I Hate Dialysis Message Board
Dialysis Discussion => Dialysis: General Discussion => Topic started by: wrandym on January 10, 2009, 08:08:08 PM
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Sorry-had to. Inquiring minds want to know...
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I would expand the poll to include:
o You should be allowed to eat anything you want, anytime.
o The center has the right to tell me what to do and I will obey.
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I would expand the poll to include:
o You should be allowed to eat anything you want, anytime.
o The center has the right to tell me what to do and I will obey.
So it shall be!
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I think each of us or our nurse/Dr. should be able to make this decision and how much or what.
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This is coming from the viewpoint of whether the center should allow food or drink at all
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As long as the CEO makes 26 MILLION dollars a year??? I'll eat what and when I want to.
:sir ken;
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I believe that as long as the patient is coherent, then the patient should have the option of bring in some water, light snack or have ice chips if they wish.
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From my experience yes we should be allowed to bring food (not a lot) and a drink. At my center we had a couple patients keep asking for ice chips or water, but the staff wouldn't bring them any because they were on fluid overload. If they had their own water, then staff could not stop them from having it, but would have to try to adjust for it on the machine.
I figured you would make a post wrandym after reading your reply on the other topic.
Have to agree with rerun 100%. If they make that much money, you better allow me some sort of pleasure I still can have while stuck to a chair many hours a day.
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Making our own decisions about food and drink is an important part of taking responsibility for and control over our illness. It is our duty to learn about as many aspects of kidney disease as we possibly can and management of CKD goes on 24 hours a day not just the hours we spend on the machine. No one has told me what to eat or when to eat it since I was about 6. Suggestions yes, orders no.
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I think rules are rules. if the center does not allow food or drink during treatment then they have their reasons. I would suggest finding another clinic that does allow drinking and dining if that are your desires...Boxman
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As long as the CEO makes 26 MILLION dollars a year??? I'll eat what and when I want to.
:sir ken;
I agree
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I'm against bringing any food or drink into the center. I have had to kill 9 ants at my seat in the past 3 weeks, one of which was crawling all over my permacath! Also, what I see being brought in, such as Cheetos, Jack in the Box, Burger King, dark sodas, etc., are simply not good for us due to high sodium and/or phosphorus content. If I can arrange my eating schedule around my dialysis, I don't see why everyone else can't.
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I think that we should be allowed to bring in food and a drink. I do however think that if we choose to bring in food or a drink, we should be respectful enough to clean up after ourselves, and not to bring in foods that have strong odors, which can really bug people. I sometimes will bring in a slice of pizza, but most times its just a sandwich and a drink. I admit it I am a pepsi drinker lol. There is this one lady at the center who is always eating sunflower seeds, and she spits them out into a cup which grosses me out. I mean she practically hawks them out and makes a nasty spitting noise. Not to mention they are loaded with salt, and I swear she puts on so much fluid in between her treatments and she skips treatments for a week at a time too, which causes her to be sick and throw up during treatment and I cannot stand the sound of people throwing up, and I don't feel sorry for her because shes doing it to herself. Sorry I kind of got off topic, but I guess I'm saying be sensible if you bring in food.
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I think a sensible snack and drink should be allowed. I had to do dialysis after work. I wasn't hungry before I went into the center so I took a snack or sandwich with me. After a full day of work, 4 1/2 to 5 hours in a dialysis center, and a 30 minute drive home, the last thing you want to do is make dinner for yourself. All you want to do is climb into bed.
We are all adults and should be allowed to make our own decisions. If we want that high phosphorous soda or that bag of chips, it is our choice. I can make all the suggestions to the parents of the children I teach. I can not MAKE them make the choice that is better for the child.
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If I can arrange my eating schedule around my dialysis, I don't see why everyone else can't.
Because some people aren't lucky enough to have their own transport - one person at my Dad's unit has to leave home at 11 a.m. (she's told to be ready from 9.30 onwards!) and doesn't get back until between 6.30 and 7 p.m. because she has to rely on hospital transport that picks her up then goes an hour's round trip collecting others and the same on the return journey. When she gets in (she lives alone) she is so tired that she just goes to bed so she has to eat at dialysis or she would only get breakfast. I do agree however that strong smelling, very messy foods should be avoided and that due consideration for other patients is important. :twocents;
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Ugh. I personally get nauseous at the thought of eating at the center... other peoples blood, dirty people, dirty bathrooms. I am always amazed when people can eat in that environment. To each his own I guess. I do have ice chips or something to sip on but even that is not appetizing. I can see how a hot beverage can pose a problem since the side trays that we have are not very steady and drinks are easy to spill. Since this is a medical procedure, I can understand common sense needs to be used here. Snacks...ok. Full blown meals?...maybe not.
I read somewhere that if people eat a lot during dialysis, the blood goes to the gut for digestion which can affect dialysis or vice versa.
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Where I live, the state of New Jersey has banned all food from the treatment area of all dialysis centers. I was told it is a sanitation issue.
Note that this applies to both outpatient and inpatient dialysis centers. When I was an inpatient, this required interesting scheduling of my dialysis and surgeries.
The two centers I dialyzed at provided drinks and ice on demand and allowed outside drinks. They followed the law and no food for patients or staff was allowed in the treatment area.
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I live in NJ and it is posted as soon as u walk in the door that no food is allowed in the treatment area, there is alot of sneaking snacks.
