Very low initial drain on APD

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Very low initial drain on APD

Postby newbie123456 » Thu Jan 12, 2017 1:53 pm

Hi,

My husband has just started APD. He is on day 7 on 1 yellow bag, 1 green and 1x2L Extraneal.
We have been plagued with low drainage alarms since day 1 which the PD nurses cant explain but the main problem is that his initial drain is only ever 200-300mls which has everyone confused as he has been carrying 2L of fluid all day.
Last night his initial drain was 200mls but his total UF was 2500mls. he spoke to the PD unit about it and all they say is that shouldn't be happening and that the total UF doesn't count if the initial drain is so low.

Has anyone else experienced this? What did you do about it?

Thanks very much xx
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Re: Very low initial drain on APD

Postby newbie123456 » Thu Jan 12, 2017 2:14 pm

Should also add that he's not constipated, infact he's quite the opposite.
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Re: Very low initial drain on APD

Postby Dibs » Thu Jan 12, 2017 2:48 pm

Hi.
I tend to stand for the initial drain and lie down for the rest. Has he tried different positions for the initial drain?
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Re: Very low initial drain on APD

Postby newbie123456 » Fri Jan 13, 2017 9:56 am

Thanks Dibs,

He tried standing up last night and only drained 7 mls before going on to the fill cycle. He was then very uncomfortable for the whole dwell cycle saying he felt like a beach ball and his tummy looked huge. His first drain was 2757 which gave him some relief. Don't know what his total UF was for the night as I had to go to work before he'd finished.

Surely more should be draining out than this? I'm so worried he's going to get a serious injury from all the pressure of having 4+ litres inside him!!

Thanks
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Re: Very low initial drain on APD

Postby Dibs » Fri Jan 13, 2017 10:19 am

Having only drained 7ml, didn't it alarm before the fill?

I struggled with my initial drains when I started, but not to that extent. When it alarms, I have tried all sorts of peculiar positions as well as rocking myself to try and move things.
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Re: Very low initial drain on APD

Postby newbie123456 » Fri Jan 13, 2017 10:23 am

Nope, not a single beep. Just started filling.

I think there cant be a minimum amount set to drain for the initial dain..is that possible? maybe the machine is thinking he's dry and not even trying?

It beeps during the other drains if the drainage slows down before it gets to 2000mls so don't really understand why it doesn't on the initial drain

Thanks
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Re: Very low initial drain on APD

Postby Dibs » Fri Jan 13, 2017 10:41 am

On my Baxters machine there is an I-Drain volume alarm. It was set by my nurse initially. I would ask your nurse/unit if it needs to be set.
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Re: Very low initial drain on APD

Postby newbie123456 » Fri Jan 13, 2017 11:02 am

Thanks, I'll ask them.

Thanks for all your advice
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Re: Very low initial drain on APD

Postby Pinkdiamonds14 » Fri Jan 13, 2017 1:08 pm

Hi Newbie
Is it worth ringing the Baxters Helpline number to ask their advice? My Dad started on APD in October and has rung Baxters a couple of times; they have been most helpful. It may be worth a call, assuming your husband is using a Baxters machine that is.
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Re: Very low initial drain on APD

Postby Epgibbons » Tue Aug 01, 2017 10:15 pm

Rather than spend time attached to the machine for the initial drain I attach to a drain bag, supplied by Baxter. That way I can spend more time away from the machine. Similarly in the morning I stop early using an Opticap, attach a drain bag so I get away from the machine and then after an hour or so I reattach and so the last fill. Be sure to use an Opticap to keep the patient line clean during the hour in the morning.

By the way a UF of 2500 and an an initial drain of 200ml with a last fill of 2000ml means a real UF of ( 200 + 2500 - 2000 = 750ml not so bad).

If your husband is uncomfortable during a dwell this is dangerous. In such events I stop the dwell and select Manual Drain to remove fluid until I feel comfortable.Of course stop and let the dwell complete when ready.
Heart transplant in 1990, CKD started 2015, Heamodyalisis for 6 months, APDfor 18 months.
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