Tag: peritoneal (Page 32 of 47)

GP Visit 9/12/2023

September 13, 2023 / Henry Feeser / 1 Comment

On Tuesday 9/12/2023 I had my quarterly visit with my GP. We all have these meetings, some more frequently than not. For me, I meet with my GP quarterly, my Nephrologist monthly, my dentist three times a year, my podiatrist quarterly, have a retinopathy check once a year, etc. I am a system of doctor’s appointments.

While we discussed many things, like how many pets we both have, here are the most salient points:

I agree to change the tolerance on the bounds in my CGM to 150 hi and 70 low from 170 hi and 70 low. This puts a tighter upper bound on my Time in Range readings imputing tighter diabetic control.
I have not had an eye exam for glasses or a hearing exam (I use hearing aids) for approximately three years. He chided me and we agreed that I have to start having these exams yearly. The problem for me is that I go to the VA for eyes and ears and it involves a long drive into Dallas/Fort Worth traffic, long queues to even obtain an appointment, and in general being treated with total indifference once there. The VA is not a nice place in my experience, regardless of what politicians would lead you to believe.
My wife has noticed that around the house I tend to shuffle when walking. Not picking my feet up. I discussed this with my GP and he diagnosed this tendency as potentially the start of Parkenson’s Disease. I explained that it is only around the house, and not while on my daily dog walk, etc. We agreed to continue to watch and report on this new portal into my life. He did say there are no magic bullets in this area.

Since I am now under the shadow of Parkinson’s along with all my other baggage, I felt it necessary to learn more about this ailment. I queried my AI assistant Poe with the following results:

Poe Assistant

Title: Understanding Parkinson’s Disease: A Guide to the Neurological Disorder

Introduction:
Parkinson’s Disease (PD) is a chronic and progressive neurological disorder that affects millions of people worldwide. Named after Dr. James Parkinson, who first described the condition in 1817, Parkinson’s Disease primarily impacts the part of the brain responsible for movement. This blog entry provides a concise overview of Parkinson’s Disease, its symptoms, causes, and available treatment options.

What is Parkinson’s Disease?
Parkinson’s Disease is characterized by the gradual degeneration of specific brain cells that produce dopamine, a chemical messenger involved in controlling movement. As dopamine levels decrease, the brain’s ability to regulate and coordinate body movements becomes impaired, resulting in a wide range of motor and non-motor symptoms.

Common Symptoms:
The most recognizable symptoms of Parkinson’s Disease include:

Tremors: Involuntary shaking or trembling, often starting in the hands, fingers, or limbs.
Bradykinesia: Slowness of movement, making simple tasks more time-consuming and challenging.
Rigidity: Stiffness of muscles, leading to limited range of motion and difficulty with mobility.
Postural Instability: Impaired balance and coordination, increasing the risk of falls.
Other non-motor symptoms may include depression, anxiety, sleep disturbances, cognitive changes, and gastrointestinal issues.

Causes and Risk Factors:
The exact cause of Parkinson’s Disease remains unknown, but a combination of genetic and environmental factors is believed to play a role. Some risk factors associated with the development of Parkinson’s Disease include advancing age, family history of the condition, exposure to certain toxins, and certain genetic mutations.

Treatment Options:
While there is no cure for Parkinson’s Disease, various treatment options aim to manage symptoms and enhance quality of life. These may include:

Medications: Dopamine replacement therapies and other medications help alleviate motor symptoms and manage dopamine levels.
Deep Brain Stimulation (DBS): Surgical implantation of a device that delivers electrical impulses to targeted areas of the brain to control tremors and other symptoms.
Physical Therapy: Exercises and movement techniques that improve flexibility, strength, and balance.
Occupational Therapy: Strategies to enhance daily living activities and maintain independence.
Lifestyle Modifications: Regular exercise, a balanced diet, and stress management can help manage symptoms and improve overall well-being.

Conclusion:
Parkinson’s Disease is a chronic neurological disorder that affects movement and quality of life. While there is no cure, early diagnosis, and a comprehensive treatment approach can significantly improve symptom management and help individuals with Parkinson’s Disease lead fulfilling lives. As ongoing research continues to deepen our understanding of the condition, it is crucial to raise awareness, support those affected, and promote advancements in treatment and care for individuals living with Parkinson’s Disease.

