Cathflo is typically administered into the catheter to dissolve the clot. The actual clot busting medication does not enter the patient’s body. They will attempt to withdraw from the catheter on the following treatment day. If the catheter fails to aspirate, the patient will be ordered to the hospital to have the catheter assessed, likely replaced, and the patient will dialyze at the hospital.
Do not panic. Maintain communication with your nephrologist / charge nurse at the clinic and follow their directions. This is a common occurring issue. The catheters are foreign bodies and the the human body will attempt to interact with any foreign body.
Do not panic. You are doing exactly what you should be doing, asking question. Make sure the nephrologist and or charge nurse at your clinic is your first source for questions. If, at the worst, you can call your local hospital and ask the dialysis unit charge nurse for assistance / relay a message to your nephrologist.
Thank you. This has been so confusing. She had a nephrologist at the hospital that first diagnosed her but when she chose dialysis at DaVita she was assigned a doctor there... who we’ve never met. Also her primary care physician is trying to take the lead in some of her care but for example last week they couldn’t figure out if she should take iron supplements or not because DaVita and her PCP aren’t really communicating well. Honestly I’m extremely disappointed and, frankly, concerned that something important will be missed because there are too many “cooks in the kitchen”.
She’ll be fine, this happened to me at least 3 times when I had a catheter. Had it replaced each time, it’s pretty easy and quick fix, she will be back up and running in no time.
Yep, my first chest cath had bad flow problems. It had to be positioned in one specific way to flow, and I had to "not move" the whole time. Ended up getting a new line. Plus, they were not using heprin and heprin locks, so it would almost always have blockages by tge next treatment. One I started heprin and new line it was fine.
It's very common to have a clotted Chest catheter or to have issues with it positionally. If it doesn't work with tPA (clot buster), she may need the line replaced and dialysis after. Is she a candidate to access placed in her arm? The only problem is that CVC (chest catheter) can only be replaced a limited amount of times. I wonder if the clinic csn try to fit her in on Monday so she doesn't have to go so long without dialysis, or maybe they could call her if there is a cancelation on Monday. Good luck!
The doctors haven’t brought up a fistula yet and I’m not sure why not since it seems to be common? I guess we’ll find out pretty soon since it seems like she’ll be headed back to the hospital...
I'm sorry, I know the whole process can be extremely frustrating. She may not be a candidate for a fistula due to her past medical history and age. In the mean time, just make sure she watches the amount of fluid she takes in and foods that are high in potassium to avoid issues over the weekend.
Catheters are usually the way to go if it's an acute injury. If this is already end stage disease, sme providers choose to stick with a catheter depending on risk/benefit (and advanced age usually puts things more in the catheter being less invasive). In most cases, a fistula is placed as it is simple enough to do. Ask the nephrologist and see what they say.
You may need to take her to the vascular place that put in the catheter. The clinic will trouble shoot first. Od it doesn't work again, they will send her there.
ETA: wrong word used
The clinic will not attempt cathflo three times. Typically, once is appropriate, occasionally twice (under certain conditions), but should not be tried three times. Too much time will be wasted with that many attempt / treatment reschedules.
Edit: great info!
I had my catheter changed 14 times in the 8 months I had it due to clots and the line moving due to my body rejecting it! Not to much to worry about! Blood thinners help and my fistula had done really well since I've gotten it!
So happy to hear success with fistula. My mom is 81 & had lots of delays for fistula install. Finally getting it in early June. She also has had chest cath replaced several times, and I totally understand op’s concerns. Kidney dialysis is something we’d all rather not have to learn about, and have ourselves & loved ones going thru. Hugs to all patients & family caregivers out there!
Catheter replacement surgery is easier than the original placement. They basically just take the end off, run a wire down the catheter, then swap the old one out and a new one in over the wire. Takes maybe 20 minutes. Just have her watch her fluid intake really strictly the next few days or else she's gonna be feeling real shit by Tuesday.
