I started my dialysis treatment on September 2003 and has been through it for almost seven years now. I have experienced so many things all that time, have seen fellow patients come and go , but still I’m at it up until now. A friend once asked me if I ever get tired of dialysis? Of course I do. But for someone who’s been through a lot and fought all the way, succumbing to weariness is never an option.

If you’re wondering if I ever experienced depression, well the answer is yes, I did. I was diagnosed with Chronic Kidney Failure at 26 and for someone who’s merely starting to make something of his life, the reality of my predicament is just too much to handle. I guess anybody, under the same circumstances, would feel the impact and would think about what tomorrow might bring. In fact, almost any patient (not just with kidney failure) would go through some form of depression or another. Maybe it’s simply human nature to ask the “Why’s” whenever we’re faced with life-changing events.

I did go through a state of depression while I was still at the early stages of my treatment. I still go through it now from time to time. The only difference I made is that I never let it show, not if I can help it. Depression, for me, is a mind set. The more you think about it, the more you would feel it’s effect on your life. I’m not saying that I’m numbing myself from all the pain and the weariness. All I’m implying is that when depression sets in, it’s still your choice whether to fight that feeling or simply succumb to it and allow it to conquer you instead.

I’m still here, fighting as best I can and looking forward to win an uphill battle someday. Need I say more that I chose the former? That I never allowed depression to take the most out of life, eve through the most wearying times of my treatment? They say that I’m an optimist and I tend to look on the brighter side of life. That I am. Why wouldn’t I? I’m already living on the side of life where darkness just looms beyond the horizon. Believe me, I wouldn’t deprive myself the pleasure of looking on the bright side.

I hope you would too.

- images courtesy of RLHyde and ktylerconk

Do Patients Ever Get Tired of Dialysis? is a post from: Dialysis Postings

Hypertension or high blood pressure runs in our family. Several of my relatives either died of a heart attack or stroke caused by hypertension that’s been left untreated. I had hypertension as early as my high school days, although I am completely unaware of it. It was just brought up to my attention six years ago, when I was first diagnosed with chronic kidney failure. It was both shocking and unbelievable for me at that time. Being a 26 year-old, it’s quite hard to accept at first that I am already suffering from chronic ailments and would probably face medication and treatment for the rest of my life. But there it was, already out in the open.

The kidneys play a key role in keeping a person’s blood pressure in a healthy range, and blood pressure, in turn, can affect the health of the kidneys. High blood pressure, also called hypertension, can damage the kidneys and lead to chronic kidney disease (CKD).

– Source NIDDK/NKUDIC

This might seem both alarming and outrageous, but it’s true, and it’s a fact. And I just don’t say it from research or reading journals about it, but I’m saying it from experience. Had I known myself to be inflicted with hypertension, I would have done steps to prevent it from helping destroy my kidneys. My doctor said that besides CGN or Chronic Glomerulonephritis, hypertension became one of the contributing factors that lead to kidney failure. But I was young then, and thought myself impervious to such diseases and conditions. Well, I was wrong, and paid dearly for it.

I am still suffering from hypertension up to this day simply because it’s closely associated with kidney failure. Although I am a lot wiser now than before and medications help me maintain my blood pressure at acceptable levels, I still make it a point to implement ways to keep my hypertension at bay.

• I avoid salty and sodium-rich foods as often as I can. Salt makes you more thirsty and if you drink too much water, you might experience fluid overload that will increase your blood pressure.

• I try to stay cool and avoid staying under the sun too much for the same reason that this would make you want to drink more.

• Avoid fatty and deep fried foods, as well as those that are high in cholesterol. Not only will it trigger your blood pressure to rise significantly but will also put you at risk with stroke and heart attack.

• Consult with your doctor on a regular basis and always take your medications for hypertension. Skipping them would desensitize your body to the drug and would cause dangerous spikes in your blood pressure.

It’s hard enough coping with kidney failure and dialysis alone, and even harder to manage different complications that comes along with it. But with sensible management, eager determination, and abundant amount of faith, things could go as normal as it can be for patients like me.

Be wise. Well-informed is well-prepared.

