Sunday, February 10, 2008

CCPD Part II - Training

In the last post (CCPD, at last!), I left you all with the good news about my being able to sing again. I will elaborate on the process to accomplish that in another post. Let's go on with the story of the CCPD training, right now.

We started opening packages, the nurse and I - the fluid bags, and the CCPD "cassette" that has all the tubing required to accomplish the dialysis. There seemed to be miles of tubing, lots more than with manual exchanges. There was also this handy-dandy little mechanical thingamajig that we were to use to connect the tubes to the bags, and which was much safer than using our hands. I was flabbergasted when she told me we were going to use all three bags. She gave me a set of instructions on how to program the machine, which I dutifully followed, and then the machine was ready. She showed me how to work the lever on the front to insert the CCPD cassette, and then we started sorting out the various tubes attached to it. This was the drain line, that one with the red clamp was the line that went to the first bag, the next two went to any intermediate bags, and then the last tube with the blue clamp would go to the bag that would be used for the final fill.

Conveniently enough, there was a drain just at our feet, in that room that was used for CCPD training. In real life, at home, I would need to use a 12-foot drain tubing extension to drain directly into the toilet. Then we started using that little thingamajig to punch the tubes through to the bags, in order. Then it was time to "prime" the tubing - the machine would pump fluid through all tubes in use and make sure that it was all clear for fluid to flow in whichever direction it needed to. The priming takes about 5 minutes, so I started chattering (brainlessly, because I was nervous and excited). Once the machine beeped its OK, we checked to see that there was fluid to the top of the line that I would attach to my catheter - the patient line, as it is called. Then it was time to connect - and once that was done, all I had to do was hit GO. The machine drained the fluid out, pumped a new amount in, waited about 20 minutes, drained again and filled once again. Each drain-fill-dwell set is called a cycle, and for my training we would only be setting up the machine for 2 cycles, then final fill. This would take about 2 hours, during which I tried to nap, but only succeeded in dozing now and then because I would start awake each time the machine made any kind of noise.

I was wondering how the fluid in the other bags would be heated up to comfortable temperature, because only one bag was actually on the heating stand. Then as I watched the machine go through its priming phase, I got it - the first bag, being heated, would be used for the first drain/fill cycle, then while the dwell phase was going on (in this case for 20 minutes or so), the machine would mix around the fluid in the other bag(s) into the bag on top so by the time the next drain/fill cycle came around in 20 minutes, there would be fresh heated fluid in the bag on top! Neat idea, I must say. In real life, at home, my dwell time is about an hour and 45 minutes, plenty of time to heat all bags...

We finished up by 11:30am on Thursday, and I was home and online to work by 12:45pm. I didn't get to take the machine home that day because the one ordered for me hadn't arrived yet, because of weather delays in the mid-west. So I still had to come home and do my other 3 exchanges for the day. But that night was my last manual exchange - I haven't had to do a manual exchange since, and it is GRRRRRRR....EAT!

The next day, I left the house only at 7am, sure that Friday traffic wouldn't be bad at all, and I was right. I got there by 7:30am, but was left cooling my heels until 8am. This time, it was my own machine (it had arrived the previous evening), and the nurse merely watched while I went through the steps of programming the machine, and setting it up for that morning's 2 hour, 2-cycle session. She pointed out a thing or two that I missed along the way, and then started discussing emergency procedures - what to do if the power goes out, what to do if you need to disconnect right away, what if the machine shows an error, etc. And then she left me to the tender mercies of the machine, which clicked and whirred away cheerfully, draining and filling and mixing and dwelling. This time, the last bag was an Icodextrin bag, so I wouldn't have to do any more manual exchanges that day.

Once again, I was all packed up and ready to go by noon - training was over, and I could take my machine home with me. The machine itself, I put on the front passenger seat, and the whole trunk of my car was taken up with the supplies for the machine that would last me through Tuesday, which is when my month's supplies will arrive. The nurse had already called in all the changes to my prescription that would be necessary, so I wouldn't need to do anything more, just be home to receive the pallett-full of bags and tubes and cassettes and all.

I came home and promptly unloaded the car - supplies and all. 5 boxes of green-cap 6 liter bags (2 per box), 1 box of yellow-cap 6 liter bags, 1 box of pink-cap 2 liter bags (the Icodextrin, which is rated at 7.5% concentration), a few plastic bags of the tubing and other supplies necessary for the cycler. Took the machine out of the car first and lovingly laid it on the bed, while I figured out where to put it. There was really only one spot to put it in - on my left-hand nightstand. Which meant I would have to clear it out before setting everything up. I went back downstairs, and started unloading the boxes and figuring out which were the minimum supplies I would need upstairs for the night. Plopped the boxes on the stairs, ready to be taken upstairs, then sat back, absolutely pooped. Then my friend called and asked me to come over, because her 18-month-old twins were up. So of course I hurried over there, and spent a happy several hours. When I came back home, I was still pooped, and actually fell asleep on the sofa until 11pm.

After that, I still had to have dinner, so I did. Made a quick little chickpea chundal (I luuuurve those canned chickpeas, man!), had it with yogurt. High protein AND high fiber. Good, or what? :P

The next post (CCPD Part III - Setting up the machine)will have details of how I set up the machine at home.

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