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Going Back to go Forward: Revisiting Yesterday’s Blog plus Cycler Drain Problems

January 27, 2023 / Henry Feeser / 0 Comments

But first going Forward: a bad night for me and Peritoneal Dialysis. The system would just not drain, regardless of where and how I stood, what dance steps I made or how I held my mouth. The Cycler persisted on sounding its loud “Draining slowly” warning, of course with no reflection on what was causing the slowness. I checked and rechecked both the Drain Line (yellow) and the Blue is You Line to no avail. I removed all tape and fixtures on the Catherer Line, and gently tugged the Catherer Line itself to no avail.

On average over six months, the total time I spend on the Cycler itself is on the order of 10 hrs 30 minutes; last night it approached 11 hrs, an all-time high. For the record, 3/4 nights the Cycler alarms on the Drain Cycle; only 25% of the time do I experience a restful night’s sleep without Drain Alarms.

Expecting that something was just not as it should be, I contacted my PD Nurse at Fresenius. She gracefully agreed to see me as soon as I could get there, some 1/2 hour drive away. Upon arrival at the Fresenius Clinic, she manually drained my PD Access, then added 500 mL of fluid and timed how fast it went in (fill) and how fast it Drained. She then did so with 2000mL. In both cases, specs were exceeded. (She used 100 mL per minute for the drain as the norm, so 20 minutes was the time expected.)

So available tests suggested my PD catheter system is performing to specifications. I am to suit up again tonight with hopefully better results. If not, the next step would be to x-ray my stomach area to ascertain if all is as should be with the catheter interior to my stomach.

BTW, while there I asked about replacing the line on my catheter that leads from the section that actually enters the stomach to the Blue is You connect on the Cycler and was told that this is accomplished every six months as a matter of course. Stand by for updates.

Now an update on how data moves around Fresenius or doesn’t. Clinic personnel do not have a live feed of data coming off the Cycler even though the Cycler has a cellphone-based modem to transmit data. They received stored biometric data when I visit the clinic and bring in the installed USB thumb drive. They can see and respond to any comments I make via the App, but it is unknown how much if any of the other data they can review.

Fresenius is touting a new integration of data sources and support via their Kinexus Therapy Management Platform as being specific to both the Liberty Cycler (the current PD device I’m using) and the new-to-the-world VersiPD system in early beta testing I have previously blogged about. See this link for more information. You may view an embedded video from the above link that is embedded below. It seems to take a few seconds to load – maybe.

The Kinexus rollout suggests Fresenius recognizes they need to improve their data integration efforts and lever up on the data they are by default collecting on patients. I’ll post updates as my understanding in this area improves.

Fresenius Medical PatientHub App; “Feature” not documented

January 26, 2023 / Henry Feeser / 2 Comments

Those employing the Fresenius Liberty Cycler to support their daily home peritoneal dialysis, know that when coming off dialysis in the morning, one of the last Cycler screens requests input of a host of biometric data including weight, blood pressure, pulse, type of dextrose used, last bag type, glucose, etc. On the PatientHub app (I use an Android-based Samsung S20+5G) you are required to input a bunch more data including if you entered your vital signs in the Liberty Cycler, solution information, any manual exchanges, etc. Lots of data.

My first observation is that given that I have been faithfully supplying requested data since starting dialysis on 9/30/2022, not one entity or person from my PD team or anywhere else has ever commented on the same. Not one.

We had a philosophy in the Navy that in the face of too many reporting requirements from desk jockeys, just stop sending them and see if anyone squawks. No squawks, no report, that simple. Perhaps that approach should be used here.

My second observation involved the PatientHub App’s “Features” not being implemented in a meaningful way. When you dig down from the login screen to the landing screen, there is a tab in the upper right corner named “Menu.” A menu choice is “Vital Graphs.” One would assume that some if not all of the data being input across the Fresenius Dialysis spectrum would be graphically presented herein. Such is not the case. For me, only my dry weight is listed which is not of much help in viewing data trends graphically.

