My husband has cardiac asthma and used the cycler for the first time last week. it was a disaster! The first fill was Ok but then the next fill he became short of breath. I called the PD nurse and we drained him right then. She said to try again but this time it was worse so we drained and shut down. He also gets a very sharp pain in the rectum when draining. He had to have hemo yesterday and now we don’t know where we stand. Should we give up PD? Very disappointed. I also find that doing this at home is overwhelming with all the equipment and worry about infection.
I’m not a doctor or nurse, but wanted to let you know that we do check these Boards and try to find answers if no-one pops in with any suggestions. You’re not alone in this. Meanwhile, here are some thoughts & questions for you.
My husband has cardiac asthma and used the cycler for the first time last week. it was a disaster! The first fill was Ok but then the next fill he became short of breath.
It sounds as if your husband has congestive heart failure. If this is the case, PD is a better treatment for him than standard in-center hemo, because it is much gentler and puts less strain on his heart. But, as you’ve seen, it can take some time to work the bugs out. Did you and your husband learn how to do manual (CAPD) exchanges? Perhaps he could do those–with your nurse or doctor’s permission–until he gets used to having fluid in his belly, and then start the cycler again. I’m not sure why it would make sense for him to do hemo temporarily rather than try manual exchanges. This would be a good question to ask the nurse.
He also gets a very sharp pain in the rectum when draining.
I wonder where the end of your husband’s catheter that is inside of him might be located? If this pain continues, he may need an X-ray to check on this. Rectal pain can sometimes be caused by a catheter that is too long. He may need a shorter one. There is an article in the Nephrology Nursing Journal that you can download at: http://www.hdcn.com/anna_ce/315b/315b.pdf. At the end is a trouble-shooting guide that may be helpful for you.
This article also cites research that shows that patients who are taken care of by PD programs with 20 or more patients are less likely to have “technique failure”. This may be because in a larger program, the nurses have seen more challenges and successfully figured out how to cope with them. If your husband’s program is small, you might want to think about switching to a larger one, if there is one in your area. You can check this in our “Find a Center” database http://www.homedialysis.org/v1/centers/search.php or in our coverage maps.
I also find that doing this at home is overwhelming with all the equipment and worry about infection.
There is definitely a learning curve, and it takes time to get comfortable with something new like a PD cycler. See what you can do to solve the technical problems your husband is having and give yourself some time before you give up on PD altogether.