And now we all know more “for don’t you see.”

If dialysis then osteoporosis?

September 12, 2023 / Henry Feeser / 1 Comment

During my last scheduled visit with my GP, he suggested due to my age and dialysis status it was prudent that I have a bone density test conducted which I did. You can view the result below:

Feeser_Henry_20230907 Download

As you may ascertain, the bottom line is that the results of my bone density test indicate that I indeed am experiencing Osteoporosis. This phenomenon is a lot like diabetes; in my case, you can’t see it or feel it, it’s just there for a doctor’s prognosis. So the question becomes, in the pickle that I am currently in with dialysis, what can be or should be done about it? And just what is this ailment that I have now been flagged with? It can’t cause my hair to fall out because that has already happened – like when I was but sixteen.

So the first thing let’s look at is the measurements used in flagging me with this fragility, and what does WHO have to do with it?

I asked Poe to provide insight in this area with the following results:

The criteria for osteoporosis diagnosis are primarily established by the World Health Organization (WHO) and are commonly referred to as the “WHO criteria.” The WHO criteria for osteoporosis are based on bone mineral density (BMD) measurements obtained through dual-energy X-ray absorptiometry (DXA) scans. The criteria are as follows:

Normal: A T-score of -1.0 or above indicates normal bone density. A T-score compares a person’s BMD to the average BMD of young, healthy adults of the same sex.

Osteopenia: Osteopenia refers to low bone mass, which is a precursor to osteoporosis. Osteopenia is diagnosed when the T-score is between -1.0 and -2.5.

Osteoporosis: Osteoporosis is diagnosed when the T-score is -2.5 or below. This indicates significantly low bone density and an increased risk of fractures.

It’s important to note that the WHO criteria are primarily focused on postmenopausal women and men aged 50 and older. For individuals under the age of 50, other criteria may be used, such as the Z-score, which compares the BMD to the average BMD of individuals of the same age, sex, and ethnic background.

Lastly, I queried Poe about the relationship between dialysis and osteoporosis with the following results:

Poe Assistant

Osteoporosis and dialysis are two separate medical conditions that can often coexist or be linked in certain individuals. Let’s discuss each condition individually and then explore their potential relationship.

Osteoporosis:
Osteoporosis is a skeletal disorder characterized by low bone mass and microarchitectural deterioration of bone tissue, leading to increased bone fragility and susceptibility to fractures. It is a common condition, particularly among postmenopausal women, but it can affect both men and women of all ages.

The development of osteoporosis is influenced by several factors, including genetics, hormonal changes, lifestyle choices, and certain medical conditions or treatments. Risk factors for osteoporosis include advanced age, female gender, low body weight, sedentary lifestyle, smoking, excessive alcohol consumption, family history of osteoporosis, and the long-term use of certain medications like corticosteroids.

Dialysis:
Dialysis is a medical procedure used to artificially replace some of the kidney’s functions in individuals with end-stage renal disease (ESRD) or severe kidney failure. ESRD occurs when the kidneys are no longer able to effectively filter waste products and excess fluid from the bloodstream. Dialysis helps in removing waste products, regulating electrolyte balance, and managing fluid levels.

Now, let’s explore the potential relationship between osteoporosis and dialysis:

Chronic kidney disease (CKD), which often leads to ESRD requiring dialysis, can be associated with an increased risk of osteoporosis. Several factors contribute to this increased risk, including hormonal imbalances, reduced vitamin D activation, impaired calcium-phosphate metabolism, and the use of certain medications like corticosteroids during dialysis treatment.

Moreover, individuals on long-term dialysis may experience mineral and bone disorders (MBD), which encompass a spectrum of bone-related abnormalities. MBD in dialysis patients is characterized by alterations in bone turnover, mineralization, and volume, leading to various bone disorders, including osteoporosis.

