Red Light, Stupid Light: PD Color-coding Gone Wrong

This blog post was made by Fabio’s Mom on December 7, 2023.
Red Light, Stupid Light: PD Color-coding Gone Wrong

Let's talk about stoplights. And dialysis. Stoplights only used to tick me off when I was a very young driver (more about that later!). But dialysis, and stoplights? RIDICULOUS.

Now, follow along with me, because if you are not on peritoneal dialysis, you are like, “Do the stoplights…slow down the solution from being delivered?” "Are there some kind of stoplights on the machines?" What is happening here??

But if you are on peritoneal dialysis, I bet you a bunch of bucks that as soon as you read “Stoplights” and “Dialysis” you knew where I was going. As in the Miller Analogy Test (MAT) for dialysis patients…(Stoplight is to Dialysis as Smart is to Stupid?).

Here are the stoplightsGreen means Go, Yellow means Slow Down. Red means Stop. Now, I know this is controversial but I am going to go out on a limb here and say that we all pretty much know this system. Heck, kids even have a game based on it (Red Light Green Light)! I am a woman of a certain age now, so I don't honestly remember if there was a Yellow Light in Red Light Green Light, but if there was….we all would have known what it stood for, even as children.

I have both been to, and presented trainings where people used the “Red Light/Yellow Light/ Green Light” analogy as a tool for people to gauge how they felt about a proposed issue…If you're a green light, you're good to go with this idea; if you are a red light you really do not want to proceed with the idea. You'd like to stop the process. Yellow lights are in the middle. We “greenlight” projects.

So why, oh WHY does Peritoneal Dialysis (PD) do the following?

Weakest Solution: Yellow

Medium Solution: Green

Strongest Solution: Red

????? Have. You. Lost. Your. Ever. Loving. Minds???

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Listen, I am quite grateful for peritoneal dialysis. It is, for starters, keeping me alive—so you know, props for that. Also, I cannot even imagine the brilliance it took for someone to figure out how to do this at all—and then how to invent a machine that does it for you. So, I am not trying to split hairs here…but dumb stuff just makes me crazy…(Examples: Computers can connect to Google Earth) to. see. the. entire. earth. In seconds. My dialysis machine? Takes 20 minutes just to start. What is THAT? Cars—start and drive within seconds. At worst, maybe minutes.

My first car in college was a 10-year old Datsun B-210 deathtrap. And even that thing was ready to drive me 500 miles with a 10-minute warm-up. They can't make a dialysis machine that can wake up in less than 20 minutes? My dialysis machine wakes me up in the middle of the night because I rolled over wrong. So, YEAH, there's some room for improvement in the technology. But I can forgive all of that. It's a small price to pay for the valuable gift of health, life, and not having to go in to a hemodialysis center.

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But the BUTT-STUPID things just make me crazy. I have already written in a prior blog about my favorite “stupid dialysis trick” which is: “Do not lift over 20 pounds after your PD access is placed, because you are at an increased risk for a hernia now.” (Next breath) "Now, we are going to send you 28 boxes weighing nearly 40 pounds each every month.” Good luck storming the castle!

OK… REALLY?? But we figure it out. I live alone, and I have, and I am certain there are others out there on PD who have probably figured it out way better than I have at all.

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But YELLOW, GREEN, RED? In that order? I don't understand…when you were inventing it, were you distracted by a butterfly? Did you have a recent concussion which caused you to FORGET traffic lights exist?? Were you a bicycle only inventor? (Even they have to obey traffic signals, by the by.)

Maybe you went with a, “Well we use the 2.5% solution the most so we'll make that one the green one”? But even if you did, did you really not have a wife, or a lawyer, or you know, a five year old child who said, “Uhhh…Isn't that's going to be confusing? You know, what with the TRAFFIC LIGHTS and all?”

Listen, I know someone smarter than me is out there and has a perfectly good answer for this, and it is going to be something like: “We started out in years past with only 2.5 solution and 4.0 solution, so we made them green and red, but then we needed another strength so we had to add yellow,” or “They do it that way in other countries and we wanted to be consistent.” Or some other equally logical reason.

