Within a few months I had become quite comfortable with PD. The best part was there were no diet and fluid restrictions. I did put on some weight and flab because of all the glucose that was being absorbed by my body from the dialysis solution. I couldn't care less however.
I soon decided to take up atleast a part time job. I was feeling wasted and needed to get some activity for my brain! I took up a part time job with a family friend's software company. I would go to their office in the morning and return in time for my lunch time exchange. After lunch I would work from home.
I strongly believe that I could not have worked had I continued hemo. Well, everyone is different and what is true for me may not be true for others. But for me, I can easily say - PD worked like a charm.
That year I did the unthinkable. I went for a vacation to Kodaikanal, a hill station. This would absolutely not have been possible on hemo because the nearest dialysis center was a 4 hour drive away. One other thing that made vacations on PD possible was Baxter's excellent PD network in India. You could go to pretty much any place and there would be a supplier of dialysis fluid close enough.
I soon took up a full time job. Obul, a friend of my uncle's and I along with a few others started a software company called Effigent. I would do two exchanges at work in a separate room and would work the whole day there.
Things couldn't have been better. My work was good. I had no diet and fluid restrictions. No needles being jabbed into my arms every other day. The only problem was the two exchanges during the day. The morning and the night too were not a problem. It was only the middle two.
I discussed this with Dr. Shastry who suggested that I could consider a cycler. The way a cycler works is that you hook up to a machine at night and the exchanges are performed automatically with shorter dwells (a dwell is the period between exchanges when the fluid is cleansing your blood). That way, you do not have to do anything during the day.
The only problem is that the machine is not portable so you need to do manual exchanges during the day when you go out of town or are away from home.
We did a test called the Peritoneal Equilibrium Test. This test basically determines the rate of transfer of solutes across the peritoneal membrane. The test would indicate whether I was a 'low transporter' or a 'high transporter'. High transporters were more suited to PD using a cycler because the dwell periods were shorter on a cycler and you could get more out in a shorter period of time. Low transporters, on the other hand, are more suited to manual exchanges because the dwell periods are longer and you need the extra time so that more can be pulled off. My test returned a result of 'low average' which did not rule out a cycler but meant I may not get very good dialysis. We nevertheless went ahead with Automated PD at night using a cycler.
During this period, I changed from Dr. Shastry to Dr. K S Nayak, who was known to be a PD specialist. More than that, Dr. Nayak visited a hospital much closer to my house than the one Dr. Shastry operated from.
We did another vacation, this time in Mahabaleshwar, another hill station the next year. I did manual exchanges during this trip.
I was now leading an almost normal life apart from the exchanges at night on the cycler and morning post shower dressing of the exit site. Of course, if I lifted my shirt, to expose my stomach, you would see this cloth pouch tied around my stomach holding a plastic tube. The sight can be quite unnerving to the uninitiated!
A few months later, I switched from Dr. Nayak back to my original doctor Dr. Girish Narayen due to a difference of opinion on the brand of cycler to use.
I had finished about five years of PD by April 2004. I was featured in the 'PD Heroes' section of Baxter's quarterly newsletter.