Hypertension and Kidney Failure is a post from: Dialysis Postings

I recently wrote an article on why dialysis patients must be sensible on their eating habits, and the equal importance of consulting with your Nephrologist and Renal Dietitian before starting a diet plan. This time, I’m writing about the basic minerals found in food that concerns a dialysis patient, like Protein, Potassium, Phosphorus, Sodium, etc. You can work closely with your renal dietitian to decide on the meal plan that includes some of your favorite foods and is best for you.

Your individual meal plan will be based on your age, your weight, foods you like, your dialysis treatment and other medical conditions such as diabetes, heart disease, and high blood pressure. It will be tailored to your needs but may not meet the specific needs of other patients. Most people with kidney disease must modify their intake of certain nutrients such as protein, potassium, sodium, phosphorus, and fluid. Following the meal pattern suggested by your renal dietitian will help you feel your best.

The following are some things a dialysis patient needs to know about:

• Protein is used to build and repair tissue. Several of the foods you eat contains protein. The best sources are meat, poultry (chicken, turkey, etc.), seafood, dairy products, and eggs. The best source, also called High Quality Protein, comes from red meat like beef, though it produces more excess waste in the body than other sources. Your renal dietitian might limit you from taking these.

• Potassium regulates nerve and muscle function. Since your heart is made mostly of muscle, this mineral plays a vital role in the regulation of heartbeat. Excess potassium in the body is removed by the kidneys. For people with malfunctioning kidneys, dialysis performs this job. But if you accumulate too much potassium in between treatments, it might cause heartbeat irregularities. Worse, your heart might suddenly stop if potassium is left uncontrolled. Almost all foods contain some potassium. Some foods that are very high include bananas, avocados, oranges, tomatoes, winter squash, dried fruits, milk and nuts. How often these foods can be eaten, and/or their portion size may need to be limited.

• Calcium and Phosphorus work together in the body. They are balanced to keep your bones strong and healthy. There’s an imbalance of these minerals in kidney failure but it can be restored with medications and a moderate level of phosphorus in your diet. Since calcium and phosphorus are found in many of the same foods, it is difficult to get enough calcium without getting too much phosphorus. Almost all foods have some phosphorus, but the highest levels are found in dairy products (milk, yogurt, cheese), eggs, meats, dried beans and nuts. You may be asked to take a calcium supplement and a phosphorus “binder”. It is advisable to ask your doctor about it.

• Sodium helps regulate the fluid balance in your body. High-sodium foods may upset this balance in kidney disease. Some foods that have the highest amounts of sodium are cured, processed, and smoked meats and cheeses (ham, bacon, sausage, cold cuts, cheese and snack foods like potato chips, pretzels, corn chips, salted nuts and pickles). Some foods that do not taste salty have a lot of sodium. Examples are soups, ketchup, mustard, relishes, some seasonings, steak sauces, meat tenderizers, canned or packaged foods and restaurant foods, When you prepare foods from scratch, you can control the amount of sodium used, like salt, for instance. Also, avoid using salt substitutes because they’re most likely to be high in potassium, and it’s more harmful to you than sodium.

These are meant to serve as a guide and a patient is still advised to consult with his/her doctor and renal dietitian for individual meal plans. Eating wisely and sensible food choices are vital for a kidney failre patient to stay healthy while undergoing dialysis treatment.

Food Considerations For Dialysis Patients is a post from: Dialysis Postings

Diet and nutrition are two important things a dialysis patient must consider. Food gives you energy and helps your body repair itself Your blood picks up nutrients from your food and carries them to all your body cells. These cells take nutrients from your blood and put waste products back into the bloodstream.

Good nutrition is the key to good health for everyone. It is especailly important for people with kidney disease. Even with the help of artificial kidney (dialysis), you cannot get rid of all the wastes and fluids that build up in your body from what you eat and drink. When your kidneys were healthy, they worked around the clock to remove wastes from your blood. Now that your kidneys have stopped working, Dialysis removes wastes from your blood, but between sessions, wastes can build up and make you sick. You can reduce the amount of wastes by watching waht you eat and drink.

If you’re currently undergoing dialysis treatment and is concerned about diet and nutrition, I strongly recommend consulting with your Nephrologist and Renal Dietitian. A Nephrologist is a doctor that especiallizes on kidney diseases and a Renal Dietitian is a dietitian with special training in care for kidney health. They are the people that could help you with your diet concerns and it is imperative that you consult with them first before implementing a meal plan.

