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APD advice

PostPosted: Wed Apr 12, 2017 12:11 am
by danmiller84
Hi all, longtime reader first time poster.

I started APD just over a week again. 12000ml on 80% tidal made up of two clearflex bags and one extraneal bag. I'm using the baxter homechoice. The thing is after first fill all the others are not warm enough and it wakes me up as I can feel it going in. I have tried all sorts from using 6x pyhisoneal bags to having the second clearflex on my bag warmer (the one you get for CAPD). Baxter and my nurses are at a lose what the issue us (the machine is hearing up etc). I have googled and googled but no one else seems to have this problem.

I wonder if anyone else has had this issue and most importantly have solved it!



Re: APD advice

PostPosted: Wed Apr 12, 2017 9:10 am
by Soobee
Hi Dan,

I have 2 x clear flex so your third bag might make the difference?
Do you put your top bag on to warm before setting up the machine? I put one bag on the warmer about and hour before I set up, I press start etc until the machine reads 'load the set' but don't load it, this starts the warming of the top tray (and the bag), then at bed time I load the set, connect the bags and prime the machine before plugging in.

I find that if I haven't put the bag on to warm for about an hour before setting up and plugging in the machine will wait until the top bag reaches a certain temp (warmish) before it does the first fill but it feels noticeably colder than usual.

When our heating broke for a week and our bedroom was very cold I put a folded fleece blanket on top of the top bag (to help keep it warm) I'm sure this isn;t recommended but I don't think it ca be too risky (fire ect).

Hope you get it sorted soon,

Re: APD advice

PostPosted: Wed Apr 12, 2017 3:04 pm
by wagolynn
One way would be to warm the third bag by immersing it in hot water (not too hot but aim to get the bag a little warmer than normal), before you start then wrap in a towel to keep it warm until required.

Re: APD advice

PostPosted: Thu Apr 13, 2017 9:24 am
by rheaybou
It has been a while since I was on the baxter APD machine but it sounds like a problem with the setup. Between fills the bag on the warmer acts as the central store, topped up from the other bags and so the fluid should be warmed for the next fill - the same for the extraneal bag - mine would be on a drip stand for the last fill.

I would speak to your PD nurse or give baxter a ring on the helpline. A cold fill is not nice at this time of year

Re: APD advice

PostPosted: Tue Apr 18, 2017 9:36 pm
by danmiller84
thanks for all your help. Putting the bags on the heater earlier has helped some. I have also found that rolling the bag up and using a bulldog clip to keep it rolled up helps.

But i am struggling with getting all 3 bags warm. The PD unit is out of ideas and Baxter are next to useless - they blamed me :D

dialysis sucks!!

Re: APD advice

PostPosted: Tue Aug 01, 2017 10:04 pm
by Epgibbons
Hi danmiller84, sorry to hear you have such a problem. I am on APD with a Baxter machine and do not have this problem. Are you placing the mainbag ( the one on the machine) properly so that it covers the thermometer. How about attaching a photo of you setup at the point of priming. How warm is your roomand the room in which you store the boxes?