I submitted a report to the Fresenius App keeper and received the response below a day later. It is the last graphic below.

From the response, it is clear that the most obvious integration of reporting systems is totally lacking, and apparently not a priority either. This further begs the issue of where all this data is going, who is viewing it, and to what end. I want to know and will be pursuing this “issue” further with Fresenius personnel. Standby. Out. (Screenshots of the App are below:)

Scorebox After Four Months of Peritoneal Dialysis

January 25, 2023 / Henry Feeser / 0 Comments

I have been on Peritoneal Dialysis, supported by the Fresenius Medical Team in Granbury, Texas, for approaching four months. In this blog, I intend to share my experiences, good and not-so-good, thus far.

First, the Good:

I feel great most of the time but get tired toward the day’s end. I am 84 years old, so what? I don’t nap at all. I can still take care of the necessary yard work on our half-acre chunk of paradise and stay up with necessary house repairs, more or less.
I have established a routine for dialysis-related requirements that is effective, efficient, safe, and satisfactory. It includes the Navy Seal credo “Make your bed.”
I can’t overstate the satisfaction of having a routine for taking down, setting up, and using the Peritoneal Dialysis System. In truth, it has become part of my daily life and, by extension, my very existence. Not only is PD keeping me alive, but it is also the reason I’m alive, and as such, is deserving of my full attention. It is not a burden or a crutch but a central component of my life. There is no me without dialysis. We are the same.
Fresenius and Fresenius Team Support are central to my current successful PD. Supply ordering at first seemed to be obtuse but proved to be straightforward. I use the app for ordering. Supplies have always been delivered within the stated window and stowed where we desired. Team meetings occurred as scheduled, and a team member professionally dispelled all my questions and concerns.

The Not-So-Good:

The’s lots of “stuff” to keep in mind with PD. Supplies, the status of, do you have all the expendables you need – tape, gauze, germicidal crème, etc.?
The Cycler throws excessive amounts of errors during the Drain Cycle in particular. Last night, for instance, I had to get up during the first three drain events and stand up to complete the drain cycle for about 10 minutes each, resulting in about half an hour of lost sleep. Drain problems take place on about 8 out of 10 nights. I can’t wait to see how much the new VersiPD improves in this area.

The Ugly:

erectile dysfunction (ED) is very common in men on dialysis—as is sexual dysfunction (difficulty with arousal or orgasm) for women undergoing treatment. I can attest to this from a male perspective.

I am on a fixed four-cycle of two-hour duration each night. What on the surface would appear to be eight hours of dialysis neglects drain times. On average, the PD process for me takes about 10 hours and thirty minutes. The longest is 10 hrs 55 minutes; the shortest is 10 hrs 13 minutes. Not included are setup and tear down times, handling of necessary components, added time to shower because of catheter requirements, and other necessities. When you add all the time requirements, half your day is involved in PD. PD requires a fixed block of time. If you stay up to watch an NFL game, you pay for it on the other side by remaining hooked up to the Cycler later in the morning. There is no way around it. Half your life is devoted to Peritoneal Dialysis in one form or another.
At the start of our dialysis journey, unknowns bugged us. (By us, I mean my wife and me.) We watched YouTube videos on using the Liberty Cycler and had that down before requiring PD, to the degree that I accomplished two weeks of training in four days. The most critical question in our minds, mirrored in Fresenius-sponsored Forums, is how we would deal with all the supplies required to support PD. I have previously blogged on how we deal with this aspect of PD; for us, it’s no big deal.
One of the problems often listed in Forums is the weight of the solutions boxes, the new boxes not having handles like the old ones, and so forth. Yes, the boxes are heavy and difficult to move around easily. I understand how some people regardless of age could find this effort to be challenging, especially when accompanied by the frailty of old age. But should people be denied PD based solely on this? I don’t think so. On a bag-to-bag basis, rather than a box basis, I think most people could cope. An organization such as I use wherein supplies are moved from bulk storage to ready storage next to my Cycler would help I’m certain. Maybe Fresenius could offer this service as part of their package.
erectile dysfunction (ED) is very common in men on dialysis—as is sexual dysfunction (difficulty with arousal or orgasm) for women undergoing treatment. I can attest to this from a male perspective.

