Drain Alarms every night

Hello,
My father started PD 1.5 weeks ago and his drain alarm has gone off every night 1-3 times. He gets up and moves around and it is OK until the next drain. A lot of what I have read so far is at least 1 year old (usually more) and I know how fast technology moves so I thought I’d post again. He is on the Fresenius machine.
Advice I’ve seen-

  • Lower height of machine (I’ve seen bottom should be 6" below top of mattress)

  • Raise height of machine

  • Use Tidal mode

  • Change to one 2.5 bag and one 1.5 bag

  • Try different sleep positions

Obviously he will discuss with PD providers but I’m really confused about the machine height thing. Is there an ideal height (and if so why isn’t the cart that comes with the machine at that height)?

I just have to say that it is very disappointing that the people who presented this option to him didn’t tell him how common it is that his sleep would be disrupted 3 times nightly. They painted it as a perfect solution.

Thanks in advance

I am sorry to hear about the drain issues. I would not call drain issues common, I would say it’s the surgeons placement that is this issue. Unfortunately tidal will be the only option to help with the sleep unless you do have a second surgeon (with more experience with placement) look at it via ultrasound and X-Ray for potential adjustment.

If you father has at least a liter if urine a day, and some residual GFR…there are some very amazing once a day options using a manual exchange, no cycler.

Above all work with your PD nurse to find the best solution to keep your father on PD. This can be fixed and there are options for him to stay successful with PD and get rest.

Josh

Thanks Josh - I would say that manual is not an option. At 85 setting up the cycler is fairly intimidating but the 36 step manual process is terrifying to him and unfortunately he is alone most of the time.

We do a Only one 2L bag of extraneal that dwells for 12 hours. It’s a supply order of only 5 cases vs 35 cases a month for the patient. Most people think manual and picture 3-4 times a day, that’s why we hope to educate about “FILL, LIVE , DRAIN.” Extraneal also has no dextrose so is great for helping with A1C.

Ask your PD nurse and doctor and start with the tidal At 100cc it by 100cc until he finds the appropriate number to keep him sleeping. That has worked well for patients in the past. It’s important not to leave too much tidal or it can lead to overfilling. Hope you get it handled soon!