If you are a pre-dialyzor or dialyzor who wants to choose the right type of dialysis, here are 3 quick secrets you need to know.
Secret #1: Two Basic Types Of Dialysis – 5 Flavors
Pre-dialyzors and dialyzors hear me closely on this secret: Choose your type of dialysis carefully. You can do frequent and gentle dialysis in the comfort of your own home, or less frequent, but harsher dialysis at a dialysis clinic. You need to know the effects of each on your time and your body. Home dialysis comes in two flavors, hemo or peritoneal. I will explain each of these in detail, so read on..
So, here's what this really means: the type of dialysis needs to fit your lifestyle and your abilities. Are you able to do peritoneal or hemodialysis at home? These are the choices that will give you the best health, the most freedom and have the least impact on your diet..
This secret is key because If you just take the first or “easy” option of in-center dialysis, you will have a very restrictive diet. You will feel terrible after each session, and you will, in all likelihood, lose any residual function you may have. You want to maintain your residual function because, the more residual function you have, the less dialysis you will need! And, your organs will be stunned, especially the heart and brain. This can shorten your lifespan!.
My advice at this point is to find out all you can about the different types of dialysis, right now! It will affect your life and overall well being. Read the next two sections describing the different types of dialysis. It is very important to understand the impact each type of dialysis will have on your life.
I have very little good to say about in-center dialysis, except that it will keep you alive for a while. Your quality of life will very likely not be good.
- You are at the mercy of the clinic's schedule
- The techs vary widely in their ability and their compassion
- The in-center machines remove too much fluid too fast, making you feel sick after your treatment.
- The pump speeds run way to fast stressing your organs, especially your heart
- These are very common side effects of in-center dialysis
- Low BP or Pass Out
- You will have the most restrictive diet
Secret #2: Peritoneal Home Dialysis – What The Heck Is That?
The main idea with this secret is Peritoneal Dialysis (PD) is a form of home dialysis that relies on the peritoneum, a membrane in your abdomen that surrounds your organs. A catheter is placed in your belly! Dialysate fluid enters and exits the abdomen through the catheter, either manually, via gravity, or automatically via a pump. The peritoneum acts as a filter, as the blood comes through the peritoneum it encounters the dialysate which removes toxins and excess fluid. The cleaned blood then passes back through the peritoneum and on to the rest of your body.
The manual version is done several times during the day. The “automatic” version is done several times over night. In either case, the dialysate fluid “dwells” or sits in your abdomen for some amount of time before it is removed, complete with toxins and excess fluid, and then replaced with fresh dialysate..
So, here's what this means to you.
It is important to know that a catheter is placed in your belly, usually just below the belt level. This catheter is a gateway to your organs and blood. Absolute cleanliness and sterile (aseptic) methods are required to avoid serious infections. Many people are able to do this and live their life, but remember, these infections can be deadly!
The Pros of PD
- You can shower.
- Using a cycler over night will give you your day back.
- There are very few restrictions on your diet.
- Easy to travel with.
- It works great for many, if not most poeple.
- Most people on PD feel good, and go about their life.
The Cons of PD
- Automatic sometimes causes drain pain. Not everyone experiences it.
- Must be super careful with cleanliness. Peritoneal infections are easy to contract.
- The peritoneum will wear out. The duration varies with the individual.
- You cannot swim or bathe with the catheter (to avoid infection).
- You will need space for lots of supplies.
- It does not work well for everyone.
Pro or Con? You Decide
- PD takes off a lot of protein.
- So, you can eat a lot of protein rich food. It can be difficult to eat enough protein, especially if it leaks in your urine.
- PD may also remove too much potassium, if so, you will need to eat potassium rich foods!
- Bananas, Chocolate anyone?
Bottom Line for PD
This secret is key because PD is very gentle on your body and allows you to eat most anything you want, especially protein. If you are able to sleep with a PD pump at the side of your bed, you will have your days free and be able to live your life again.
If you choose manual, you will have to “exchange” dialysate 3-5 times a day, depending on your size and dialysis needs. An exchange consists of a dialysate bag hung on an IV pole. The dialysate is allowed to drain into the peritoneum. After about 4 hours, the fluid is drained from the peritoneum, and the process is repeated. You can still, for the most part, go about your daily routine. You'll just have to find a time and place to exchange the dialysate..