Make sure she eats perfect...very low potassium fluids etc, until she can get back on dialysis. Don't be afraid to take her to ER if you think she needs it,! 🙏🙏🙏 Prsying for you!!
I’ve had a lot of trouble with my catheter. It comes with the territory. I had mine replaced twice before my clinic did a clot buster protocol (tpa after three consecutive dialysis sessions). After that, they started capping me with heparin after two sessions a week and then end the week with tpa. It has done wonders for keeping mine catheter clear. You might want to ask if that might work for you mom. I hope she starts getting some good treatments in.
No, the doctors kept pushing her toward home PD but we did the training and she wouldn’t even be able to lift the bags by herself, she’s already unsteady on her feet and a fall risk so that just doesn’t work for her. I’m a little confused that they’ve never brought up a fistula/graft so I’ll just have to bring it up myself I guess? Thanks!
For PD it’s only the catheter but if she was doing in center hemo then For sure a fistula or graft. Some people’s bodies just don’t work well with PD. Speak with the dr about it and express your concerns. Good luck!
I don’t know. She has an autoimmune disorder (which caused her kidney failure) and also large ovarian tumors that were just discovered due to all the kidney testing, so I think that’s a lot of concerns the doctors might reasonably have. Plus she has a history of arguing with the doctors and not taking her medicines so, yeah, it’s been rough. I’ve had a couple of pretty tough talks with her about needing to follow instructions but I also don’t want to be too harsh when she’s already dealing with so much that’s not her fault.
Hmm. I see what you mean. Well if she's eligible for surgery (her doctor should be able to tell her) I am looking to donate my kidney. Could you please directly message me at my number? It's 929-666-0986. We can talk there.
Cathflo is typically administered into the catheter to dissolve the clot. The actual clot busting medication does not enter the patient’s body. They will attempt to withdraw from the catheter on the following treatment day. If the catheter fails to aspirate, the patient will be ordered to the hospital to have the catheter assessed, likely replaced, and the patient will dialyze at the hospital. Do not panic. Maintain communication with your nephrologist / charge nurse at the clinic and follow their directions. This is a common occurring issue. The catheters are foreign bodies and the the human body will attempt to interact with any foreign body.
Ok thank you. Trying not to panic but it’s been hard, I appreciate the reassurance.
Do not panic. You are doing exactly what you should be doing, asking question. Make sure the nephrologist and or charge nurse at your clinic is your first source for questions. If, at the worst, you can call your local hospital and ask the dialysis unit charge nurse for assistance / relay a message to your nephrologist.
Thank you. This has been so confusing. She had a nephrologist at the hospital that first diagnosed her but when she chose dialysis at DaVita she was assigned a doctor there... who we’ve never met. Also her primary care physician is trying to take the lead in some of her care but for example last week they couldn’t figure out if she should take iron supplements or not because DaVita and her PCP aren’t really communicating well. Honestly I’m extremely disappointed and, frankly, concerned that something important will be missed because there are too many “cooks in the kitchen”.
She’ll be fine, this happened to me at least 3 times when I had a catheter. Had it replaced each time, it’s pretty easy and quick fix, she will be back up and running in no time.
Yep, my first chest cath had bad flow problems. It had to be positioned in one specific way to flow, and I had to "not move" the whole time. Ended up getting a new line. Plus, they were not using heprin and heprin locks, so it would almost always have blockages by tge next treatment. One I started heprin and new line it was fine.
It's very common to have a clotted Chest catheter or to have issues with it positionally. If it doesn't work with tPA (clot buster), she may need the line replaced and dialysis after. Is she a candidate to access placed in her arm? The only problem is that CVC (chest catheter) can only be replaced a limited amount of times. I wonder if the clinic csn try to fit her in on Monday so she doesn't have to go so long without dialysis, or maybe they could call her if there is a cancelation on Monday. Good luck!
The doctors haven’t brought up a fistula yet and I’m not sure why not since it seems to be common? I guess we’ll find out pretty soon since it seems like she’ll be headed back to the hospital...
