Father is doing pd question about apd

My father has been doing pd for 1 week when he goes home from the hospital next week they are considering teaching us how to do the apd. which one is better? If he doesn’t do the night one they want him to do pd 4xs a day. Also how did you learn it? They want us to go for 6 hours a day for 4 days at a dialysis center, we want a home nurse. What do you think?

Also he has been having pains in his stomach. Could this be because they are pulling too much fluid out?

He is doing so well since they started the dialysis. His BP is low though it was 75/39 when I was up there tonight.

He also has blood sugar problems.

I am usually the one to talk to the kidney dr, so I want to know perhaps what to ask her. Whap are your opinions on the night one is it apd.

Thank you. I am new to this and will be one of his caretakers.

Next week I have to go to the training with him. Has anyone been threw this, what do you do all day, it is from 9-3.

Also I am wondring if there are some stipulations to doing the night one only. They are thinking they want to do this one, but are there side affects or what is your opinion as to what was easier and better for you or your family.

(he can’t do this he will need help from us whenever it is done)

I am a bit nervous, as his bp and his bs are down and up often. Not sure if we can get a nurse. Anyone have advice? I also want to come up with or print off a sheet so we can post his info on the frig so we are all on the same page in the family, anywere I can find one online?

Thank you
Angela

Hi Angela,

I’m a moderator, not someone who has ever done PD. So, I can tell you that nationally, use of a cycler to do PD at night (automated PD = APD) has been growing over the past 10 years, and use of manual PD with several exchanges each day has been shrinking. I can only assume that this means people prefer the cycler, since most people have to train on manual first, so they have a chance to try that, and then they can train for the cycler. Using a cycler means one connect and disconnect instead of several each day–though your dad might also need a daytime exchange. As far as a sheet to post on the fridge, you’d be given training materials by the PD nurse when training is done–I’m not aware of anything that’s out there, mostly because each center does things a little differently…

If his blood pressure is low, it will be important to pull off the right amount–not too much–fluid. This would be something to ask about in training. If he is on insulin for his blood sugar problems (is he diabetic?) the dose would need to be adjusted to cover the sugar in the solution. If his problem is low blood sugar, this might be a reason why the doctor thinks PD would be a good choice for him–because he would be getting some sugar from the PD solution. This can cause weight gain, though, so it’s important to make up for the extra calories by cutting back elsewhere (best to cut out things with no nutrition, like soda, if he drinks that). A dietitian can help with these sorts of questions.

Have you read our descriptions of the two types of PD? You can find them here:
http://www.homedialysis.org/learn/types/capd/
http://www.homedialysis.org/learn/types/ccpd/

I, too, am a moderator and haven’t done PD myself, but I worked for many years as a social worker in dialysis facilities where patients learned how to do PD. It may seem like a lot of time in training, but there is a lot to cover to make sure that patients understand not just the procedure for how to do PD, but why they are doing what they’re trained to do.

You asked about the length of training time. In my former clinic, patients usually trained for a week…sometimes more if they didn’t feel comfortable at the end of the week. The training nurse gave patients a training manual that they used throughout the training and that they took home. Some of the things they learned included:
[ul]
[li]What kidneys do and what happens when they don’t work
[/li][li]The theory of how dialysis works
[/li][li]How to take vital signs (blood pressure, temperature, pulse, weight)
[/li][li]How to recognize symptoms
[/li][li]How to recognize peritonitis
[/li][li]When and how to contact dialysis staff for questions/problems
[/li][li]Diet for PD and how to tell if they had extra fluid weight on
[/li][li]Oral and injectible medications
[/li][li]Which PD solution to use to take off more or less fluid
[/li][li]How to cope with kidney disease
[/li][li]Costs of care
[/li][li]The importance of coming to clinic visits (usually 1x/month)
[/li][li]Lab tests and what they mean
[/li][li]How to take care of the catheter exit site & signs of infection
[/li][li]“Sterile technique” & why it’s important to follow it
[/li][li]How to do manual CAPD exchanges (power failures, travel)
[/li][li]How to set up the cycler and make connections
[/li][li]What machine alarms mean and how to take care of them
[/li][li]Plus more
[/li][/ul]
In a week of watching and doing the process over and over, patients gain confidence in their ability to do their own dialysis.

