Just curious about something.

[frankswife]

Okay. I realize every person is different, but I was curious about something. For those of you on 3x weekly in-center, how many days have you ever gone (for whatever reason) between sessions and you were still "ok" ?

[nursey66]

One time, on a Friday, 1/2 hr into the dialysis rus, my hubby's vien clotted, or at least, wouldn't work, so they sent him home & he was to go on Saturday for the TX at anouther site. Well they couldn't start it at all , so he waited untill Monday, and luckily it worked then. I was pretty worried because his potassium is always on the high side. So he went 5 days between TX and seemed to be OK. His center is only open M,W,&F.

[MommyChick]

When I was on dialysis I was in-center and did M/W/F as well. I tried to never miss dialysis, but there was a time or two where I went 4-5 days with no dialysis. Due to a snow storm was one I really remember. It happened over a weekend a storm hit and our driveway was blown shut. It was a pretty long drive way to go down and everyone was getting there suv's stuck. When it hits more then just a weekend for me i would really start to feel like crap! Once I was back in to dialysis I felt much better though! If it is a longer period of time for whatever reason your not at dialysis, you just have to really watch what you eat and drink.
Best of Luck!

[jeannea]

When I was on hemo, I was Tues, Thurs, Sat. (Later switched to PD.) Once to accomadate a short vacation, I asked to do Wed morning instead of Tues night. So I was 6 am Wed instead of 4 pm Tues. that was an awful treatment. I was so sick. Just tossing my cookies. After that I never missed. YMMV.

[frankswife]

jeannea, I am asking because of a vacation. Our kids are treating us to a trip to the Adirondacks father's day weekend. The closest dialysis center is an hour and a half away from where we'll be. I managed to add Friday to Frank's schedule (after much fighting and arguing with his center) so he will dialyze Tues, Thurs, Fri and wont dialyze again until we return Tuesday. I am a little worried about him going that one extra day without but he's not worried. He says he'll just watch his fluid extra careful.

[noahvale]

jeannea, I am asking because of a vacation. Our kids are treating us to a trip to the Adirondacks father's day weekend. The closest dialysis center is an hour and a half away from where we'll be. I managed to add Friday to Frank's schedule (after much fighting and arguing with his center) so he will dialyze Tues, Thurs, Fri and wont dialyze again until we return Tuesday. I am a little worried about him going that one extra day without but he's not worried. He says he'll just watch his fluid extra careful.

No, Frank is not just adding one "extra" day between treatments - he's adding two extra days.  He's already missing a day due to the long dialysis weekend incenter schedule, made even worse if his treatment time is the usual 3-4 hours per session.  So by going from Friday to Tuesday, Frank will be missing another treatment day.   

Real time observation and now a recent study already show an increase in death, cardiac problems and hospitalizations for patients undergoing dialysis after the two-day weekend gap in treatment.  Frank's odds go up greatly by going 3.5 days, especially coupled with the recent health issues he has experienced.

From Hemodoc:  http://forums.homedialysis.org/threads/3161-The-Long-Dialysis-Weekend-Might-Kill-You-But-We-Won-t-Change

However, even with this knowledge, if he wishes to go such a long period w/o dialysis, then watching fluids won't be enough.  He'll need to watch potassium intake as well.  See if his nephrologist or GP will prescribe a bottle of kayexelate.  It is a potassium binder.  http://chealth.canoe.ca/drug_info_details.asp?brand_name_id=6119  Also, see if the clinic will run him at least an additional hour on Friday.

Personally, yes, I've gone 3 days between treatments.  Let's just say it's a lot harder on me physically the older I get and the longer I'm on dialysis, even at 6.0-6.5 hrs x 3 weekly (incenter).  It's no fun having to be so careful.  Mentally exhausting as well.  Plus, the next couple of treatments back are harder on the body than normal as well. 

And, wouldn't this be defeating the purpose of going to the Adirondacks in the first place?  Enjoying time with family?  I hope Frank will think a bit more long term - even if it's just past Father's Day weekend - and look into getting a treatment at the facility 1.5 hours away. 