Fresenius Medical Care: My Peritoneal Dialysis support company

January 24, 2023 / Henry Feeser / 0 Comments

I have put my very life in the hands of the company providing me PD support, Fresenius Medical Care, ticker symbol FMS. They provide Liberty Cycler equipment, medical support personnel, disposables, monthly supply replenishment, labs, and online support. Quite a mouthful. Given the level of my dependence on FMS, it behooves me to know all that is relevant about this company.

Wiki offers the following insights: Fresenius Medical Care AG & Co. KGaA is a German healthcare company that provides kidney dialysis services through a network of 4,171 outpatient dialysis centers, serving 345,425 patients. The company primarily treats end-stage renal disease (ESRD), which requires patients to undergo dialysis 3 times per week for the rest of their lives (When on hemodialysis – I am on Peritoneal dialysis every night.)

With a global headquarters in Bad Homburg vor der Höhe, Germany, and a North American headquarters in Waltham, Massachusetts, it has a 38% market share of the dialysis market in the United States. It also operates 42 production sites, the largest of which are in the U.S., Germany, and Japan.

The company is 32% owned by Fresenius and, as of 2020, generates around 50% of the group’s revenue.

The company is on the Best Employers List published by Forbes. (Note: Fresenius is #339 on Forbes’s Global 2000 in 2022.)

In December 2022 Helen Giza (54) was appointed Chief Executive Officer of FMS. Helen Giza joined Fresenius Medical Care in 2019 as Chief Financial Officer and took on the additional roles of Deputy CEO and Chief Transformation Officer in 2022 heading the FME25 transformation program. Previously, she was Chief Integration and Divestiture Management Officer at Takeda Pharmaceuticals since 2018. Before joining the Takeda Corporate Executive Team, she served as Chief Financial Officer of Takeda’s U.S. business unit since 2008. Prior to that, she held a number of key international finance and controlling positions, amongst others at TAP Pharmaceuticals and Abbott Laboratories. Helen Giza is a U.K. Chartered Certified Accountant and holds a Master of Business Administration from the Kellogg School of Management at Northwestern University in Evanston, Illinois, USA. From here:

Graphical analysis of FMS from a stock perspective from here is below:

On 1/20/2023 I bought 500 shares of FMS at $18.26 per share. Today, 1/24/2023 I am down $.20 per share. They have plenty of room to run (I hope!)

Blood Chemistry, Chronic Kidney Failure (CKF), and Dialysis

January 23, 2023 / Henry Feeser / 0 Comments

Hank Feeser 1/3/2023 Labs

Blood chemistry, that is the readings obtained from lab results, is extremely important for those with CKF and/or on Dialysis. Lab results provide markers for your Nephrologist to follow in prescribing Cycler settings, as well as keeping your overall health as optimum as possible.

There are many specifics provided in lab reports, one of which is your Phosphorus level. Over time my phosphorus levels have been increasing beyond normative levels of 5.5. See lead graphic. I attempted to control and/or reduce the level via diet to no avail. Recently my Nephrologist, Dr. Turner prescribed a medication called a Phosphorus Binder.

Phosphorus binders (also called phosphate binders) prevent the body from absorbing the phosphorus from the food you eat.

Phosphorus binders help to pass excess phosphorus out of the body in the stool, reducing the amount of phosphorus that gets into the blood. Usually, phosphate binders are taken within 5 to 10 minutes before or immediately after meals and snacks.

My PD doctor prescribed a non-calcium treatment named Velphoro, which is sucroferric oxyhydroxide in a chewable tablet form, at a 500 mg level. The medication is made in Switzerland and distributed by Fresenius Medical Care North America, the company in charge of my PD care and feeding. It is Rx only. I will start taking it today. Below I’ve included a screenshot of the phosphorus section of my most recent lab report and some additional info on phosphorus.