Most PD patients don’t need a nurse or any kind of helper. Even those who are blind or have problems with their hands that might make it hard to make connections can use assistive devices to help them make connections without getting germs into the catheter. You say your father will not be able to do this himself and will need help. What limits him doing it independently? If he needs help, it may be that the doctor or clinic is suggesting the cycler (APD) because they believe it would be less burdensome on the family to make one connection and one disconnection per day rather than doing 4 exchanges.

So far as which is better…I haven’t seen any research that has found that one is better than the other. Even though most patients today use the cycler, I know patients who prefer CAPD and have worked it into their daily routine. It’s pretty much up to the patient whether he/she wants to do CAPD or APD.

Thank you. I really want to help him. I know I can do it because we change his heart medication bag already. Yet I am a bit nervous. He is almost 80 and he wouldn’t feel comfortable doing it himself, I don’t think my mother can either, she is nervous. I know us kids can do it, I just hope it all goes fine and we can manage this.

I am just trying to inform myself so we can better understand it all, and in return help him more.

Thank you again, I really appriciate it being new to all this… :slight_smile:

People well into their 80s have successfully done PD by themselves–I met one gentleman who lived alone and did just great with it, so it may be that as your dad gets more comfortable with the process, he’ll be able to take over, if he’s physically and mentally able to learn the steps. If not–or until then–he’s very lucky to have such caring family members to help him.

Others who are older might be able to but he is unsteady and slow with his hands sometimes. We are there and would do anything for them, it is our turn.

Thank you, your info eased my mind, and I feel better about going Tuesday. Hopefuly I will learn alot and be able to teach everyone else in our family how to help him also. :slight_smile:

The key is to do the steps in order–just as they’ll teach you–to avoid infection. In some programs, they’ve taught folks so well that patients can go as long as 7 years without getting an infection. Your PD nurse will be able to answer your questions, too–he or she will be a real resource for you and your family. And, someone from the center should be on call 24/7 in case you need something in the middle of the night.

[quote=Unregistered;14421]My father has been doing pd for 1 week when he goes home from the hospital next week they are considering teaching us how to do the apd. which one is better? If he doesn’t do the night one they want him to do pd 4xs a day. Also how did you learn it? They want us to go for 6 hours a day for 4 days at a dialysis center, we want a home nurse. What do you think?

Also he has been having pains in his stomach. Could this be because they are pulling too much fluid out?

He is doing so well since they started the dialysis. His BP is low though it was 75/39 when I was up there tonight.

He also has blood sugar problems.

I am usually the one to talk to the kidney dr, so I want to know perhaps what to ask her. Whap are your opinions on the night one is it apd.

Thank you. I am new to this and will be one of his caretakers.[/quote]

Hello Angela, if you wish to speak to someone who does PD one on one over IM I can refer you to someone that I speak to alot…

Also, I invite you to see a few videos on people who use PD, it will give you an idea on how this process is done.

PD VIDEOS

I got an account so this is me. Thank you I will look more at the videos, I found one in chinese but that is his machine. Are there some in English that are the machines at night? That would be so nice.

Today was very overwhelming. He just got out of the hospital yesterday so this was hard on him today. Tomorrow is the dietician. I did the manual and the machine good though, I know by the end of the week I can do it Saturday by myself. (well with my sil I am going to be teaching and she will have seen it once) Alot of information but they are so good at explaqining it all. It is very steril!!

forgot to tell you his collor had to be shaved because it was on the outside of his body, they said this can happen if too much weight is lost after the surgery and the treatments are started. He said it isn’t common. I hope it will be fine.

Thank you for your help you have a nice site here!