As stated in my blog entry last Friday, yesterday (Monday), I called Fresenius Tech Support concerning the seemingly continuous throwing of drain alarms by my Liberty Cycler. We spent over 20 minutes with the tech rep requesting data from various cycler screens. As of the phone call, the cycler was throwing drain alarms for exactly 50% of the evening dialysis treatments. Let me explain this so those not acquainted with the cycler have a little more insight into what I’m talking about.
The Cycler is a computer-controlled pumping device that controls the three phases of my evening dialysis treatment. After turning on and plugging my catheter into the cycler, it first checks to see if any fluid is left in my stomach cavity and if so pumps it out. It defaults to 50mL or more of such fluid. If there previously had been a “good” drain, the machine can’t remove at least 50mL of fluid so guess what, yes, it throws an alarm. You have to manually bypass this phase to move on.
From here on what takes place depends on what your nephrologist has ordered. From me, I am on 8000 mL total fluids, pumped in and out of my stomach lining 2000mL at a time, for four cycles total. So initially 2000mL is pumped in – called “fill,” which is left in my lining for two hours – called dwell, then pumped out – called a drain. Each fill is supposed to take 10 minutes, and each drain is 20 minutes. If you add up the total fill times 4×10=40 minutes and drain 4×20 = 80 minutes, you have 120 minutes or two hours ideally spent on fill and drain, plus 4×2 hrs = 8 hrs total dwell. So altogether, 10 hours in an ideal world. My best time is 10 hrs 11 minutes, and the worst is right at 11 hours. The problem is with the drain. For me, as previously stated, 50% or more of the time my system has problems with drains. Is it me, the cycler, or God knows?
On the me vector, I have been doing EVERYTHING my team has suggested. We tested my plumbing, and everything is working properly. I am on my second cycler; I have read that some patients have gone through more than 10 with drain problems. The internet is full of complaints by patients concerning drain problems with the Fresenius Cycler. The PR fluff Fresenius has released on their new cycler touts improvement in this area which is moot acknowledgment on their part of the cycler’s intrinsic problems with the current cycler. I guess other than the cycler, it’s in God’s bailiwick.
This morning I received a call from my Dialysis Team Nurse who had been contacted by Fresenius Tech Support. The bottom line is this: Tech Support’s solution to grossly excessive alarms is to turn them off. I was directed to a section in the Cycler manual called “Flow Alerts” wherein it states that if both flow alert and flow alert sound are set to “NO” the sound will not occur, but the cycler will display an alarm when you are draining or filling slowly. So I fired up my Cycler, went to the proper panel, and turned off the flow alert, defaulting the sound to N/A. Note the differences between what the manual stated needed to be accomplished and what took place on my Cycler.
Regardless, the alarm is now off, and we’ll soon know what effect this “fix” has. I’m going to watch what happens to the overall time I’m on the cycler. I suspect it will increase, perhaps drastically, because I’m not getting up to increase the drain flow as I have in the past. We’ll see, and I’ll report back.
CGM: Last week I had a conversation with my online pharmacy, ExpressScripts about an unrelated matter. Upon conclusion of this call, I inquired about their provision of Libre3 CGMs. I was assured that they either have them or will provide them when presented with a valid prescription by my doctor. I call my GP who sent them a script yesterday. My ExpressScripts app notified me they had received a script to fill. Today I received notification from ExpressScripts that a “Prior Authorization Required” has to be in place before they can ship my CGM order. My benefits plan must be approved through prior authorization to ensure my plan covers this medicine.
It looks like governmental red tape is taking over. Meanwhile, I’m paying $204.xx out-of-pocket for the Libre 3. I’ll keep you posted.
Hank
s
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You answered my question about Libre3. I’ll continue to watch your comments. Thanks Jerry