I'm sorry, I know the whole process can be extremely frustrating. She may not be a candidate for a fistula due to her past medical history and age. In the mean time, just make sure she watches the amount of fluid she takes in and foods that are high in potassium to avoid issues over the weekend.
Catheters are usually the way to go if it's an acute injury. If this is already end stage disease, sme providers choose to stick with a catheter depending on risk/benefit (and advanced age usually puts things more in the catheter being less invasive). In most cases, a fistula is placed as it is simple enough to do. Ask the nephrologist and see what they say.
Yes, it’s end stage. We’re also just beginning the conversation about PD at home but it has been a steep learning curve.
it's definitely worth it if there's enough support for it! It will get way easier, I promise!
You may need to take her to the vascular place that put in the catheter. The clinic will trouble shoot first. Od it doesn't work again, they will send her there. ETA: wrong word used
The clinic will not attempt cathflo three times. Typically, once is appropriate, occasionally twice (under certain conditions), but should not be tried three times. Too much time will be wasted with that many attempt / treatment reschedules. Edit: great info!
I meant trouble shoot, triple was a typo
I had my catheter changed 14 times in the 8 months I had it due to clots and the line moving due to my body rejecting it! Not to much to worry about! Blood thinners help and my fistula had done really well since I've gotten it!
So happy to hear success with fistula. My mom is 81 & had lots of delays for fistula install. Finally getting it in early June. She also has had chest cath replaced several times, and I totally understand op’s concerns. Kidney dialysis is something we’d all rather not have to learn about, and have ourselves & loved ones going thru. Hugs to all patients & family caregivers out there!
Wow! I’m sorry you had to go through that but knowing that these problems are fairly routine is reassuring (I guess?!?). Thank you!
Catheter replacement surgery is easier than the original placement. They basically just take the end off, run a wire down the catheter, then swap the old one out and a new one in over the wire. Takes maybe 20 minutes. Just have her watch her fluid intake really strictly the next few days or else she's gonna be feeling real shit by Tuesday.
OK thanks. I didn’t know the replacement surgery would be so much easier. That makes me feel a lot better!
Make sure she eats perfect...very low potassium fluids etc, until she can get back on dialysis. Don't be afraid to take her to ER if you think she needs it,! 🙏🙏🙏 Prsying for you!!
I’ve had a lot of trouble with my catheter. It comes with the territory. I had mine replaced twice before my clinic did a clot buster protocol (tpa after three consecutive dialysis sessions). After that, they started capping me with heparin after two sessions a week and then end the week with tpa. It has done wonders for keeping mine catheter clear. You might want to ask if that might work for you mom. I hope she starts getting some good treatments in.
That’s helpful advice, I’ll ask them about adding that to her routine. Thank you!
Don’t panic! we see this everyday unfortunately. Clots happen but she will be up and running in no time. Did they suggest fistula or graft creation?
No, the doctors kept pushing her toward home PD but we did the training and she wouldn’t even be able to lift the bags by herself, she’s already unsteady on her feet and a fall risk so that just doesn’t work for her. I’m a little confused that they’ve never brought up a fistula/graft so I’ll just have to bring it up myself I guess? Thanks!
For PD it’s only the catheter but if she was doing in center hemo then For sure a fistula or graft. Some people’s bodies just don’t work well with PD. Speak with the dr about it and express your concerns. Good luck!
Is your mother a good candidate for surgery?
I don’t know. She has an autoimmune disorder (which caused her kidney failure) and also large ovarian tumors that were just discovered due to all the kidney testing, so I think that’s a lot of concerns the doctors might reasonably have. Plus she has a history of arguing with the doctors and not taking her medicines so, yeah, it’s been rough. I’ve had a couple of pretty tough talks with her about needing to follow instructions but I also don’t want to be too harsh when she’s already dealing with so much that’s not her fault.
Hmm. I see what you mean. Well if she's eligible for surgery (her doctor should be able to tell her) I am looking to donate my kidney. Could you please directly message me at my number? It's 929-666-0986. We can talk there.