:mad:Ok I just found out when they went to flush my new pd (was put in last week)
that it is not working it will not let in or drain out .They were able to manually push some in but nothing came out .I was sent for xray at which time they had me go back for more (so guessing they saw somethig but was told report wont be sent until tomorrow)
When it was put in they were able to fill but couldnt drain and dr said most likely bloodclots but didnt put me on anything Should it just have been redone in the or when they realized something was wrong then ?? Anyone go threw similiar and will I have to have this whole thing done over ???
thanks in advance …
Hi Piglets,
I wish I could tell you that everything always goes perfectly when a PD catheter is put in (or an HD access, for that matter), but as you’ve seen, that’s not always the case. The X-ray will help them to see if the problem is a kink in the tubing. If it is, they will probably start over. If there is no kink–just a blood clot–ask about using drugs to dissolve the blood clot. It may be possible to clear the catheter so it will work.
Some folks, like Virtsma http://forums.homedialysis.org/showthread.php?t=1685&highlight=catheter+failed had lots of problems at first, but then got everything going and are now doing well. You’re not alone. This sucks, but you should be able to get it sorted out.
You might also ask how much experience your doctor has with PD catheters. Doctors who place lots of them tend to do a better job than those who only do one once in a while. You want to get the doctor who is really good at it and has a high success rate.
The most common reason why a catheter doesn’t drain correctly is because the the patient is constipated, which can happen because people on dialysis are restricted from drinking lots of fluid and eating high fiber foods that aid bowel regularity and because certain medications like phosphate binders have a side effect of constipation.
The catheter could also be plugged with fibrin. The most common way to deal with fibrin is to use heparin through the catheter.
There’s also a possibility that the tip of the catheter has flipped up so it’s not in the lower abdomen near the rectum like it should be. This would mean that fluid could drain in but the tip of the catheter would not be low enough to allow the fluid to drain. The catheter can sometimes reposition itself correctly if the patient moves around. If that doesn’t work, sometimes they can physically reposition the catheter.
Here’s a fact sheet from the UK on PD problems, including difficulty draining.
http://www.kidney.org.uk/Medical-Info/pd/pdproblems.html
Dori
thank you again .The link really helped (always good to know bad things dont only happen to me LOL)
Beth thanks for the info but it is not constipation plus I have not been put on restricted diet.
Had Xray and shows it is in place. they tried to give heparin (sp?) in case of blood clot but since fluid wont go in that was useless.
I still havent spoke to dr but he advised pd nurse to try and flush again so who knows hopefully moving around helped and put it in place or knocked out reason it is not working…
ok here we go it now is taking fluid in but very slowly .and still will not drain…arghh this frustrating…
they now want to try and xray with dye into catheter …who knows hopefully something will show up and can get this fixed without going back in…
btw…beth I tried your url and I got a ‘forbidden’ msg stating I dont have access…thank you though
Piglets I am praying that things will work out with your cath. Keep us up todate on what is going on.
When hubby’s cath was done surgeon tested both putting in and draining. He told us it was working great before he let hubby leave operating room. I feel your surgeon should have done this also.
The cath was put in place the first week in December, 2007.
DHolland
I am thinking same thing …I can’t believe this surgeon let me off the table knowing the catheter was not working now I have to go threw all this other stuff to figure out what is wrong.
I have to have contrast tomorrow which I am allergic too so we will see how that goes…
(and I am surprised they are giving me contrast when I was told when in kidney failure you shouldht have contrast …)
Hey girl my name is Dianne. Where do you live?
Hi Piglets
I was recently advised to have a scan, which requires a contrast. I checked with my renal team (nurses) & was told there is a particular type of contrast (no idea of the name) that is used to protect renal patients. I trust this will be the contast solution they used for your xray.
Cheers, Aussie Angie.
Diane hey nice to meet you …thanks for all info …I am located in jersey…
Aussie Angie thanks for advice I went in today and it was going to be the regular contrast when I asked about effecting kidneys I was told 'well your kidneys dont work anyway" arghh this is a nightmare. I explained I have not started dialysis yet and we are still trying to get the catheter to work so what lifttle function I have I would still like to keep .so (after 1 1/2hrs) we got the other contrast that is ok on kidneys and had a 30 second scan…
Turns out : the catheter is sitting up high around my intestines …It is suppose to be more in pelvic area so looks like they are going back in …See again if he just did this while I was still on table alot of things wold have been avoided…I am losing faith
Piglet, I’m sorry you didn’t get the link to work. It worked for me just now when I clicked on it in my posting. Basically it mentioned the situation of the catheter out of place.
I’ve heard being able to reposition the PD catheter using a guide wire inserted into the catheter to relocate the catheter tip to the lower pelvis. As far as I know, this doesn’t require a surgical incision. However, they may do something else to manipulate the catheter into place in your area. I’ve heard and read that keeping the bowels moving is a good way to help maintain catheter placement in the lower pelvis. Hopefully when they reposition your catheter your PD will work great!
Oh please don’t do that. Let’s get this thing fixed and working right. PD is the way to go Piglet.
d
Me again…update which is really no new news…Still not working. and still dont know why.
