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contemplating dialysis

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  • contemplating dialysis

    Hi All,

    I am a 31 year old male. I was diagnosed with ESRF November 2010. My GFR is currently 10 and my creatinine is 7. I was able to complete my bachelors degree in June and i am currently pursuing a paralegal certificate. My nephrologist has been insisting i put the PD catheter for a while. I believe since late 2011. I keep on postponing. I know my immune system is low but i am able to do day to day activities. I get tired too easily and i feel sleepy alot. I am always feeling cold too. for example, anytime i am exhausted and don't catch enough hours of sleep. I wake up the next morning with cold. I keep on sneezing (as if i have allergies). That makes my whole day miserable. I would have to take some benedryl at night to dry up my nose. I am also suceptible easily to common cold and flu viruses. Asides i do fill pain around my kidney area. I know i am not in good shape but i am postponing dialysis first until i can get married and also finish my paralegal certificate because right now i am single and with no family nearby. Doing dialysis will greatly take a whole lot of effort. At least i need someone that can ease my stress like helping with cooking, cleaning and i also don't want to do dailysis when going to school sort off just to reduce the work load. Luckily for me i found a beautiful girl who knows about my ailment and is willing to marry and take care of me. We are just waiting for everything to be right. By Gods grace next year december we will get married.

    On a side note. I hope to accomplish more in life. I want to go to law school. Please if you people have any advice for me i will be glad to hear them. Also specifically how i can limit my constant recurring cold. I am so glad i found this forum. I wish everyone here good health. I have been on the transplant list since march 2011. I live in Denver Colorado and if anyone want to get in touch please let me know.

  • #2
    Hello come1enjoy,

    There is no reason why you can't begin dialysis and manage all of you other life's ambitions. Based on your numbers you are in Stage V kidney failure and it's no surprise the symptoms you are experiecing. I cannot speak to the immune system issues, I felt that my immune system was bolstered by the high blood toxicity levels that preceding the commencement of hemodialysis. I've been a home hemodialyis patient for just over a year and have had little difficulty conducting treatments and working a demanding full time job that requires short notice overnight travel for several days at a time. There are challenges, indeed, but nothing my care partner wife and staff at my home dialysis clinic have not been able to address.

    Peritoneal dialysis will afford you more travel flexibility, especially if you use a cycler for nocturnal treatments. However, you must have catheter/port placed in your abdomen that must be maintained to prevent infection and will have to do fluid exchanges during the day if you do not use a cycler at nights. I didn't have the space in my abdomen for the PD dialysis fluid given the football size of my polycystic kidneys and I wasn't keen on the plumbing and having a foreign object in/on my person. Hemodialyis requires access to your blood and this best achieved through an artertiovenous fistula (AVF), which is created through the ligating (joining) of a artery and vein in your forearm or upper arm. The other less preferred options because of the use of materials that are foreign to you body would be a venous catheter (least preferred) or a arteriovenous graft. These are also more likely to clot and get infected and require more maintenance. I had a AVF placed in October 2011, well in advance of beginning hemodialysis. The vascular surgery required to place an AVF is done on an outpatient basis in most instances. There can be complications in the surgery and in the use of the AVF, as in my case with a series of infiltrations during placement of the needles. Ideally, a home hemodialysis patient uses button hole access in their AVF, which permit the use of blunt dialysis needles and effectively painless cannulation as the button hole tract tissue is much like a pierced ear, tough from regular use (sticks) as well as the flap that was cut in the fistula that is pushed open by the blunt needle to gain access to your blood.

    I have visited two DaVita Dialysis Centers in the Denver area, while on business to obtain hemodialysis that enabled me to extend my trip and stay on my 5 day per week treatment schedule. One or more of these supports PD and HHD. You can use this web site to locate units nearest you and determine the treatment modalities that they offer. I suggest you get on the stick and schedule a visit along with the necessary surgery to place a catheter for PD or a fistula for HHD.