Is there a way for the family to maybe spend some time in the town where the center is located or sightseeing close by while Frank's getting treatment?  Then, once he's through, all of you can have a nice dinner somewhere on the way back to the Adirondacks.  Yes, it's not the perfect way to spend part of the weekend.  But it seems this would be a less stressful scenario - for all - and Frank would have a better opp to enjoy the getaway.

Wishing you the best with whatever decision is made. ~ NoahVale
 

[Cowdog]

I did exactly what you are proposing in early April to attend and out of town event on a Saturday. I was extra careful with my fluids and actually weighed in Tuesday a kilo lower than my typical weight over a regular weekend. no problem or ill effects.

[nursey66]

I often wonder why they don't have in-center D every other day, to avoid the long week end problem for Patients ?  What's to stop them from saying " if Patients can get by on the long week end, why not try skipping 2 days all the time to save money?" I know when my husband had to skip 5 days because they couldn't get his site to work, he did OK, but stayed in bed all the last day, kept saying he was fine, but I was so worried about high potassium, a heart issue, all sorts of things that can go wrong. We had a dose of the Kayexelate in the house ,because our pharmacy doesn't keep it on hand, but he wouldn't take it without a blood test, and of coarse by then , everything was closed up for the weekend. For me, it was a scarry weekend.

[frankswife]

I'm not giving him kayexelate without knowing what his potassium level is. His level has been steady at right around 5. I'm going to talk to his neph on Tuesday and see what he thinks. Maybe we will end up having him dialyzed on that Saturday, if the center will take him on short notice. He still pees, so that helps if we have to skip Saturday, right? I waver back and forth between being excited for the trip (Old Forge is my favorite place on earth) and being terrified that something will happen and we are 45 miles from the nearest medical center. I feel selfish possibly subjecting him to danger. I believed when he began dialysis that we would never go camping again, and was thrilled that I figured a way to go. Noahvale, you brought me to my senses AND scared the hell out of me.

[noahvale]

*

[cdwbrooklyn]

When I was in-center, I took off 4 days to go to the Bahamas.  I was treated on a Saturday night and did not return to that following Thursday.  I’ve gain 14 pounds of water but had it removed within two treatments.  I felt fine because I still peep.  However, I had a good time and would do it again.  For the first time in a long time I was able to enjoy myself and not think about dialysis because I was miles away.  I believe pray changes everything with faith that’s just me.  Talk to your doctor and see what he can do.  I would hate to see you missed this trip.  Also, I know how it is to dialysis while vacationing.  If his treatment does not go well, it can ruin y’all vacation.  Anyhoo, should you guys choose to go, tell Frank to eat a lot of ice so he can stay cool and limit a lot of sugar and salt which makes you thirsty. Also, if he stays in the sun a lot it will reduce some water from his body. 
Enjoy!

[frankswife]

Frank's SW is looking into some centers in the region. The closest one just opened in March and only runs a MWF schedule. The next two closest centers have no chair time available. Theres one a 2 1/2 hour drive he's checking on. Noahvale I will take your suggestions under advisement and talk to his neph about extending the treatment a bit before we leave and about the speeds you mentioned. Thank you. Thanks to all who took the time to answer.

[JW77]

Much depends on any remaining kidney function, and what your existing blood is like. I've done 3 nights away between dialysis, and my consultant is happy for that 'occasionally' but to be honest I didn't feel that great, and of course it takes time to catch up and clear those toxins

[iolaire]

jeannea, I am asking because of a vacation. Our kids are treating us to a trip to the Adirondacks father's day weekend. The closest dialysis center is an hour and a half away from where we'll be. I managed to add Friday to Frank's schedule (after much fighting and arguing with his center) so he will dialyze Tues, Thurs, Fri and wont dialyze again until we return Tuesday. I am a little worried about him going that one extra day without but he's not worried. He says he'll just watch his fluid extra careful.

Its last minute to make plans, but I'd recommend trying to get an early Saturday shift 1.5 hours from where you are, that way he is on his normal schedule and you don't need to worry.  Maybe use the six+ hours that he dedicates to dialysis to go to the outlets or some other activity that he will not miss!  If you get the dialysis done everyone will stress less and he will not need to feel guilty/worried if he takes advantage of special food and/or drink over the weekend.