I did speak with Dr (thank goodness at least I feel better about that ) He stated he was able to put in and aspirate out but blood clots were coming out slowly so he assumed given the particulars it was just a bloodclot ( I guess i undestand his reasoning)
they are now sending me for a Cat Scan to see the intestines clearly and get better idea of position.
Looks like I am going to have 2 options 1) have a surgeon go in threw stomach and reposition or 2) take this out and start over …either way not what I pictured…seems always me nothing can just go as planned…
Piglet lets see what the scan tells you.
I am sooo frustrated …I HATE this drs receptionists and everyone who pretty much works there. Every time I call they give me attitude like I am bothering them. I asked if they got my precert yet and was told 'oh we have to wait for dr to get back from vacation because ins company needs additional info. when I asked when that was they said a FEW MORE WKs…I said that is unacceptable and she says 'I dont have to take this dont get loud with me …what a LIE I know she was saying that because others were standing there…anyways I called ins company and they said oh we just need to know if you have other ins…I called back and said Ins comp has info can you call back and I was told NO make a long story short I explained how sick I been getting she didnt seeem to concerned. I now go on Fri for this other test which most likely is going to be useless and a waste of time. Meanwhile this thing has been in me with no one telling me how to care for it and it looks like old blood up on top and some fluid crusty in it…i am nervous I am now getting an infection !! I have not been told to change the bandage or if I can take a shower but I have a cast on leg so really been taking a bath without the water reaching my stomach…this is soo beyond frustrating…To top if off I feel a big lump where the incision was is this the tube???It is popping out and my skin is red there now …I dont know what to do …Do I look for another dr to take this out and start over,?? I am getting sick my creatine last was 5.7 pls anyone have any ideas???
Oh, Piglets, it certainly sounds like you have lots of reasons to be frustrated. I just switched my daughter’s MD after a visit where she made us feel like we were wasting her time–and she only had a bad virus and a nasty muscle tear. Doctor’s office staff can be just about as important to your care as your doctor, as you’ve seen. They are gatekeepers, and right now, they are holding the gates closed. The run-around you’ve been getting–and not getting info about how to care for your catheter–is unacceptable, IMHO, if you have alternatives. (Sometimes there is only one nephrologist in a small town).
Early on, we asked you if your doctor had had a lot of experience putting in PD catheters. Do you know if he or she does? Do you really like this doctor–enough to have a frank conversation about your treatment by the office staff and lack of info about caring for your catheter (even though it isn’t working yet?). If not, please do check out your other doctor options ASAP. Look for the largest PD program in your area. Call and ask them how many patients they have on PD–the more they have, the better the chances that they know what they’re doing and can help you.
You said that your last creatinine was 5.7. Do you know your glomerular filtration rate (GFR)? You can find this online by plugging your creatinine and other info into this calculator: http://www.mdcalc.com/mdrd. A GFR that is less than 15% means you need dialysis. I suspect that yours is probably in the 9% or less range, which is why you are starting to have symptoms. It’s important for you to clear this up NOW–you have every right to be upset when someone on the phone says “weeks!”
Hopefully some folks who’ve had PD catheters can give you some detail about what they were told as far as how to care for it and what it should look like. Hang in there! You’re certainly going through a rough patch, and we all want to see some smooth sailing for you.
How about going to the Emergence Room at the hospital where you had your surgery. I am at a loss Piglets. I can’t imagine this happening to anyone.
Dori thanks according to that it says I am 8.9.
I do like the dr and last visit I had a frank heart to heart with him about staff. He was extremely upset about they way they treated me and said he would talk to them. He stated he will advise if I call so much as to ask if I have a cold what to do they are to put me through .He agrees their treatment is unacceptable. Problem being he is on vacation so that is why I believe they are back to their old tricks
I believe he comes back tomorrow so we will see.
As for switching problem is I called a few and they seem to not be able to get me in for months ! I truthfully am at a loss.
As for the E/R question my concern is I have 3 kids under 3 with my creatine they would make me stay in hospital and right now my mom just had major surgery and she is in hospital so I have to help with her and she is my sitter when I am not around …
Piglets I will be praying for you and your situation. You do have a full plate.
Oh my gosh, 3 kids under 3! PD is definitely a good first choice once you can get it to work. You have a LOT on your plate even without kidney failure. I’m really glad to hear that your doctor is supportive, and hopefully when he’s back again tomorrow, you can reach him and get some immediate help. Most nephrologists practice in groups so that if one is on vacation, another can pick up the slack. Doesn’t yours have a partner you could call when he’s away? It also sounds as if he really needs to replace some of his staff or at least make it VERY clear to them that their behavior is unacceptable. They are frontline healthcare staff, even if they are trained as secretaries, and they need to act like it.
I think it’s got to be very scary feeling like you’re all alone with this, with your doctor away, your mom recovering from surgery, and not knowing how to take care of your catheter. You’ll feel a lot better when you can talk to your doctor again. It sounds as if he cares and is willing to help you. Please do ask him about what to do for back up care when he’s away, since none of us ever knows when we’ll need a doctor’s advice in a hurry. Meanwhile, we’re here for you. 
It would be really nice if someone who has a PD catheter could weigh in on those other questions you had. Didn’t you have a PD nurse who tested whether your catheter would work–is she someone you could call to ask about how to care for it?