The management of osteoporosis in individuals undergoing dialysis involves a multidisciplinary approach. It may include optimizing dialysis treatment, ensuring an adequate intake of calcium and vitamin D, encouraging weight-bearing exercise, and, in some cases, prescribing medications to improve bone density.

It’s important to note that the relationship between osteoporosis and dialysis is complex, and not all individuals on dialysis will develop osteoporosis. However, if you or someone you know is undergoing dialysis and has concerns about osteoporosis, it is advisable to consult with a healthcare professional for an accurate assessment and appropriate management plan.

My GP recommended that I start on a regimen of OTC drugs Vitamin D3 and K2 along with Ca. My nephrologist vetoed calcium as my current dialysis labs indicate I’m doing OK in this area.

So what’s the bottom line? Seems that If dialysis, then Maybe/Perhaps Osteoporosis, and the link is casual but not inclusive. But it got me, didn’t it?

Drain Alarms + Heparin + Labs re Dialysis

September 11, 2023 / Henry Feeser / 2 Comments

As I write this blog on Sunday for posting at 0800 CDT Monday I have been adding Heparin to my dialysis solution for three nights. In all cases, the drain function has not stalled as it did on one previous night of hell. All three nights there has been an alarm on the first drain; only on the first night of heparin use was there a second drain alarm. The last two nights I have had only an alarm on the first drain taking place roughly at midnight after turning out the lights by 10 PM. I can live with this and am holding out that things will improve.

A little on the technical side of using heparin. My dialysis nurse provided me with what is labeled 30 mL bottles of heparin for my use. My dosage is determined by the rule of thumb 2 mL of heparin for each Liter of dialysis fluid in use. Since I am using 8 L total, this suggests injecting 2 mL x 8 = 16 mL of heparin. While the bottle is labeled 30 mL which infers you can’t get two nights out of each bottle of heparin, at least my first bottle had more than enough heparin in it to draw two night’s worth, or 32 mL of heparin.

My labs continue to be so-so. By the numbers:

Albumin 3.4 versus a goal of 4.0 or higher. It has never reached this goal.
nPCR 0.97 versus a goal of 1.2 or higher. Again, never been close.
Potassium 4.2 goal 3.5-5.5. I’m good here.
wKt/V 1.86 versus goal of 2.0 or higher. On been over 2.0 once.
Calcium 85 versus goal of 8.5-10.0 Ok here.
Phosphorus 5.4 versus goal of 3.0-5.5. Close to top of range and corrected phosphorus is probably over.
Hemoglobin 10.9 versus goal of 10-11. First time under 11 – Yeah!!!!
Glucose 121 versus goal 70-160. Blood draw was non-fasting and after breakfast so this is outstanding!
Lastly, Creatinine of 7.27 down from 7.5 last month. Just of interest and since I am on dialysis does not, to my knowledge, factor into my treatment.

Coming up later this week, I have a dermatologist appointment to cut out some skin cancer and look at a funky growth on the back of my head that is bothersome, and a GP appointment for a blood draw to ensure that my blood still clots as it should so I can keep on using testosterone injections, and whatever else pops up out the woodwork. Stay tuned.

BTW I just noticed on the lead photo I took of the Heparin bottles Fresenius supplied that heparin is derived from “porcine intestines” which is a polite way of saying pig intestines.

Worst Drain Night on Dialysis EVER

September 8, 2023 / Henry Feeser / 1 Comment

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.

Too Much Monkey Business: My Dialysis Day

September 7, 2023 / Henry Feeser / 0 Comments

Chuck Berry had a less-than-well-known song named “Too Much Monkey Business.” It is embedded at the blog’s end. That’s what my last several days have felt like. My wife and I have driven thousands of miles without a flat tire. In the last week, we have had two, one on each of our two BMWs. The BMW X5 that we are going to load up with peritoneal dialysis supplies for our forthcoming trip to visit with relatives in Indiana is in the body shop to have a dent removed from the rear hatch door where I put the garage door down on it. We took it in Monday and not a word has been heard from the shop since although I was promised that we would be informed ASAP on how long repair was going to take.

