just my luck!

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Mike
Posts: 1594
Joined: Fri Apr 23, 2004 2:47 pm
Location: Mansfield :o)

just my luck!

Post by Mike »

well inow this is my fourth day of PD and I have got my first problem :shock:

Everything has been going smoothly until now, I have had much less pain but last night the exit site was very painful and so today I have been to the hospital as I have got a very very painful exit site infection. I can't believe it as I have been so careful and the last thing I need is toi give my consultant any reason to take me off PD :x

I am really angry but I dont think there is anything I could have done as I have followed their instruction to the letter. At least I caught it early so the antibiotics should be effective.

Can you answer a question for me?

I was told that after having a shower all I needed to do iis dry the wound with sterile swabs? I have not been told to dress it at all unless I dont have a shower. Is this the same for all of you? as when Ed was on PD he had to clean the wound daily with iodine?

I think from now on I'm going to do that on a daily basis just to be sure.

Mike :cry:
amanda in CA
Posts: 1806
Joined: Fri Apr 23, 2004 5:14 pm
Location: Georgia, USA

exit site

Post by amanda in CA »

Hi, Mike sorry to hear about your exit site infection and I don't think that it should be viewed as a failure on your part, and certainly shouldn't be viewed that way by your consultant. Once it has healed there is no need to cover the exit site with a dressing and I never do. I simply shower and then dry gently around the exit site with a clean towel or wash cloth. Amanda
Elaine
Posts: 1704
Joined: Sat Apr 24, 2004 11:06 am
Location: south west

hiya Mike p/f infection

Post by Elaine »

Hiya Mike aww soo sorry to hear about u problem :(

Im sure that more than likely it's nothing u have done or not done, it's very common p/d exit site infections etc. :shock:

Each unit varies in accordance to their protocols and I know each unit have definate do's n dont's etc. Our unit wouldn't allow a shower until 4 weeks post-op. Then protocol was to clean exit site clean with saline and dry sterile gauze if prefere,.Which we did place sterile dressing over exit site after each shower etc.

Hope things improve for you soon Mike sadly even with following by book 100% exit site infections can still occur through no fault of u own.

best wishes Elaine UK :roll: :lol:
Hal
Posts: 617
Joined: Wed Apr 21, 2004 9:56 am
Location: Liverpool, UK

Post by Hal »

Hi Mike,

I can say its highly likely you've just been very unlucky. These bugs are floating around everywhere and your especially susceptible to them if your exit site is relatively fresh, like yours is. Don't feel like its your fault.

Most hospitals now believe that covering the site with dressings increases the chance of infection and some that iodine or saline can degrade the catheter. The only time I have had a dressing is for the few weeks we waited for the site to heal before I started PD (I had a hernia op at the same time).

When I have a shower, I do all my normal washing, then peel off the tape near the exit site, leaving tape still holding the tube to my skin higher up my stomach. I then wash my hands with aquasept and clean the exit site and tubing near the site with sterile swabs with some aquasept on them.

Then when out of the shower I wash my hands with aquasept , dry them and put purell on them. Then I dry the site and the tubing around it with sterile swabs. Then I put a small piece of tape on the tube just as it comes out of the exit site at its natural direction and another piece about 2 inches further along. I then coil up the rest of the tube and tape this to my stomach a bit higher up.

I would hope you have been advised to tape the tube just as it comes out of the exit site as this gives it support and reduces the pull on it, hopefully reducing aggravation to the exit site (and so indirectly chances of infections). If you haven't been told this, I would check with your community PD nurse.

Take care,

Hal
Mike
Posts: 1594
Joined: Fri Apr 23, 2004 2:47 pm
Location: Mansfield :o)

Post by Mike »

I have been told pretty much what you suggested, I was told to remove the dressing when showering then tape the catheter to myself and then shower as normal but not use soap near the exit site and allow the water to just run over it then use sterile swabs to dry the exit site. I was told I only need to dress the site using normasol and sterile swabs every other day if I don’t have a shower.

I was told that I could have a shower 2 weeks post op and my PD nurse said it was ok when she came to give me my training.

I think at least for the time being until my site heals a bit more I will do as you suggested. I have been told to keep a dressing on it unlike you but I was told to put a bit of tape to the left of the dressing where the catheter comes out to give it extra support in case it is pulled by accident.

I didn't sleep well last night due to the pain and I have a temperature so feel pretty crappy today. It was just starting to get more comfortable so it is really annoying that this happened :(

My consultant didn't want me to do PD so that’s why I don’t want to give her any reason to take me off it. She said that I wouldn't cope with it so I am determined to prove her wrong :!:

Thank you Hal & Elaine for the advice, it is reassuring that it looks like there is nothing I could have done to avoid it.

