Worst Drain Night on Dialysis EVER

Wednesday night was the worst night I have had in almost a year while on peritoneal dialysis. It makes the Beatles “Hard Day’s Night” song seem trivial. (Song embedded at blog’s end.) The first of four drain cycles I was awakened by a drain alarm, and got out of bed in a vertical position. and fifteen minutes later was able to jump back in bed with the first drain cycle completed. The second drain cycle alarmed with negligible drain started. Despite doing everything including standing, laying, massaging my stomach, doing joga with my wife, praying, cursing, you name it, the cycler would at times drain 13 mL, then 8, then 4 then stall, over and over again with constant alarms in between. (The numbers are for illustration only; they were all over the spectrum.)

I tried unhooking from the Cycler and draining into the bathroom sink but only a dribble came out of the catheter. Hooked back up to the Cycler, and an hour later or so about 1500 mL of expected 2000 had drained. At this point, the Cycler automatically kicked over to the third fill and we went back to bed. This time, the Cycler made it through fill 3 and drain 3, and I got up during drain 4, the last drain, which was also normal.

During the ordeal with drain 2, I called the off-duty nurse and talked to her about what was going on and we agreed that I should talk to my Fresenius Dialysis Nurse in the morning which is what I did. My Dialysis Nurse, Cindy had me come to Fresenius and started me on a week’s worth of Heparin. Heparin (Heparin Sodium) is a medicine that prevents clots and in peritoneal dialysis is used to prevent fibrin formation.

So what is this “fibrin formation?” Fibrin occurs as a result of protein formation from fibrinogen in the blood. Also referred to as “worms,” strands of it lead to poor drainage (inflow and outflow) and may be seen in the drain inspection window or in collection bags. None of this has been evident for me, but in the interim, until Dr Tan bores a hold in my stomach and looks around, at my catheter end, this is the best we can do.

So starting tonight, I have added to my evening dialysis prep routine by injecting 16 mL of heparin into my 5L Dialysate (the fluid used in dialysis.) Wish me luck and some sleep also!

BTW, labs are not up yet so more on this aspect later.