under the tube adjacent to where it comes out of the skin.
Open new 4x4 Island dressing package and lay aside on table
Position the tube comes so it comes out at natural angle (about 22 degrees down for me) from the exit.
Apply the 4x4 island dressing one end at a time over the exit site so the fabric center creates a "blanket" just over where the tube comes out of the skin.
Anchor the tube just outside island dressing with tape making sure the the tape touches all the way around the tube and to itself under the tube to secure.
Coil remaining tube on top of Island dressing and tape to secure or put it in a PD Catheter belt or some other method to secure it from getting caught on things.
That's it! I refer to these notes as I do the procedure every morning so I don't forget a step.
First day of dialysis
Young Adult Kidney Patients Doing PD Dialysis
