Catheter positioning. I'd like to think that it is an exact science. I mean, someone is implanting a catheter into my gut so I hope they really know where it's supposed to go. What I have learned is that catheters are not identical in placement and function.
I remember talking to a friend of mine who also does PD on a cycler. She told me that she was gaining weight, felt bloated, and had significantly low UF (ultra filtration - the amount of actual fluid that is removed during the night) numbers in the morning. She said she could drain just fine during a manual exchange and didn't think there was a real problem with the catheter itself.
Aha. Positioning.
The way her catheter fell inside her body when she was in bed and the way she slept curled up in a fetal position were causing her to limit the catheter's ability to drain. A strange little kink or a specific positioning can slow or even stop the drain of fluids.
We talked about it and I told her what I did.
1. I accepted the fact that there would be four drains during the night. And I want to get some good, solid sleep. So if the first three cycles had low drains, that would be okay.
2. I had to set my alarm to wake up when the last drain was scheduled to happen. Usually a bit before, so I could really encourage the final drain.
3. That final drain would set the tone for my day. I didn't want to "trap" a lot of fluid inside my abdomen and feel full, sluggish, bloated, or sore all day. I wanted it all out so that I could have my final fill and be on my way. Comfortably.
4. I wake up a bit before that final drain starts. I sit up to encourage the drain. I get up and make the bed. Start recording my cycler information. Move around. All of this movement helps me get a complete final drain.
My friend said that sometimes it seemed like her catheter drained slow/poorly when she had been sedentary for a while. I completely agreed. My usual exercise includes alternating walking with cardio DVDs. A good amount of movement. What I have found is that during times when I am unable to exercise (having the flu, for example), I need to encourage that catheter's flow in any way I can.
And yes. I do mean the very bad hula dance.
Last year I had the flu. I was on the couch for three weeks. It was just awful. And that limited activity seemed to cause my catheter to lie stagnant in my body. No little movements or exercise-related jostling to keep it moving at all. Every time I had to do my final morning cycler drain, I had to stand up and gyrate my body to get the fluid to flow. It was ridiculous. I'm sure I looked ridiculous. But there I was, standing next to the bed, looking like a drunk hula dancer. Just moving around to make sure the drain would be complete.
Is this all in my head? You might think so. The fact that I have now talked to two other people who have had to do the Bad Hula on occasion tells me that it very well may be a PD "thing." Unknown.
Generally speaking, I find I drain much better when I stay as active as I can. Seems like it encourages things to go very well and keeps my insides limber. I have no science to back this up. But if you experience poor UF numbers (when they should be higher) in the morning, try sitting up, standing up, and maybe doing your version of the Bad Hula to get things moving.
Ah, the ridiculous things we think of on PD. Keeps it interesting!
- Rachael M.
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