The most searched subject on this blog is “Alarms.” Seems almost all users of the subject machine experience them, some more than others. In this blog I am going to relate my experience with alarms, and what I have found to somewhat mitigate their occurrence.
First of all, I would like to state up front that Fresenius knows full well that its Liberty Cycler has “alarm challenges.” When they were in the PR mode in pre-rollout of a new Cycler, now since abandoned for business reasons, they touted its reduced alarm rate. Alas, it does not appear that this improved cycler will be available, period. My Dialysis Team, in particular, my nurse, has been most helpful in attempting to troubleshoot alarms. Let’s jump into alarms.
What are alarms? The Cycler throws obnoxious beeping alarms when it determines that something in the Drain-Fill cycle is not going according to its parameters. In general, it appears that the pneumatic pumps in the Cycler have more oomph in the Fill cycle than in the Drain cycle. I have always experienced more alarms during Drain than Fill, by a long shot. This is particularly true if you are slightly lying on or have a bend or kink in your catheter line. But I digress – some history.
I started on PD using the Liberty Cyler on 9/30/2022. At first, I experienced a few alarms, but not so many that I couldn’t handle them sleep-wise. Over time, they increased to the level that I was having multiple alarms, mainly drain, each night, and had to get up out of bed in a verticle position for drains to complete, as much as on every drain. I started calling tech support documenting what was going on and was finally issued a new Cycler. This seemed to alleviate the alarm problem but again, over time I was back to the old alarm situation. Yet another replacement Cycler and the same story. So we had pretty much eliminated the Cycler as being the problem. That left me. Of course, this is what Fresenius tech support said all along.
In concert with my dialysis team, it was decided that I needed to have my catheter placement looked at which required me to go back to the hospital and have a surgeon again look at it which I did. So now I’m on my third Cycler and second catheter placement which seems to be working. In three weeks, I generally have four alarms, This is out of a possible 184 drain/fills which is more than acceptable. What is the secret? I have found through trial and error that I cannot sleep on my left side during any drain cycle, and have to be careful during fills. I can sleep on my back in general but have to make certain my catheter line is flaked out straight from my left side toward the cycler. I should note here that my catheter is positioned on the right side of my body and runs from right to left across my stomach. A natural position for it it exit without obstruction is from left to right thus having to make certain it runs straight to my left side which is also the side where the Cycler is located. My best sleep position is on my right side. While on my right side, I make certain my catheter line is running free and not kinked over my side and toward the Cycler. Turns out my wife of 62 years is prone to sleeping on her right side so as often as not I snuggle up to her back and that’s where I wake up in the morning, alarm-free.
While my configuration may not work for you, the point is there is some optimum sleep-catheter configuration that should minimize alarms. I doubt those of us on PD using the Fresenius Liberty Cycler will ever be without alarms.
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