This is for the simple reason that every patient has a unique dietary need that should be considered first before proposing an appropriate meal plan. It would also depend on your kidney’s remaining functions. A patient in the earlier stages of kidney failure would have a more restricted diet compared to those who are on the latter stages. This is because they’re already going through dialysis and the machines helps in eliminating excess waste. In my case, I was given a 50-gram protein/ day diet plan. Protein, being an essential mineral that your body needs and produces the most waste as well, will be your doctor’s primary consideration. Along with other minerals like potassium, phosphorus, and calcium, this is where your diet would revolve.

With sensible food choices and smart eating habits, dialysis patients are more likely to stay healthy throughout their treatment. It also minimizes the need for hospitalization, if not totally eliminate it. Together with exercise, a patient has the means to keep kidney failure at bay. One only needs sensibility, discipline, and the determination to abide by the laws that govern their wellness.

Diet and Nutrition For Dialysis Patients is a post from: Dialysis Postings

“Love is all we can take with us to the grave…”

A bit morbid isn’t it? But I must admit that there’s a grain of truth in it. You can’t take money, clothing, and any earthly thing with you when you die. But what about love? Indeed you could take the love of your family and your friends with you to the other side, for it’s in your heart and soul and nothing could take that away from you. Not even death itself. You might be wondering where am I going with this or what has this got to do with kidney failure or dialysis? Well, for two reasons, actually, that I’ve decided to blog about this subject. One is that Love is an essential need of a dialysis patient, and Two, Death is not such a peculiar matter for them anymore.

Dialysis patients needs all the love and support they can get, but most of us won’t say so. I’m not entirely sure why, and there are various reasons behind this facade. One of them is the desire to regain a certain level of normalcy to our life, telling ourselves that everything’s still the same and we don’t need that extra attention. Another is that we accept our invisible disability but doesn’t want to be a burden to our family and friends.

But you know what? I guess it’s simply the fear of being pitied. Especially by those dear to us. Know this — we dialysis patients don’t need Pity, for we already had an ample amount of that within ourselves when we were at the early stages of the fight. What we need is Love, to constantly give us the inspiration to fight. Care, to make us feel warm and included. Support, to help us ease the burden we’re carrying.

Some of us patients strive to be normal, or regain a certain amount of normalcy back into our lives. And in general terms, we are indeed still normal. We go on with our everyday business, do what we have to do, and try not to let our illness be a reason for inactivity. But at the end of each day, as we lie down to bed and when we begin to think of it as a whole, we come to realize that it’s simply not the same anymore. I guess Kidney Failure doesn’t just deprive you of your kidney’s function… it also takes away a part of yourself.

In my case, I’ve long accepted my illness, along with it’s subsequent complications and consequences. I had my share of depressions, pain, and suffering. But after six years of fighting, I’m still here, willing to continue the battle for as long as it takes. If you could see me today, you would never think that I suffer from kidney failure, or undergo dialysis treatment. But the truth is that deep inside me, all that remains is that of a weary traveler.

If somebody dear to you suffers from the illness, give them your love and support. There’s no appropriate time to give these so just give it anytime. Neither must you expect them to tell you that they’re in need of your attention, for this is not likely to happen. Simply reach out at any time and at any moment.

It’s hard enough for us patients to cope with our ailment, harder for us to brace ourselves each time we endure the rigors of treatment, and hardest for us to think that everytime we go to dialysis, there’s always a possiblity that we might not be getting back. Morbid? Yes it is, but it’s one of the uncertainties that we patients must learn to accept and live with.

A simple reminder that a family’s or friend’s patient is always there for him. A simple touch of care, a simple pat on the shoulder for encouragement, a simple nod of assurance that everything would be all right, even if it’s only half-true. Simple things that makes a great difference to suffering mind and an aching body.

A warm embrace for a weary soul.

A Warm Embrace For A Weary Soul is a post from: Dialysis Postings

CKD can go unnoticed because your kidneys have a lot of spare work capacity. Your kidneys may be able to lose more than 75 percent of their ability to function before you realize that anything’s wrong. Consequently, CKD can be quite advanced before it’s discovered. That spells trouble not only for your kidneys but for your cardiovascular system as well. The risk of cardiovascular problems — which mainly include heart attack and stroke — rises dramatically when you have CKD. In fact, cardiovascular problems are the top cause of death in people with CKD.