    Regarding your constant recurring colds, I suffered with at least two terrible (2 week in duration) colds annually for the years before I started an aggressive vitamin and supplement therapy. I wouldn't consider a day without my supplements, which now contain binders for phosporus (prescription) and others that help me achieve enviable lipid (cholesterol, triglyceride) values.

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    • #3
      Thank you Stumpr54, i am very grateful for your advice. I have one question for you though, do you know if when i marry, my wife can become pregnant when i am on dialysis? Or if i have kidney transplant can my wife still get pregnant. I read someone post here saying it is nearly impossible for a female to get pregnant when her husband is on dialysis. Thank you very much. You seem to be doing great. You just bolstered my confident about this whole contemplating dialysis thing. I see my Dr on wednesday. I know you are also successful on dialysis with the support of your wife. That is what i am hoping to accomplish to get that support of a spouse before eventually doing dialysis if my health permits me because managing a 30 hour per week job, going to classes two nights per week, cooking, cleaning, doing laundry, grocery shopping, etc its takes a toll on someone. What do you think about this?. Thanks very much.

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      • #4
        Hi Stumpr54,

        I also have some more question for u and i will be glad if you can answer them. So i get it that in doing home hemodialysis, all you need is the dialysis machine, meaning you don't need any kind of liquid exchange fluid like the peritoneal dialysis? How big is the home hemo dialysis machine and what makes you to easily pack your load and go on a trip? Can the machine fit in a small luggage like the peritoneal dialysis machine? What are the disadvantages of the home hemo dialysis? Thank you.

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        • #5
          Hello come1enjoy,

          I believe that you will be able to maintain your busy lifestyle on home hemodialyis, you simply have to alot approximately 20 hours per week or about 4 hours per day that you will be treating to encompass the set up and tear down of the machine, making batches of dialysate, and conducting your treatments of between 2 and 3 hours. Realize that these 5 times weekly treatments can be conducted any time of day, depending on the demands of your schedule. I learned quickly that there is much I can and have done while sitting for 2 or 3 hours, the time it takes to complete a treatment. Examples include: watching my weekly tv shows, watching a DVD movie, watching a football game, paying bills online, reading the Sunday newspaper, reading magazines, listening to music, working on a laptop or desktop computer, and so on. The time in treatmen can easily be productive time. You could even fold laundry, once you are confident with your needle placement and secure your blood lines from the machine to you, you can have the full use of your access arm. I can and have played my electic guitars while in treatment.

          I have not read anything regarding impotence while on dialysis. While the kidneys share some of the same plumbing that are required for sex, they are sufficiently independent, as limitations in one would not affect the other. You may not be able to produce urine, but there is no reason why you would not continue to produce semen and ejaculate provided you achieve and maintain a functional erection. Depression is not uncommon amoung male dialysis patients and this alone can lead to erectile dysfunction (ED). That may be resolved with the use of medications developed to treat ED. Along with ED, dialysis patients, both male and female can become disinterested in sex and thus any any attempts prove ineffective. If you and your wife have the necessary interest/desire, I can't see what would prevent successful conception.

          The NxStage System 1 cycle is less than 24" in each of height, width and depth, and weighs 75 lbs. It is designed to be portable, and to travel with adequate protection from handling damage if contained in travel containers offered by NxStage, a soft sided case for auto travel, and aluminum case for air travel. It is larger and heavier than the PD cycler and travel with the unit does require more space and logistical planning. You would make arrangements with your dialysis clinic to have cases of premixed dialysate bags and cycler cartridges shipped to your travel destination in advance of your arrival. You may travel with enough premixed dialysate and cartridges for up to 3 treatments. The other option is to arrange for dialysis at or near your travel destination via a clinic that can accomodate your schedule. This usually needs a two week lead time to set up and is done through your home dialysis center's social worker.

          You can check out the NxStage equipment and other supplies they offer on thier website, nxstage.com. You should be able to find a dialysis center that offers home hemodialysis training in your area using the davita.com website.
          Last edited by stumpr54; 09-02-2013, 05:39 PM. Reason: Grammar

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          • #6
            Continue dialysis
            marriage counseling

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