I’ve been thinking about this post all week. I want to make
this post simple and clear, not overloaded with information.
Rachael spoke previously about the idea of Why PD? Our
answer is always Why not?? It’s so much easier on the body than hemo and really
gives you a sense of control over your health and welfare.
For this post I want to talk a little more about the process
of starting on PD. Your clinic likely offers an orientation when you start on
dialysis and presens all types of
therapy to you. You can do at home hemo, in clinic hemo, and PD. They will of course say that a transplant is
the optimal form of therapy, but is it really? We all know what the waiting
lists are like and you might even know what it’s like to want a living donor,
but are too hesitant to ask family and friends to donate because it is a BIG
DEAL.
That’ll be another post for another day! J
I decided very quickly that I wanted to switch from hemo to
PD. At first, I hadn’t been interested in doing anything other than what I was
doing because I was still adjusting to the idea of being on dialysis and
adjusting my life to that whole process. However, I got a job working nights
and dragging myself to the dialysis clinic after working all night and sitting
on a machine for 3 hours was REALLY unappealing. Thus, my decision was made to
switch to PD.
I was working a week on-week off rotation and the surgeon
booked me in for catheter placement surgery on the Tuesday of my week off. In
my naivete I thought a week of recovery would be more than enough. HAHAHA. It
wasn’t.
The catheter surgery is a day surgery procedure. I checked
in to the hospital in the morning, the surgery happened at about 1pm and I was
home by 5. My only instructions were to keep an eye on the catheter site for bleeding
through the bandages and to NOT MOVE AROUND.
Unfortunately, the catheter site wouldn’t stop bleeding, so
I drove myself in to emerg and a surgical resident did a little bit of
restitching on the catheter to close the site a little tighter. That helped and
I began the healing process. I have a REALLY hard time sitting still, so my
healing time was perhaps a little longer than normal. I ended up taking an
extra week off work because I still couldn’t move around freely. It didn’t
hurt, it was just tender and prone to bleeding (because I kept moving around).
I still continued to do hemo while the catheter site healed.
I think it took about a month before I started on PD. In that time I also did
the PD training – a full day of instruction and practice using the cycler,
setting up bags, learning about alarms and proper care & treatment. The
training was excellent and the only problem I had was the nurse yelling at me
because she was used to training elderly patients with bad hearing. I did tell
her that she didn't need to yell, and that helped. J
One bad/disappointing/frustrating moment while all this was
going on – and hopefully this reminds nurses out there how important it is to
be encouraging. One nurse had the gall to tell me that PD didn’t usually work on
patients because the catheter floated up inside the peritoneal cavity instead
of staying lower down like it should. She told me that I shouldn't get my hopes
up. Boy, was I pissed off. So, nurses, even if you think that, keep your mouths
shut. Please and thanks. J
The worst part for me, and I've had people agree and
disagree with me here, was the flushing of the line once the healing was well
underway and I was ready to start PD on my own at home. PAIN. Oh my heavens.
Pain. I have tattoos and and those didn't hurt AT ALL. Getting the line flushed
was pain and nausea all rolled into one. I’m not sure if it was the temperature
of the solution or what. I just wanted to curl into a ball and cry. Oh wait, I
did.
I’d like to tell you why the line flush is important or
necessary, but I’m not remembering why. It might have to do with the healing of
the catheter, or the solution that’s put into the tubing during the surgery. I
can definitely ask and get back to you. I just remember that it was not
pleasant. Like I said before, though, I’ve talked to people who have had no
pain during the flushing process. So there is hope that yours will be pain
free, too!
I first started out doing manual exchanges 4 times a day.
The exchanges take about 20 minutes and I would do them in my kitchen and do
dishes or read while draining and filling. After a couple of months of that, I
was able to switch over to the cycler as I had the right type of peritoneal
membrane for the cycler. There are four types of perintoneal membrane, with two
of those types being right to use the cycler. You’ll want to speak more to your
nephrologist or PD nurse about that.
To wrap up, switching to PD was the best decision for me. It
is easy, I have more energy, and I feel –almost- like a normal person. I like
that I can hook myself up at night, go to sleep, and be done in the morning. I
like that I can control the machine and set it up for MY schedule. I’m not at
the whim of a clinic and a clinic schedule. I don’t have to worry that I’ll get
a nurse who is in a hurry, overworked, distracted, or just in general pissy
while poking me with needles. I like that there are no needles, period.
Don’t get stuck thinking that your form of therapy is your
only choice because your doctor chose it for you. Be the manager of your care
and fight for your care, your comfort, your health, and your body.
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