No one (and certainly not manufacturers of medical equipment) is eager to say, “Hey! I had the DUMBEST IDEA ON EARTH…..and then I sold it to you for years and you paid money for it!” Hahahaha. Oops! There is a pharmaceutical company commercial out there right now that says that one of the side effects of their medication is that it, “causes bad taste.” I know what they mean...they mean it causes a bad taste in the mouth. But you know, someone approved that copy out there. And Hukd On Fonix really worked on their grammar skills. Because every time I hear that commercial, I picture someone having nausea and dizziness and a ringing in the ears...and buying fuschia polyester drapes. Because they have gotten bad taste from their medication.

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And listen, I have made some of colossally dumb mistakes of my own...that sounded just right at the time. C'mon, admit it— so have you probably, too. I have a wonderful smart friend, who was the epitome of “flower power” back in the flower power days who told me he skipped Woodstock, "because it really was not going to be that good concert.” Whoopsy! My incredibly brilliant techie brother, chose a BetaMax for his first VCR, and told the rest of us to do the same, because that VHS thing was going nowhere.

So, since I am calling out the dialysis people, let me confess here: When I was 17, I myself was away in college in Florida, and drove across the state in the wee hours of the night at. I was at the time studying Adolescent Psychology (and an adolescent myself still at the time, as it turns out) so I thought one of those “Soft Shoulder” road signs they have all over Florida would be a great look in a guidance counselor's office. (We will analyze the dynamics of a future psychologist stealing road signs for her office at a different time.) It was the 80's…I don't know why we all thought it was a good idea to steal street signs…probably because our frontal lobes had not fully developed, but lots of us were doing it.

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So, in the wee hours of the night, on a deserted road, driving from the west side of Florida to the east side of Florida, LO AND BEHOLD: There, in the middle of absolute nowhere, away from prying eyes, was my “Soft Shoulder” sign! I was alone, it was a deserted road, no police to catch me=Perfect Opportunity! (“Here's your Sign,” as Jeff Foxworthy would say later in the 80's. It's like he was just begging me to steal the sign.)

But you know what? Road signs are tall! This one was considerably higher up than I had anticipated. So, being 5'4” and 17 years old, I did the most brilliant thing ever! I pulled the nose of my car right up to touch the sign, so I could climb on my bumper to reach the sign. OF COURSE! It was brilliant. You know, except for the part where I was unsuccessful at loosening the sign, and my car was stuck in sand pulled up against (say it with me) a Soft Shoulder. You know how you could tell? There was a SIGN.

Free truck vintage transport illustration

So, you know, at that moment with my wheels spinning in the sand, and later when the good old Florida swamp boys came by in their pickup truck, God bless them (you know the one…the truck with the baby seat and the gunrack next to each other, equally visible in the back window—and don't even think I am making that up), what could I say? “Din't ya see the SIGN?

Well…yeah, that's sort of a funny story…in the future I am going to invent dialysis bags and deliberately mis-order them to perplex kidney patients.

So, listen, kidney dudes, I am willing to admit it—we've all had bad days. (Call them bad taste days.) I am the first one to admit it…but doctor dudes, that was ONCE, and I was 17 years old. Woodstock? BetaMax? One time mistakes. You people have been repeating this same foible for years. This is not a complicated rocket surgeon fix:

  • Change the green solution bags to “blue” solution bags…

  • Send out notices for a YEAR in advance saying, “We are going to change this system to match the bag colors to the more known order of traffic lights.”

  • Make the yellow solution seals orange.

In “Soft Shoulder sign” units of measurement, just how many signs worth of stupid do you have to accrue before you correct this? Just sayin'.


  • Sharon Jensen

    Dec 15, 2023 9:03 PM

    I guess I have greater problems than worrying about what color the supplier applies to each strength of dialysate. I zone in on the color I am supposed to use but I am also smart enough to know the strength I require.

    You suggest that the system be changed to match the bag colors to the more known order of traffic lights but also suggest using colors that are not seen on any traffic light that I've seen. What am I missing here?
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