PD Drain alarms

I was told this might be a good place to post this. My husband has at least one drain alarm a night, sometimes 3 or more. I had to move to the guest room to get any sleep as he has to stay awake during the drain to sit up, roll around, stand up etc. He’s had his catheter removed and replaced laproscopically to make sure its positioned correctly and the same thing is happening. Its quite frustrating but we’ve become resigned to it. We saw the PD nurse here today and she said that its hard to diagnose because there is no pattern to it. She looked at his IQ card records too. Its different each night and no one position makes it better consistently. She suggested that he switch from the Fresenius Newton IQ to the Liberty which actually pumps out the drain. Heparin doesn’t seem to help either so its not fibrin. We’re about to head back north (snowbirds) so may suggest the change there. He still believes its better than Hemodialysis which he was on for about3 weeks. He hated it and felt awful each of those three days.

This is an unusual and curious problem. Some patients have pockets where flluid becomes trapped but this usually happens in those who have had previous surgery and subsequent adhesions. If this is the case, despite proper catheter placement he may need adhesiolysis or removal surgically of these adhesions in order to have a good functioning catheter. Has your husband had a dye study to see where the fluid goes when infused? This may help to define the problem. It is a fairly simple procedure in radiology as a sterile injection of dye. The PD nurses’ suggestion to try the newer cycler with a pump mechanism may help----perhaps it could be tried in-center for a couple of exchanges with your husband in a reclining chair making it similar to lying in bed. This may be easier than ordering a whole new cycler. I wonder what kind of prescription your husband has on the cycler (numbers cycles, volume each cycle, total cycler time), and also is this drain issue a problem on CAPD as well as on the cycler? Is his total ultrafiltration for the day adequate? In other words, is he achieving full drains eventually with the cycler after moving about? Is the initial drain on the cycler normal (that is the one usually done when the patient is still sitting up? I’m afraid I have more questions than answers. Keep in touch,

Thanks for your response Judy. I’d not heard about the dye procedure before. That might be what he needs. A different doctor put in his second catheter laproscopically and he said he would make sure its placed correctly and that there were no problems in the area. So I’d guess he looked for adhesions. He’s averaging a minus UF number each morning ranging from 120 up tgo 700 give or take. He’s not retaining fluids, no swelling or trouble breathing. Lungs sound good. He does still urinate quite a bit. During his 24 urine collection he fills the jug. He just turned that in along with a whole nights output on Tuesday but haven’t gotten the results yet. We had a printout off his IQ card but I can’t find it right now to tell you his prescription. We’ll take a print out of what you suggested in to his first appointment when we get back north soon. We’re snowbirds. Thanks Judy. Linda