Yesterday I had my monthly labs with Fresenius. Since it was my quarterly visit, my catheter lead was changed out which takes some time, I picked up supplies that Fresenius provides, had blood drawn, etc. I was informed that Fresenius will be providing flu shots but they as yet don’t have info on when they will be available. Both my wife and I are scheduled to have the standard flu shot, the new COVID shot, and an RVS in the coming weeks at CVS. Tomorrow I hope to have the initial lab readout and will share on tomorrow’s blog any/all areas of apparent deviation from expected norms. Chuck Berry is next:

Pigs and Kidneys

September 6, 2023 / Henry Feeser / 0 Comments

There is a saying “You can’t make a silk purse out of a sow’s ear.”This proverb is first found in English in Alexander Barclay’s Eclogues. Barclay (1475? – 1552) was a Scottish clergyman and poet who is believed to have been the first to write pastoral eclogues in English. In this use, it means you can’t make something good out of something bad. However, research into the use of pig’s parts in humans has been anything but unsuccessful.

In the far distant past, while a junior in electrical engineering at Purdue University, I was part of a research team exploring the electrical synopsis of swine, aka, pigs. We would put the pigs to sleep, go into their spinal cord, and attempt to ascertain what electrical signals resulted in various stimuli applied to the pig. It was interesting stuff and I got paid well for having fun learning more about lab procedures and working across the aisle with veterinarians.

Ed Cara stated in the 8/31/2023 Gizmodo “Surgeons at New York University have reportedly reached another milestone in making pig-to-human organ transplants a reality. They now claim to have transplanted a genetically engineered pig kidney that has survived inside a human body for six weeks and counting—the longest period yet. It’s likely that larger clinical trials will be in the near future.” You may read the entire article at this link:

Given my background and interests especially in research leading to better outcomes for kidney failure treatment, I next turned to my Poe AI to ascertain more about the historical background of pig parts. The following for your historic edification is from Poe:

Introduction:

Throughout history, humans have sought innovative solutions to overcome various health challenges. One such solution that has captured the imagination of medical professionals and researchers alike is the use of pig parts to repair human ailments. The idea of xenotransplantation, the transplantation of organs or tissues from one species to another, has been a topic of interest for centuries. In this blog post, we will explore the fascinating history of using pig parts in medicine and delve into the current status of this practice.

Ancient Origins:

The concept of xenotransplantation can be traced back to ancient civilizations where it was believed that the properties of an animal could be transferred to a human recipient. In ancient India, for example, the Sushruta Samhita, a Sanskrit text dating back to the 6th century BCE, described the use of animal bladders to repair damaged human bladders.

Advancements in Transplantation:

Fast forward to the 20th century, when significant advancements in transplantation techniques and immunosuppressive therapies paved the way for the exploration of xenotransplantation. Pigs emerged as the most promising candidates due to their anatomical and physiological similarities to humans, making their organs and tissues compatible for transplantation.

Pig Heart Valve Transplants:

One of the earliest and most successful applications of pig parts in human medicine has been the transplantation of pig heart valves. The first pig-to-human heart valve transplant took place in 1962, and since then, millions of patients have benefited from this procedure. Pig heart valves are used to replace damaged or diseased human valves, providing a lifeline for those suffering from heart conditions. ( I do believe my sister-in-law has benefitted from such valve replacement.)

Insulin Production:

Another significant breakthrough came in the field of diabetes treatment. Before the advent of synthetic human insulin, pig insulin was widely used to manage diabetes. Pigs possess a similar insulin structure to humans, making their insulin compatible for therapeutic use. Although synthetic insulin has largely replaced pig insulin today, the early use of pig insulin revolutionized diabetes care and saved countless lives.

Challenges and Ethical Considerations:

While the use of pig parts in human medicine has demonstrated immense potential, it is not without challenges. One of the primary concerns is the risk of transmitting infectious diseases from pigs to humans. Pigs harbor retroviruses, such as porcine endogenous retroviruses (PERVs), which could potentially infect human recipients. Extensive research is being conducted to develop strategies to eliminate PERVs and ensure the safety of xenotransplantation.