Cheers

Mike :D
Elaine
Posts: 1704
Joined: Sat Apr 24, 2004 11:06 am
Location: south west

Mike hiya

Post by Elaine »

Hope u feeling better soon, its such atender area anyhow u exit site. :shock: As things ease with antibiotics etc (presume they given u some) should start feeling less tender soon and more comfortable for u to get a good nites sleep. :)

best wishes Elaine UK :wink:
Mike
Posts: 1594
Joined: Fri Apr 23, 2004 2:47 pm
Location: Mansfield :o)

Post by Mike »

Yes I've got 2 different antibiotics but they could only give me just enough until monday as the pharmacy at the hospital was closed :roll: so I have to make an appointment with my GP to get some more :shock:
Bruce
Posts: 65
Joined: Thu Jul 29, 2004 1:21 am
Location: Long Island, New York

just my luck

Post by Bruce »

Mike:

I was told to remove the dressing from my exit site when I shower and NOT to use soap on it. When I have dried off I clean the wound with ExSept (a sodium hypochlorite antiseptic solution) followed by Bactroban cream. Then I cover it with an IV sponge. I have never had a problem and I do this daily.

Hope this helps. --Bruce
gary in bc
Posts: 93
Joined: Wed Apr 28, 2004 2:40 am
Location: Campbell River, British Columbia, Canada

exit site

Post by gary in bc »

Hi
I leave my dressing on through the shower. The last thing I do is remove the dressing, wash the exit site with a clean 4 x 4 dressing and wound cleaner. (everyone seems to use something different. Mine comes from Baxter) I then dry off, and dry the exit site with the second 4 x 4 (they come 2 to a pack), and add bactraban to the exit site, then redress it. Something I have found. If you enclose the sticky part of the dressing aroung the tube, and then stick the rest to your body, it doesn't pull on the site. I have also found in I keep the area around the site well shaved, be dressing sticks better. A lot of new sites get infected by being pulled on before they have had time to properly heal all the way. There is some kind of membrane on the tube, and the wound actually heals right to the tube. If you pull on it you lossen the tube, and get leakage.
gary
LadySycamore
Posts: 73
Joined: Tue May 18, 2004 9:48 pm
Location: Philadelphia, PA USA

Post by LadySycamore »

Hello Mike.

Sorry to hear about your problems with PD. However, it's par for the course to have a bit of a problem when it's new as your catheter is. It should be ok.

As far as cleaning the site, it's a wonder that your PD nurse/doc hasn't told you to put some Amukin (aka "body bleach") on your site after your shower. And I would put a dressing on it since it's new (to avoid any infections).

Also, to avoid pulling, you could see if you can get your hands on a PD belt. I've heard that they are good for holding the line in place under your clothes.

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Hope this helps. Good luck. :wink: 8) :)
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Mike
Posts: 1594
Joined: Fri Apr 23, 2004 2:47 pm
Location: Mansfield :o)

Post by Mike »

thank you all for your advice, I think I am going to properly dress it daily from now on.

I saw my PD nurse today and it is so painful still but she said I should hopefully start to see some improvement tomorrow. I have been taking the antibiotics since saturday, they are very powerful and I've got to take them for 3 more weeks! They are making me feel pretty crappy and the exit site looks horrible, all yucky!!

My exit site is very new and my training was brought forward a week so I think that could not have helped. They did show me a catheter and explained about the membrane which the wound heals into.

anyway hopefully I should feel better tomorrow and maybe get a better nights sleep without waking up every 4 hours from the pain.

cheers

Mike :D
oldborris
Posts: 266
Joined: Fri Apr 23, 2004 1:01 pm
Location: Fulham, London, U.K.

Post by oldborris »

When I was due for dialysis my renal adviser talked me into accepting pd [probably cos it's more cost effective for the NHS] but circumstances conspired to switch me onto HD. Reading the accounts of the problems people on PD get - boy! I'm glad I went on HD!
Rachel in NY
Posts: 650
Joined: Fri Apr 23, 2004 1:11 pm
Location: NY, USA,

Post by Rachel in NY »

Yeah me too oldboris. I started hemo bc I needed emergency dialysis and hemo is the only option. In the back of my mind I always thought of PD as the easy one... and I wanted it. To me it sounded so much more hassle free, people feel better, have less diatary and fluid restrictions, more time to themselves, etc. I never thought about the daily to day now. After reading people's PD accounts on this site, well, I can't say i'm GLAD I had hemo, but I can say I stopped the "should've had pd" thinking. Lets put it this way, I'm much more informed now.

Rachel
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"When life keeps giving you lemons, get to work and make a tall frosted pitcher of icy cold lemonade."
wing
Posts: 345
Joined: Tue Aug 03, 2004 10:56 am

Post by wing »

Hi Mike.
Certainly getting an infection is not your fault - any more than having renal failure is!
I won't add to the myriad of tips you have been given here to help you make your mind up regarding dressing or no dressing - suffice to say, that I do a different regime to others listed here as well. It just goes to show that there's more than 1 way to skin a cat!
My only tip would be - humour your renal unit - particularly if you think they may have concerns about you being non-compliant in the first place.!
If they said "dress it" - then dress it! By all means discuss alternatives with them and make your views known but try to come to some agreement between yourselves as to how you will manage it.
It's your wound and your body - but they are trying to help and you will probably have contact with them for many years. The pleasanter it is, the better for you both! (Which doesn't mean give in to them every time!)
Good luck.
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