My suggestion to you now is to Check out PD. It is a great choice if it works for you. It works well for many people, it is gentle on the body, does NOT cause organ stunning and it gives you quite a bit of freedom and good health. Talk to your doctor and nurses about the pros & cons of PD. Ask to speak to other patients that are on or have been on PD. .
Secret #3: Home Hemodialysis – An Excellent Choice
One thing is for sure, Hemodialysis at home is an excellent choice if you are able. You will have a dialysis machine at home. In the U.S. it is usually a NxStage brand which is designed for home use. It is much smaller than the machines used in the dialysis clinics, and easier to learn how to use. There are new home dialysis machines becoming available, however, I have no experience with those.
Dialysis at home allows you to slow down the blood pump and to slow down the rate at which fluid is removed. Doing this is MUCH easier on the body than the high rates used in dialysis clinics. Your organs won't get stunned, it is easier on your fistula (an artery and a vein connected together), and you will feel ok when you get off the machine. You will be able to go on about your day or evening. Home hemodialysis can either be done short daily, or nocturnal (overnight while you sleep).
Home hemodialysis (HHD) will require that you or a partner insert 2 needles into your fistula, this is called cannulation. It is often the most intimidating part of the process, but it is worth working through it. Blunt needles are sometimes used for cannulation on “button holes”. Button Holes are kind of like pierced ears. A needle track is created with sharp needles. After several (5 or 6) days usage, a track is formed and blunt needles can be used. They are much easier and much less painful than the sharp needles. Using the button hole method requires that the same person do the cannulation each time. It will not be successful with multiple people cannulating. This is why button holes are not used in clinics.
Training for HHD takes about two weeks at your clinic. Your nurses will teach you everything you need to know before they let you go home..
This is important to you because it means HHD can be done overnight (nocturnal) while your sleep 3 to 5 times a week or short sessions daily (Short Daily) 4-6 times a week. HHD, with the correct prescription can give you as long a life as with a transplant. If you choose nocturnal, you will have your days free and you'll likely feel like doing something!
Benefits of Home Hemodialysis
- You'll feel as close to “normal” as you possibly can without working kidneys.
- Little or no diet restrictions.
- Probably won't need blood pressure medication.
- Blunt needles are much less painful than sharps.
- You can travel with some of the home dialysis machines (NxStage is somewhat portable)
- As with short daily hemodialysis, you are in control!
This secret is critical to your success because HHD can have a very positive effect on your life. In my opinion it is the best option short of a transplant (which can have its own side effects). It can give you a good quality of life. That is why I am on HHD!
The Downside of HHD
- HHD is a serious and significant undertaking.
- Not everyone can do it.
- Most people need a partner to help with the prep work and cannulation.
- Some of the boxes are very heavy.
- You will need space for lots of supplies.
- The equipment is heavy to travel with.
My husband was a huge help to me. But, I know several people who do it all themselves. It depends on you!.
Bottom Line for HHD
Home hemodialysis can give you your life back allowing you to live much more normally. It did for me. Just realize that it is a significant, and often scary, undertaking.
The Bottom Line
You may have to try the different types of dialysis to know what is the best choice for you. I initially chose Automatic PD overnight because it would fit my lifestyle the best. However, it did not work well for me at all. I felt great, but I kept getting infections (weird ones too!). Drain pain was a bit of a problem, but I was able to work around that. I would never have known without trying.
Ask as many questions as you can. Talk to people who have “been there and done that”. Choose the type of dialysis that will have the least impact on your lifestyle and let you feel your best.
Not everyone will act the same way when they finally learn these 3 types of dialysis secrets. Just don't be the pre-dialyzor or dialyzor who puts all the advantages of choosing the right type of dialysis on the shelf. You earned this knowledge, so use it wisely. Become that pre-dialyzor or dialyzor who shakes their head in sorrow for the people who had to lose control of their life. If you want to choose the right type of dialysis, be smart about it.
My next article will be about Diet and Getting the Correct Prescription. Stay tuned! this is also very important to your life and well being.
Hey, One More Thing!
Before I forget, check out my videos on dialysis where I talk about all sorts of things dialysis related. Find them here: Walking With Sue
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