There are literally hundreds of pounds of supplies associated with PD. The majority are provided by
Storage
Fresenius and a few out-of-pocket by me by my own volition (subject of a future blog). Let’s start with the largest, bulkiest items, the solution boxes. As stated in the last blog post, I am on 8L of PD solution which consists of one 5L bag and one 3L bag per day for 8L total. Fresenius ships the 5L solution two to a box, so a month’s supply (30 days) is 15 boxes. The 3L bags come four to a box, so 30 days’ supply requires 30/4 or 7 1/2 boxes. Cassettes (provide all the plastic lines and special fitting required to interface with the Cycler) come 10 to a box, so a 30-day supply is three boxes. Add all of this up and we have about 26 boxes just for a month. If you add in another 10 days for backup, you have on the order of 35 boxes steady state just for ongoing needs. Our storage schema is shown in the picture which is in our spare bedroom closet. We order supplies on a monthly basis. CAVEAT: The initial solution mixture provided by Fresenius contained much too much 2.5 solution and is not returnable to them. Try to ensure that your initial solution shipment matches what your doctor is recommending for you to start with!.
However, at least at the beginning of PD, things are not steady state. Early on and continuing until today, I experienced EDEMA in my ankles (Puffiness caused by excess fluid trapped in my tissues.) To assist my body in properly disposing of this fluid via PD, my Clinical Nurse and erstwhile guardian (part of the Fresenius-provided team and a Godsend) Cindy suggested upping the strength of the dialysis fluid, called DIALYSATE. (The Components of PD which directly impact efficacy of the PD and can be manipulated to maximize solute and fluid removal are dialysate volume, dwell time, number of exchanges per day and potency of the dialysate itself.) There are three “strengths” of dialysate, 1.5 (yellow), 2.5 (green) and 4.25 (red) where the numbers indicate percentage of dextrose (yes sugar for diabetics reading this) in the solution. I started off on all yellow/1.5. To combat edema, we moved up to 3L of 2.5/green on MWF which to date has at least moderated my ankle swelling. Thus, I have had to juggle types of 3L boxes to accommodate my 1.5 and 2.5 requirements. Same number of boxes but different logistics.
The next blog will address the third leg of our PD effort, the stand-alone workstation.