–Source: PCHRD Library

I went to my dialysis treatment the other day as scheduled. It went okay, generally speaking, though the only setback was that I had to endure the scorching summer heat during the travel from our house to the clinic. Not that I am complaining much but I guess you really can’t blame me for doing so. Anyway, while I was in queue, I can’t help but notice the age diversity of my fellow patients. Many in our clinic are old folks, but the equally disturbing fact that I noticed is that there are also a number of patients who seems to be barely out of adolescence.

Yes, you heard me right. There are young people in our clinic suffering from kidney failure and undergoing dialysis treatment. Isn’t it a sad and depressing fact? Yes, it is, but still a fact nonetheless.

“Anyone can get chronic kidney disease at any age…”

- National Kidney Foundation

In my case, my Kidney Failure was a secondary complication to Chronic Glomerulonephritis, and possibly, a long, undetected, and untreated case of Hypertension. Here are some list to take notice if you’re thinking of getting yourself screened for kidney disease:

You may have an increased risk for kidney disease if you:

• have diabetes
• have high blood pressure
• have a family history of chronic kidney disease
• are older
• belong to a population group that has a high rate of diabetes or high blood pressure, such as African Americans, Hispanic Americans, Asian, Pacific Islanders, and American Indians.

Source: NKF

The saying “An ounce of prevention is worth more than a pound of care” does rings true, for me in any case. If you feel it in you that you need to have your kidneys, or your general health for that matter, checked, go ahead and do it. Although it’s true that it’s hard to detect kidney failure at it’s early stages and exhibits symptoms belatedly, prevention and early detection would still make a difference.

Better safe than sorry…

Are Your Kidneys Okay? is a post from: Dialysis Postings

I was waiting for my turn at the dialysis clinic last Thursday when I overheard the conversations of the other waiting patients. Somebody has “Graduated” recently from kidney failure and dialysis treatment. In our clinic, and I’m guessing on others as well, “graduating” has two different meanings. One is that you’ve recently underwent kidney transplant, thus freeing you from the bonds of dialysis sessions; and the other is simply succumbing to the disease and passing to a much happier world. In this case, “graduated” pertains to a patient who recently died.

Pardon me if I sound a bit morbid, but death, for us patients, is an inevitable aspect of our fight against kidney failure. The moment you are diagnosed with it and required to undergo dialysis, dying is something you have to accept, whether you like it or not. I am not saying that you’ll just wait for your time and that’s it. What I am trying to emphasize is that death is part of the deal. Unless you learn to accept it, you’ll find it difficult to enjoy your remaining time.

Me… I have long accepted that reality and made peace with myself. But I must admit that news of a fellow patient dying simply want to makes you do a raincheck.

Raincheck is a post from: Dialysis Postings

How is dialysis done?

Dialysis is done by using a special fluid called dialysate. Dialysate, a mixture of pure water and chemicals, is carefully controlled to pull wastes out of your blood without removing substances your body needs.

A semipermeable membrane keeps the blood apart from the dialysate. This membrane lets the wastes and fluid in your blood flow through into the dialysate. Your blood cells and larger molecules, like protein that you need, cannot fit through the holes.

What is hemodialysis?

Hemodialysis, the most common treatment option for treating ESRD, is a way of cleaning your blood using a dialysis machine and a special filter called dialyzer. The dialyzer works as an artificial kidney, straining toxins and removing extra fluid that build up because of ESRD. However, the dialyzer does not completely replace your original kidney’s function. Remember, healthy kidneys work 24 hours a day, 7 days a week, while hemodialysis takes a few hours a day, 2-3 days a week.

What happens during hemodialysis?

During a dialysis treatment, two needles connected to hollow plastic tubes are inserted into your fistula or graft. Your blood is pumped out by the machine through one line to the dialyzer to be cleaned. Once cleaned, it is returned to your body through another plastic tube. Your nephrologist will prescribe the length of your treatment, usually four hours a day done three times a week, either Mon/Wed/Fri or Tues/Thurs/Sat, but may vary depending on your body size, laboratory results and medical condition. You will have the same morning or afternoon time for each treatment.

