Surgeon Questions

Hi all,

So, I had a followup with my nephr today and my lab values dropped again from a GFR 10 to 6 and creatinine went from a 6 to 9.
He wants to schedule me immediately for surgery to have my PD catheter implanted. Im wodering what questions need to be asked of the surgeon? I have been trying to research PD online to know what to expect, but now the day is here. I would really appreciate input from those who have been down this road.

Needless to say, Im scared to death.

Jeff

I am a social worker and have worked with PD patients for decades. Most of the patients I worked with were frightened when they were approaching the need to start dialysis. They learned that they could work, marry, raise children, travel, and live full active lives.

Have you read the information on PD in the “5 Types of Home Dialysis” that you can access from the Home Dialysis Central home page? It describes manual PD (CAPD) and PD using a machine (CCPD or APD). From the home page you can also read “Patient Stories” about people who are doing PD.

Also, you may want to look at the Life Options Patient Interest Checklist which has a list of questions that you may want to ask your doctor about kidney failure in general and PD in particular:

Here are fact sheets that answer the questions in that Checklist:
http://www.lifeoptions.org/catalog/catalog.php?prodCat=pic2

Hopefully some patients on PD will also respond to your message soon.

I thank God that we went the PD way. I had a temp catheter in my chest for 3 months while we waited for the PD surgery to heal and start using it, and the brief experience se in the clinic every other day taught me to avoid it when I could. Too many people resigned to a slow death there. I for one don’ t do well waiting and owudl rather have a more proactive involvement in my treatment.

The hemo catheter was put in on about an hour as we started using it the same day, it was very quick. I find the arms of hemo patients very unsightly and hope it never happens to me.

Surgery was an uneventful few hours in the hospital. Recovery was easy but one myts learn not to pcik up anything over 30lbs or so, which is hard on my self image. I have heard that some PD placement are poorly done, but I don’t have any gripe with mine other then the un slightly hole in my body and the 10~15 lbs of wight I have gained with a “beer belly” look. I suggest that you avoid placing it on which ever side you prefer to sleep on. DCK

Good point about avoiding the side you prefer to sleep on for the PD catheter, DCK. I’ll remember that to pass along to future folks.

A thought about HD access, though. Most of the folks you see probably have grafts. These don’t grow the way fistulas can, but often need a lot of revisions, each of which can create new surgical scars. If people get fistulas these days, they can use the Buttonhole technique for the needles. Instead of rotating needle sites (which tends to lead to aneurysms–those large bumps–over time), the Buttonhole technique means choosing just one spot for each needle and using it over and over at EXACTLY the same angle, until it forms a tunnel tract–like a pierced earring hole. Once Buttonholes are formed, putting the needles in is nearly painless, and those bumpy aneurysms are much less likely to form, so the fistula itself is less noticeable. Just in case you ever need HD in the future, I thought it might be helpful to know this.