If you are in Stage 3 or higher of CKF, I would become very familiar with your blood chemistry and what to attempt to mediate to the best of your ability.

What is phosphorus?

Phosphorus is a mineral found in your bones. Along with calcium, phosphorus is needed to build strong healthy bones, as well as keep other parts of your body healthy.

Why is phosphorus important to you?

Normal working kidneys can remove extra phosphorus in your blood. When you have chronic kidney disease (CKD), your kidneys cannot remove phosphorus very well. High phosphorus levels can cause damage to your body. Extra phosphorus causes body changes that pull calcium out of your bones, making them weak. High phosphorus and calcium levels also lead to dangerous calcium deposits in blood vessels, lungs, eyes, and the heart. Over time this can lead to an increased risk of heart attack, stroke or death. Phosphorus and calcium control are very important for your overall health.

Under the Hood: What It Takes to Run This Blog, feeser.me

January 21, 2023 / Henry Feeser / 0 Comments

Novices to the blogging world may be interested in what’s behind my blog on Peritoneal Dialysis, feeser.me. So for those with a slightly more technical bent, this blog documents build status as of the posting date.

To start the blog, I needed a Domain Name and a web hosting company to host the blogging software I intended to use (and am using) to make daily blog entries. I did a Google using WordPress (free open-source blogging software I used while at Purdue) and “hosting” and came up with numerous providers. I sifted through the offerings and decided on Dreamhost.com as optimum. For the grand sum of less than $100, they registered my selected domain name feeser.me. They provided web hosting and offered a simple one-click solution to installing WordPress’s latest version, 6.1.1. According to Wikipedia, WordPress is used by 42.8% of the top 10 million websites as of October 2021.

With the essential blogging computer-based support system set up, I had to figure out how to use it. I used three sources. First, I signed up for a $15.00 Udemy course on WordPress. I browsed through the course content and picked up what I needed to get up and running. Second, I went to Amazon and purchased a book on WordPress, which I have yet to use (frown face!) The book’s title is “WordPress for Beginners 2022” by Dr. Andy Williams. I have it as a reference should I need it. Third, I used and use Google extensively for specific guidance for WordPress’s many bells and whistles. Two of these are Themes and Plugins.

Hundreds of Themes are available, which provide the appearance of the blog/website being constructed by WordPress. I wanted a simple-looking interface and selected Twenty Twenty-One to meet my needs. This is what you see when you visit the site. Spartan in appearance, to the point, clean and uncluttered.

Plugins are a different story. Simply put a WordPress plugin is a piece of code that you can “plug in” to your WordPress website to improve – or add – a specific feature on your site. Keep in mind that the WordPress Plugin Directory has over 55,000 plugins available, which have received over one billion downloads. It is not a trivial task to decide how you can best tweak your WordPress-based blog to perform to your liking. To date, here are the Plugins I have installed and are running unseen in the background:

Visitor Statistics Pro ($29.00). This is my go-to Plugin to see what traffic is coming from where. Because of this, I am going to include in this blog all that this Plugin provides from their website:
- Visitor Traffic Pro version is an innovative and easy-to-use plugin for WordPress to display your site traffic statistics in detail with excellent charts.
  - Full reporting
  - Online users, visits, visitors, and page statistics
  - Today visitors & visits chart & Today search engines
  - Recent Visitors (GeoIP location by Country, city, and region)
  - Comprehensive overview page (Dashboard), including browser versions, country stats, hits, exclusions, referrers, searches, search words, and visitors
  - Visits, see how many hits your site gets each day and each week & month, Visits time graph to view the daily visitors per hour
  - Visitors, see who’s visiting your site
  - Recent visitors by IP & region
  - Visits, see how many hits your site gets each day
  - Visitors, see who’s visiting your site
  - Page tracking, see which pages are viewed most often
  - Search Engines, see search queries and redirects from popular search engines like Google, Bing, DuckDuckGo, Yahoo, Yandex, and Baidu
  - GeoIP location by Country
  - Interactive map of visitors’ location
  - Widget to display website statistics
  - Overview page for all kinds of data, including; browser versions, country stats, hits, exclusions, referrers, searches, search words, and visitors
  - Exclude IP’s Export primary data, Pagination, and date range search
  - Exclude user role from statistics (NEW)
  - Plugin Accessibility (NEW)
  - Free Mobile App included (NEW)
  - Support shortcodes. Click here to get the list of shortcodes (NEW)
  - Multisite (network) support (NEW)
  - Full GDPR
All-in-One SEO ($49.60/year for Basic). SEO, or Search Engine Optimization, takes up most of my post-post editing time. It involves tweaking the title, applying tags, meta concerns, etc., to optimize a given blog post’s probability of receiving a higher ranking by search engines. While I opted for the paid version, to date I am experiencing massive problems getting login credentials from the company.
Grammarly Premium ($151.78/year). Grammarly Premium is a paid extension/app that offers over 400 types of checks and features, checks for grammatical errors provides vocabulary enhancement suggestions, detects plagiarism, and provides citation suggestions. It helps keep my prose in order.
GoogleSiteSit Kit. While I have this Plugin installed, I am not using it to any extent, yet. See this link for additional info on the Kit.
Smush (running free version). Smush is a cloud-based service that optimizes images posted on WordPress to make them smaller in size and load faster. The free version I am running is limited to 25 MB in size. Most of the pictures I upload are larger than this so I haven’t received much value from this plugin.
TablePress (free). Supports the creation of an embedding in WordPress blog’s various types of tables. I haven’t used it yet, but when you view a table in the future you will know that this Plugin was used to create it.

As of 1/21/2023, the blog has been up for a couple of weeks now, with 14 or so posts. We have had visitors from 8 different countries viewing blog posts as follows:

United States (70)
Egypt (2)
Ghana (1)
El Salvador (1)
Italy (1)
Algeria (1)
Ireland (1)
Canada (1)

The order of referring sites is below:

1	https://www.google.com/	9
2	https://www.pinterest.com/	8
3	http://m.facebook.com/	2
4	https://www.facebook.com/	2
5	android-app://com.google.android.googlequicksearchbox/	2
6	http://blogpros.com/	1
7	https://www.linkedin.com/	1
8	https://lm.facebook.com/	1
9	https://blogpros.com/

Social Fitness and Dialysis: What is the most important factor?

January 19, 2023 / Henry Feeser / 0 Comments

A recent full-page ad in the WSJ paid for by La Foundation Publicis states that “50% of all people with cancer are afraid to tell their employers.” (WSJ 1/18/2023 p. A18) The ad goes on to state “We aim to abolish the stigma and insecurity that exist for people with cancer in the workplace.” I strongly suspect that the word “dialysis” could be substituted for “cancer” with the same implication. If people are afraid of what their employers, and by extension, the population view them as, what does that say about how they view themselves, their feelings, their mental state, and their relationships with others? Feelings are a two-way street. What single factor has been found to keep people physically stronger, minds sharper, experience less depression, less diabetes (keep in mind the strong positive correlation between diabetes and dialysis), recover from illness sooner, and generally live a fulfilled life? Sounds like a lead-in to a TV commercial for a magic pill or a snake oil sales pitch. It’s not.

For more than 85 years a group of Harvard studies has investigated what really keeps people healthy and happy, regardless of their circumstances. Particulars of this research have been published in the book shown above. It is linked to Amazon for reference and linked here also.

ONE factor in their study consistently stands out with a high explanation of ties to physical and mental health and by association longevity, and that is (drum roll please) the “enduring importance of good relationships.” The Harvard researchers found that close personal connections are the single overriding principle for living. good relationships keep us healthier, and happier. Period. End of discussion. So if you desire to be healthiest and happiest while on dialysis, cultivate warm relationships of all kinds. Reach out to your family and friends. Engage with your Dialysis Team. That’s what they are there for. Read this blog and make comments. I will respond to them. Engage your nephrologist. Prepare for our monthly televisits. Read your lab reports. Do research as much as possible to understand what they are telling you and your dialysis team. You are on the one hand your best advocate and on the other your best critic. The bottom line, get it out there and shake a hand. See the video below for a discussion by one of the primary researchers, Robert Waldinger:

In the military, we have a concept of “Having a shipmate’s six.” When someone tells you that they’ve “got your six,” it means they’re watching your back. By extension, that person expects you to have their back as well. “Got your six” is now a ubiquitous term in the military that also highlights the way military members look out for each other. The term derives from aircraft of old that could not see what was behind them. In a relative clock around the aircraft where 12 o’clock is straight ahead, and six is straight behind, having a fellow pilot’s six inferred watching out for enemy aircraft sneaking up behind them and shooting them down.

Example of getting it out there: My wife and I have a Golden Retriever named Dickens. (See picture below at 7 weeks.) Currently, he is a 7-month-old 60-pound bundle of energy that requires exercise at least twice a day. Our routine is I take him to our local Dog Park in the morning and also take him on a long walk. Obviously, this is both good for him and for me. My wife takes him for a long walk in the evening. While on our morning walk I meet lots of people who must pet a Golden and by association meet with me and share the love. I just met an ex-Navy pilot on our walk who lives close to us with a pool. He has an American Golden named Jackson who gets along perfectly with Dickens. He has invited us to exercise our Golden in his pool and interface with his family socially.

As Lavern Baker sang in the 1953 song embedded below, get out there and ‘shake a hand!’ I assure you your dialysis outlook will greatly improve. Who knows, you might get to love a Golden Retriever if you are lucky also! See you at the dog park.

VersiPD Update From Fresenius

January 18, 2023 / Henry Feeser / 0 Comments

I jumped the gun in my previous blog concerning input from Fresenius on their new Cycler. First thing this morning I received a response to my query to them two days ago about the new VersiPD Cycler. For completeness, I am first including my query, followed by their response which is enlightening. Consider the following to all be in quotes. And thanks to Jeff for taking the time to respond!

My name is Hank Feeser, and I currently am on PD via your facility in Granbury, TX. I am reaching out to you because your name was listed as the contact person on the press release back in April 22 that announced FDA approval of the VersiPD Cycler which suggested rollout starting in 22 and gathering steam in 23. (Brad bounced me to you as the current contact.)

Fresenius personnel here know nothing of the VersiPD. When I order supplies monthly for the Liberty Cycler there are no supplies listed for the VersiPD. So my question is, what’s going on with it? When might we begin to see it roll out here in Texas?

FWIW, I am writing a blog about my PD experiences. It is located at feeser.me. You can check me out at feeser.net. I am eternally grateful for the support from Fresenius. Have you ever thought about an AI-driven interface so a patient could ask questions of the cycler, like ” hey Versi, how much longer do I have on drain? That would really really help!

Thanks in advance,

Hank Feeser

Hank,

I received your email from Scott Sayres regarding the VersiPD platform FDA clearance announcement and the current status of the product.

We are in an early phase of the product evaluation in a very small early user experience. This is typical for a medical device. This early user experience is focused on 2 smaller Research Clinics to ensure that the product meets our expectations for consistent reliability. This trial will likely last the entire year of 2023.

It is not surprising that many clinics and personnel have not heard of the product today. We have not started broad based promotion. Our products are recognized in the industry for their safety, reliability, in addition to innovative design. We want to ensure that this new product achieves this same expectation before we define the timeline of broader introduction in the market.

Thanks for the recommendation on the voice activation for our systems. It is a great idea and will need to have a tremendous amount of testing to insure it is safe and reliable. I use both Google Home and Amazon Echo and while I enjoy the ease of use and assistance they often misunderstand my statements. Our goal is to continue to explore these types of technologies to provide improved ease of use and make dialysis a smaller part of a patients life.

Please let me know if you have additional questions.