If I have kidney disease, will I need dialysis?

In the early stages of chronic kidney disease, you do not need dialysis. These stages can last for many years. But if your kidneys fail, you will need dialysis or a kidney transplant to keep you alive.

If I have kidney disease, how long will it be before I need to start dialysis?

Depending what stage your kidney disease is and how quickly it progresses, you may never need dialysis, or you may need dialysis right away. Dialysis is usually recommended when your kidney function is about 10-15% of normal, or about 25% if you have diabetic kidney disease, or if you have severe symptoms caused by your kidney disease, like shortness of breath, fatigue, muscle cramps, or nausea and vomiting. If you are not having symptoms, you may be able to wait a bit longer. Since chronic kidney disease often happens slowly, sometimes people do not even know how bad they feel until they start dialysis and begin to feel much better! It is important to start getting ready for dialysis or a transplant well in advance.

I am in Stage 4 kidney disease and can’t have a transplant. Can I do dialysis for the rest of my life?

Yes, dialysis is something you can do for the rest of your life. Some people have been on dialysis for 30 years or more without getting a transplant. How long you can live on dialysis, and how well you do, will depend on a number of things, including:

• How healthy you are, other than kidney disease
• How positive your attitude is (optimists live longer, depression can be treated)
• Whether you receive good quality medical care and dialysis
• How much you learn about dialysis and take an active role in your care.

Will I have to quit work when I start dialysis?

No. You dont have to quit work when you start dialysis.

Can I travel on dialysis?

Yes. With proper planning, you can travel while on dialysis. Start small—with day trips and quick weekend getaways. Then you can build up confidence and work up to longer vacations. Your center can forward a copy of your dialysis prescription and other records to the center you will visit.

If you do peritoneal dialysis, you can take your supplies with you, or have them shipped to your destination. Check with your PD nurse. Your PD nurse can help you learn safe ways to do your exchanges while camping or taking a driving trip.

Once I am on dialysis, will my kidneys get better?

The chances that your kidneys will get better depend on what caused your kidney failure. Kidney failure is divided into two general categories, acute and chronic. Acute (or sudden) kidney failure is often temporary. In chronic kidney failure, the kidneys normally do not heal.

In acute kidney failure, kidney function may recover with or without dialysis. But when the damage to your kidneys has been continuous and progressive over a number of years, as it is in chronic kidney disease, then the kidneys usually do not get better since the damage is considered irreversible. Hence, long-term dialysis is needed. While your kidneys will not get better once you are on dialysis, you may feel significantly better and live life to the fullest.

»data courtesy of Philippine Society of Nephrology«

FAQ’s Part IV is a post from: Dialysis Postings

In every dialysis session, a patient’s blood is cleaned through a dialysis machine. The process is quite simple: the machine is hooked through bloodlines in the arm, blood is pumped through the machine, cleaned, and then returned to the patient. This is a continous process in which only 300 millileters  of blood per minute is cycled throughout the 4-hour session.

You might be windering how the bloodlines are hooked on the patient? Well, first and foresmost, before you can be hooked to a dialysis machine, you must have an access for the bloodlines. There are various kinds of access for the kidney patient, and one of the most common form is the Arterio-Venous Fistula or AV-Fistula or simply Fistula. What is a Fistula?

Purpose

The surgical creation of an AV fistula provides a long-lasting site through which blood can be removed and returned during hemodialysis. The fistula, which allows the person to be connected to a dialysis machine, must be prepared by a surgeon weeks or months before dialysis is started. When the vein and artery are joined, the vein gradually becomes larger and stronger, creating the fistula that provides vascular access years longer than other types of access and with fewer complications.

»data courtesy of Encyclopedia of Surgery«

A patient’s fistula is his lifeline in dialysis for a simple reason that without it, he cannot be hooked to a dialysis machne and cannot be treated. He is the one responsible for its care — by avoiding various things and instances that might put excessive pressure on the arm where the fistula is located. One example is lifting heavy objects with your access arm. Another is allowing your blood pressure readings to be taken on that arm. These are the things a patient must always keep in mind for the preservation of his AV Fistula.

AV Fistula – The Dialysis Lifeline is a post from: Dialysis Postings