Nephrologista introducing herself

[Nephrologista]

Hello!  I have been lurking on this board for a few months; it has been very interesting to read about your experiences on dialysis.  I am a nephrologist in the US; I don't work for one of the two big dialysis providers.  I am a little cautious about posting on message boards in my capacity as a doctor so I'll probably be circumspect as to where exactly I am, etc.  Nephrology is a pretty small world.  I have been in practice for under five years.

I have already learned so much from this board and I joined because there have been threads in which I have wanted to participate!  I will try to offer factual information where I can, but I think there are quite a few people here that will frequently beat me to it.

My 3 year professional goals with my dialysis units are to 1) improve our transplant rates, 2) start a home hemo program, 3) work with our local surgeons to get better access care.  I generally believe that we severely under-dialyze patients in this country and I am looking forward to the home hemo studies to prove what most nephrologists already know, that slower, longer, more frequent dialysis is better.

[Epofriend]

Bienvenidos Nephrologista, o quiere decir la nefrologa? Tal vez estoy adelantando... habla ud. espanol?

Welcome, it is always nice to see the professionals actually "hearing" what we've got to say. Looking forward to seeing you on the boards!

Epofriend, moderator

[Nephrologista]

Mi espanol es muy terrible, lo siento mucho.

I just wanted a user name that was explanatory and kinda pretty.   

[cloud393]

Welcome to the site.  I look forward to hearing more from you. 

[galvo]

G'day Nephrologista and . You're going to be handy to have around.

[Bill Peckham]

Welcome. It's great to have docs venturing into the deep end of the pool.


If you needed renal replacement and transplant wasn't an option what would be your preferred modality? And why.

[MooseMom]

Oh man, you are SO welcome here!  And I can't wait to read your reply to Mr. Peckham.  He's really really smart, I'll warn ya!

[Jean]

Thank you so much for joining. We are glad to have you here. So,     to IHD.

[RichardMEL]

Oh the nickname is very pretty, and kinda cute too
 

Seriously though (well that was serious, but you know what I mean ) welcome!! Can never have too many professionals on here giving us useful information and at the same time getting some of the "real world" experiences that we live day to day that can help you provide better care to your patients and perhaps understanding of what we're dealing with.

I like your goals too. You're one of the good ones - and pretty too!! 

 

RichardMEL, Moderator (and unofficial flirt  )

[Nephrologista]

Thanks everyone for the warm welcome!  I'm honored to be "talking" to Mr. Peckham.

I *think* I would prefer short daily hemodialysis at home, if transplant weren't an option.  I qualify that because I have seen many patients who are sure they want a particular modality before they get to ESRD, but then their experience once they start shows that choice wasn't right for them.  My second choice would be home nocturnal.  PD would be a distant third.  I think it offers a lot more flexibility than the in-center hemo options, but PD at its best and most intensive only offers similar cleaning to thrice weekly HD, and that's just not good enough.

I do feel a little foolish telling all of *you* what dialysis I would want, since you all have the experience as patients. 

[monrein]

A very big welcome to you Nephrologista and thanks for the work you do.  I've been super lucky to have a fantastic neph and your patients (and now us) are lucky too.  I especially want to thank you for recognizing so early in your career that the only really good medical person is the one who knows how much patients have to offer.
 

[RichardMEL]

hijacking this intro thread a bit I think i'd like home nocturnal nightly (or 5-6 nights a week). I have done in-center 3x/week for the past four years, and yep, it's not good enough.. or rather it could be better. Nocturnal would offer more flexibility in days and diet (and fluids!!!) and would make it that much easier to do the daily stuff like work etc. Yes, it would mean hooking up each night, but presuming one could sleep through it, that would be easier than sitting in a chair for 5 hours 3x/week.

Still, I'm hoping my next treatment option is a transplant.....

[Zach]

It's real good to have you join our community!
 

[MooseMom]

I qualify that because I have seen many patients who are sure they want a particular modality before they get to ESRD, but then their experience once they start shows that choice wasn't right for them. 

This is what scares me.  I've already had a fistula created in preparation for hemodialysis, and my plan is to eventually do NxStage at home just as soon as possible once I'm on D.  I have the whole scenario in my mind.  We'll do it in the evenings as we watch something interesting off our Netflix queue, which is how we spend most evenings anyway.  DH gets home from work, we have dinner, then we watch something, so once I start D, we'll just add hooking up to NxStage to our evening program.  But I'm not naive enough to believe that it will be that easy.  I'm really afraid that something unforeseen will happen that will doom me to in-clinic treatments.  It's hard to know what to plan for.  I don't know what will end up being right for me.  This so totally sucks.

[Dianejt]

 

[cariad]

the only really good medical person is the one who knows how much patients have to offer.

So true, Monrein! Well said!

  Nephrologista! I am always encouraged by meeting people such as yourself. I have had hit-and-miss luck with Nephrologists but have a good feeling about you from what you've written. Please don't feel awkward about giving your opinion on modalities - I like to know that any doctor I have has given some thought to what they would do in my situation. I appreciate honest replies, and ones not influenced by the doctor's own financial considerations, if you get my meaning....

I look forward to getting to know you better!

[Sluff]

Welcome to our forum. we are a unique community because everyone here has a voice as long as it doesn't become an attack on another member or a member who has an administration position.  Expect only the truth here even if it hurts a little, but what a better way to see the world of nephrology is there, other than from the patient or the caregivers point of view? I get excited when any healthcare provider at any level joins IHD as a member because it proves that you are more interested in us than you are of the paycheck.  That means alot to us. The plus side is we learn more from your knowledge. So thank you and feel free to post often and speak up if we are wrong in an area. We would much rather know the truth.

Sluff/Admin