Interesting problem. I don't know why he was changed from cycler with card to one without, but the one with the card would have been most helpful in determining the problem with the alarms. I am assuming the alarms occur during drain. Since we know that the catheter is in the correct position from the xray, we know it has not "flipped" up in the abdomen but that the lower portion is in the area called the true pelvis. And you say he is not constipated---this is the most common cause of poor drains. It might be important to note that even though many patients say they are not constipated, they actually are. I would recommend several days of laxatives to see if it has any effect on drains because the fact that he only drains when sitting or standing indicates the problem is positional. I do not know how much residual fluid is in the abdomen when his alarms occur, but one remedy is to reset the cycler prescription for "tidal" dialysis. The nurse can do this for you. This therapy does not require a full drain but allows a residual amount (prescribed) to remain, usually just a few hundred cc's. It usually does not affect the efficiency of the dialysis significantly but may eliminate the alarms. Since you no longer have a card in your cycler, the nurse could determine the amount of residual for you by running a cycle in the clinic and seeing how much fluid has drained when the alarm occurs. If neither of these suggestions works, let me know.