The Future of Xenotransplantation:

Despite the hurdles, recent scientific advancements have reignited interest in xenotransplantation. Researchers are exploring genetic engineering techniques, such as CRISPR-Cas9, to modify pig genes and eliminate the risk of viral transmission. This breakthrough could potentially open doors to more widespread use of pig organs in human transplantation, addressing the critical shortage of human donor organs. This is the thrust of the linked article at the lead.

Conclusion:

The use of pig parts to repair human ills has a rich and storied history. From ancient civilizations to the cutting-edge research of today, this field has shown remarkable promise in improving human health outcomes. While challenges and ethical considerations persist, advancements in genetic engineering offer hope for a future where xenotransplantation becomes a viable and widespread solution to the organ shortage crisis. As science continues to push boundaries, the journey from pigs to people is poised to transform the landscape of modern medicine, ushering in a new era of hope and healing.

End Poe

I hit the wall – twice

September 5, 2023 / Henry Feeser / 0 Comments

It is a well-documented fact that the weather here in North Texas has been brutal this summer, with forty-plus days of triple-digit temperatures. This Labor Day Weekend has been no different with highs of at least 100 both Saturday and Sunday. What has this got to do with dialysis you ask?

This past Saturday I traveled about an hour north to where our son and his spouse are building an ICF home in Palo Pinto County, Texas. As the morning progressed, we were in full sun working on putting up trim for new garage doors. Actually, our son was doing the work and I was sitting on my butt watching him and acting as a gopher. By mid-morning I was not feeling very well and headed back home; the heat was too much and I wasn’t even working. That’s hit the wall number one.

Sunday my wife and I woke up to an alarm from our septic tank informing us that the sump pump was not operating and the tank was filled up to the alarm level. Luckily, our son is an expert in these matters so at 0800 I called him and by 1100 he was at our home. Together we troubleshot the problem which turned out to be a faulty float switch power cord. While we had it opened up, we installed a new sewage sump pump and float switch. In doing so, we were working in full sun and again, I got overheated and had to escape to our air-conditioned home. Our son is 61 and works outside all the time and was sweating but OK with the heat which by this time was again 100. Hit the wall number two.

Any intelligent person would begin to get the idea that maybe, just maybe, they can’t stand the heat like they were accustomed to. Why is this? For me, is it directly related to being on peritoneal dialysis? Does PD take the starch out of your body to the extent that it drastically reduces your physical stamina? Is it a product of aging (I’ll be 85 in four months.) For me, it has not been a gradual phenomenon but like the edge of a cliff; once over the edge, that’s it.

Recognizing and understanding your physical limitations while undergoing peritoneal dialysis is crucial to maintaining a fulfilling and safe life. Embracing these limitations doesn’t mean surrendering to them; rather, it involves adapting, seeking assistance when necessary, and prioritizing self-care. That’s what I’m all about, wall or no wall.

Select a Female Doctor, Given the Choice?

September 4, 2023 / Henry Feeser / 1 Comment

Julie Wernau in an article in the August 31, 2023, WSJ titled “Female Surgeons Achieve Better Results Than Male Counterparts” states “…the differences aren’t about technical skill, but about listening to patients and choosing appropriate care.” While this study was based on surgeons, we can postulate that it applies across a broader spectrum of health care in general. At the end of this blog, I’ve included a summary of the article provided by Poe for your edification.

Medicine is by far NOT the only area where it has been postulated that women’s involvement “improves the breed.” Numerous studies have found that Women on boards can have a significant impact on firm performance. They can improve managerial duties through their preparation of meetings, different viewpoints, and leadership skills. Women on boards can also improve companies’ strategic decision-making, leading them to consider a wider range of options. While in an academic position at Purdue University, my own research found that increasing the number of women in senior positions in a company, called the C-Suite, improved the happiness rating of the firm as captured by employee turnover. More women on boards, less turnover. (Turnover is employees leaving the company for their own reasons.)

I am blessed to have as my Nephrologist a female doctor named Dr. Taryn Turner, DO. She is the embodiment of the findings for surgeons cited above and summarized below. Her online Google evaluation – of 76 respondents is a perfect 5.0 out of 5.0. Comments include “Dr Turner is kind, professional, competent and cares about her patients. She is a very good communicator and takes the time to listen to her patients and their concerns.” And on and on of the same ilk.

