A little over a week ago I started having problems with low or zero pressure readings from my arterial pressure pod. After resetting the pressure pod, within a few minutes I would again have low reading. I attempted to reset it three times. I assumed this was a manufacturing error with the cartridges and begin to just ignore these low readings since I knew my fistula was working great. This continued for five days.

On the sixth day when i was ready to start I pressed run, and immediately got an error 24 – arterial pressure too low. But, I got this error before the pumps had even started. I tried everything I could think of to eliminate this problem, but nothing worked. I called NxStage support and they told me I must have crimped the arterial line when I installed the cartridge. I told them I have been doing this for almost eight years and was very sure I had not crimped the arterial line. I offered maybe I had a bad cartridge. They advised I should setup with a new cartridge and re-prime and it should eliminate this problem.

About an hour later after setting up and priming again I was ready to restart. I got the same error 24 when I pressed run again, before the pumps had even started. Now a second call the MxStage support. A different person assisted me, but was convinced I had a fistula problem. I again told her that I am very experienced with home hemodialysis and I tested my fistula by using an empty syringe to draw out blood from my arterial access, then pushed it back in, and that there was no issue with my fistula. She said I needed to setup a new cartridge a third time and that we would do a mock run to prove whether the issue was with my fistula or the cycler.

I setup again with my now third new cartridge, and re-primed. After I removed all air, I was told to leave all the connections as they were after priming and press run to start the mock run. The mock run would use saline in place of blood to allow the cycler to run like I was being treated. As soon as I pressed run I again I got the error 24. The support person agreed with me that I have a bad cycler and needed a replacement. The new cycler arrived the next day about 3:00 PM and I was back to running like normal.

What I learned from this experience was how to do a mock run. I think this is valuable in determining if you have a cycler problem or a fistula problem.

I also learned to call NxStage technical support for anything unusual that happens. I never called when I was having multiple arterial pressure pod issues because it didn’t prevent me from running. But, it may have assisted NxStage in determining earlier that I was having problems with my cycler, and may have prevented my setting up three different times to diagnose that problem. I don’t know for certain that the arterial pressure pod issues were related to my cycler failure, but since receiving the replacement cycler, I have not had any more pressure pod issues.

As always, I am very impressed with the technical support provided by NxStage and have always been very impressed with how quickly they can provide a replacement cycler.