Best regards,

Jeff

Revolutionizing Pertoneal Dialysis with Fresenius’ New Cycler

January 17, 2023 / Henry Feeser / 0 Comments

In April 2022, Fresenius announced FDA approval of replacing the Liberty Cycler PD machine with the VersiPD. This blog addresses aspects of this new Cycler PD machine. I gleaned most of the included information from the VersiPD Operation Manual linked in the PDF below:

480109_Rev_A Download

->To start with, it is much smaller than the current Liberty Cycler and weighs only 12 pounds compared to 30 or so for the Liberty.

–

It does not have a heating tray on top, but instead a heating bag that comes with the new cassette package and slips in a notch around the front and sides which are evident in the picture.

->The power consumption listed at 700VA (VA is the same as watts) is close to the Liberty also.

->It is controlled by enhanced firmware that is much more sensitive to drain challenges that have plagued the Liberty Cycler, is quieter, and is more customizable to a patient’s needs.

->It also uses a USB thumb drive to input a patient’s prescription, as does the Liberty, and employs a cellphone interface likewise.

->The cassette is completely revised (See last picture). More picture details are provided below.

->As you can see in the photo below of the bottom of the VersiPD, it also contains a battery. The purpose of the battery is undetermined. What is known is that it has to be replaced every two years by Fresenius personnel per the VersiPD manual.

->Not required by the Liberty Cycler is the new VersiPD must be within +/- 19 inches of the patient’s bed level.

In the picture above (from the VersiPD manual) you can clearly see the warming pouch provided with the revised cassette package. At the right you can see the different cassette configurations currently available.

I called and sent an email to the Fresenius Corporate PR Office requesting information on rollout timing, but in three days have yet to hear back. They don’t know either.

Dialysis Hints

January 16, 2023 / Henry Feeser / 0 Comments

Over the course of being on dialysis for several months, I have initiated several tweaks to the process to save time, energy, and increase safety of the system. Today’s blog discusses four of these “system improvements.”

The cap on the end of the “Blue is you” fitting that attaches the Cycler to your catheter line can be rather hard to unscrew from its as delivered position in the cassette package. I would surmise that those with arthritic hands would find it particularly difficult to loosen. I have found that it helps to “break loose” the fitting while it is firmly in place in the stay-safe receptacle. Don’t unscrew it -> just loosen so it’s finger tight, then proceed with your hooking up to the Cycler per stated norms. The square fitting on the end of the connection is 10 mm, so having a 10 mm open end wrench by the Cycler supports this operation. I have one as shown below which I use nightly.

By necessity, the plastic line from the Cycler to my bed travels across the floor in front of the access door to our Master Bedroom. Especially in the dark, this is a potential tripping Hazzard for my wife’s entry and exit from the bedroom. The next two hints address this safety issue.

First of all, the line: From Amazon I purchased a product that is normally used to cover electric cords as a cover for the plastic line. Nightly, as part of the Cycler setup, I run the Cycler attachment line through the bottom slit in the cover, turn it over, and presto, the tripping hazard is alleviated. See picture below.

The second hazard is being able to see the cover etc. in the dark when my wife leaves or enters the bedroom. Again, from Amazon I purchased two LED motion sensor-capable lights that are placed by the door and armoire (pointing toward the bed) that turn on automatically for about 10 seconds with motion, then off. In the dark they provide an abundance of light to light up the pathway to the bedroom.

The last item in this blog involves securing the drain line. I run the Cycler drain line to the shower in our Master Bath. It is common to tape down the drain line but cumbersome to do so. You have to get down on hands and knees to do this I’ve come up with a better way (for me) to secure the end of the drain line. My wife sacrificed a plastic bowl from the kitchen which I modified by drilling a 1/4 ” hole in the side about 1″ down from the edge. I then used scissors to cut out a “V”-shape to the drilled hole. I slip the “Yellow” plastic drain line bitter end into the V and thence to the hole to secure it. Then using the line, I just swing it into position covering the drain under the bowl face downward and I’m done. In the morning as part of cleanup I pull the bowl out of the shower, remove and cap off the line, rinse out the bowl and place it in the shower on the enclosed bench, and I’m done. Pictures follow.

And the next blog will be about?

Henry Feeser's Peritoneal Dialysis (PD) journey