The bottom line of this blog is, at least if all else is equal, strongly consider a female doctor for your dialysis treatment. My experience is you will be well cared for with empathy and understanding. Odds are, more so with a female nephrologist.

The following is a Poe AI summary of the WSJ article:

Two research studies published in JAMA Surgery have found that female surgeons spend more time in the operating room and their patients experience fewer postoperative complications compared to patients treated by male surgeons. The first study followed 1.2 million Canadian patients undergoing common surgeries between 2007 and 2020. It found that patients treated by female surgeons were less likely to experience adverse postoperative issues, including death, at both 90 days and one year after surgery. Even after accounting for various factors that could affect surgical outcomes, such as patient age, surgeon experience, and hospital setting, the results remained consistent. The study also revealed that when male surgeons treated female patients, outcomes were slightly worse. The second study analyzed over 100,000 Swedish patients who had undergone gallbladder removal surgery. Female surgeons had longer operation times but their patients had shorter hospital stays and less invasive surgeries. Male surgeons spent less time per operation and experienced complications more frequently. These findings add to the existing body of literature that suggests better outcomes for patients treated by female doctors. It is important for hospital systems to examine their own data and practices to understand the underlying factors contributing to these differences. However, the studies emphasize that gender should not be the sole basis for choosing a physician. The field of surgery is still predominantly male-dominated, and efforts are being made to encourage more women to enter the profession.

Couple More Dialysis Bits and Bobs

September 1, 2023 / Henry Feeser / 1 Comment

After not hearing from the Fort Worth General Surgeon’s office that is supposed to be scheduling me for a look-see at my catheter, I called them this morning. I was informed that indeed I was on their schedule for surgery by Dr. Tan at 1130 hours on 10/04/2023. Recall that this is in connection with the plethora of slow drain issues I have been experiencing from the get-go with the Fresenius Liberty Cycler. Obviously Dr. Tan is a very busy surgeon scheduling me as far out as his office did. Luckily, I am not in extremus.

A while back I posted a video walk-around of the storage areas in our home which house my Peritoneal Dialysis supplies. Today we had our monthly delivery by Fresenius and I thought it would be of interest to view what our storge looks like “full up.” By full up I mean we have stored a month’s supply plus a could of weeks which is what is recommended. The video won’t win any Pulitzer Prizes but here it is:

Review of new Cycler alarms to date

August 31, 2023 / Henry Feeser / 1 Comment

I have been using the newly replaced Fresenius Liberty Cycler long enough now to be able to make meaningful comparisons to the previous, alarm-prone cycler I was stuck with for so many months.

Before we jump into any data, a few comparisons:

The new cycler is much much quieter and faster. Faster how? My total time on the cycler which I log every morning has reached a low of 10 hrs 5 minutes on two occasions.
While I have experienced a few alarms, I do not have to get out of bed and hit OK twice to silence them. After a warning alarm they fade into the background on their own.
After alarms, it seems to take forever for the old cycler to resume drain activity. It appears to me that the new cycler picks up the pace much quicker.

Some data: For the past 12 nights I have experienced alarms on 3 of 12 nights, so 9 out of 12 or 75% of nights I have had no alarms. I have experienced 5 cyclic drain alarms out of 36 possible, for a 31/36 or 86% of cycles with no alarms.

The previous 12 nights on the old cycler 9 of 12 nights I experienced alarms, or 3/12 or 25 % I did not. During this same period, I had 17 cycle alarms out of 36 possible which maps to 19 of 36 no alarms on a cycle basis for 52%.

Now comparing data in the paragraphs above of old versus new, I had three times as many days of alarms, and 5 versus 17 alarms which is over three times as many. So it’s safe to say my new cycler is a least three times better at not throwing alarms than my old cycler. This comparison completely discredits the stand taken by Fresenius “tech support” and the faceless entity “Susan” who flagrantly blocked my receipt of a replacement for months. Shame on you!