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For us dialysis patients, the lap of luxury is epitomized by this dialysis center in London England:
"A selection of sandwiches, tea, coffee and biscuits is also available for patients on request."
http://www.thelondonclinic.co.uk/specialties/dialysis__renal_medicine.aspx
Dialysis or no dialysis, no British dialysis patient wants to miss afternoon tea.
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Lol RightSide.. how very brittish - Afternoon tea. I guess that's why we have a similar thing in the land of oz.
I think as I posted in the other hot thread on this issue the key here is being SENSIBLE and using common sense. Staff should inform those morons bringing in burger king, big gulps of coke and other inappropriate stuff that not only is it not right to eat this stuff in the dialysis clinic but for God's sake it's not exactly smart for your renal diet full stop! LOL OK if folks want to do that at home fine but really. I see nothing wrong with some small sandwiches, a fruit cup and a cup of tea or water with treatment.
Sure if some states or units want to ban food (probably because of that jack that brought in a pizza and didn't share or was rude about it or spilled coke all over their seat) well that's their right and I guess it would be up to the patient to find a place that will accept them having reasonable food... I find the notion of feeling the need to SNEAK snacks in to be... well.. somehow wrong and/or sad.
Why are we sometimes treated like naughty school children rather than, in the main, rational adults?
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I think that I am all grown up, and if I want to pig out because I am starving, then I will "pig out" If I want to nibble on something then I will "nibble" on something, and pitty help the person that tells me different
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I see nothing wrong with some small sandwiches, a fruit cup and a cup of tea or water with treatment.
Sure if some states or units want to ban food (probably because of that jack that brought in a pizza and didn't share or was rude about it or spilled coke all over their seat) well that's their right and I guess it would be up to the patient to find a place that will accept them having reasonable food... I find the notion of feeling the need to SNEAK snacks in to be... well.. somehow wrong and/or sad.
Pretty much my thoughts from the beginning. Since, in the US, the outpatient clinics are a business venture (not sure about other countries), the ones with this policy should fail. If it is a law or statute, then the powers that be should have their cages rattled.
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My husband takes in a lemon/lime soda and a few tootsie pops. It is against policy to eat during session, but it is not strickly enforced. Sometimes I bring him a doughnut or a Quarter pounder hamburger, he is very careful with his diet so these occasional treats are okay- (his labs are always spot-on) he generally compensates elsewhere in his food....the idea that someone else is going to decide what is 'sensible' for him to eat makes me angry. Just like you have the right to quit dialysis- you also have the right to be uncompliant. Yes, I know it could hurt the chances for a transplant- but if drinking Coke and eating pizza is how you want to go out- you should have the freedom to do it.
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This is an interesting article on the subject. They mention at least some of the pros and cons being discussed on the two current threads.
from: Nephrology Nursing Journal, March-April, 2008 by Helene Christner, Monica Riley
http://findarticles.com/p/articles/mi_m0ICF/is_2_35/ai_n25376791
Should patients eat during hemodialysis treatments?
Should patients on hemodialysis be allowed or encouraged to eat during a dialysis treatment? As with any debate, there are always at least two opposing views and this argument is one that continues to have clinicians on the "pro" and also on the "con" sides.
One point made by the pro-side is that many of our patients have diabetes. Consistency with diet, exercise, and insulin regime is important to maintaining control of blood glucose levels. Regularly missing or skipping meals is not encouraged for anyone trying to maintain a healthy lifestyle and, in particular, it is not a good practice for the population with diabetes. Skipping meals can disrupt the balance of insulin control and can lead to life-threatening hypoglycemic complications.
In general, those supporting eating during hemodialysis advocate for allowing patients to consume small meals or snacks during their treatments in order to improve their overall nutritional status. Improving or at least maintaining the nutritional status of patients on hemodialysis is just one of the many challenges faced by health care teams; and, by improving the nutritional status of our patients, we will undoubtedly increase the odds for positive outcomes.
Because treatments last 3 to 4 hours, patients on hemodialysis are often receiving a treatment through a meal period on treatment days. Treatments are routinely scheduled for 3 days per week, potentially resulting in 156 lost meals per year. This would mean that patients on hemodialysis are missing or are prevented from eating one meal on more than 40% of the days in a given year on dialysis. If patients are not allowed to eat during dialysis, they are at jeopardy for missing meals; this equates to a lost opportunity to improve their nutritional outcomes. Even the Centers for Disease Control (CDC) suggests it is appropriate for patients to eat food brought from home to be consumed while the patients are undergoing dialysis treatment (CDC, 2001).
Those advocating for meals during dialysis see this meal and treatment time as a good opportunity to supplement and improve the patients' dietary intake by allowing patients to eat during their treatments. Both sides seem to agree that treatment time is a fortuitous time to discuss and review dietary intake, lab results, and general teaching. Because of the potential distractions, however, those arguing against eating during treatment do not see this time as appropriate for consuming any foods. There is evidence that food intake should be limited an hour or more before all hemodialysis treatments to avoid medical problems during dialysis.
If a patient's blood glucose drops during hemodialysis, those against eating during dialysis can argue that glucose testing is easily attainable while the patient is on dialysis. The dialysate electrolyte concentration is a dextrose based solution of 200 mg/dl, but despite this, some patients will experience hypoglycemia. If blood sugars do decline, juice is available in most units and may be effective in reversing the low blood sugar levels. Since treatments are routinely scheduled, patients can be encouraged to adjust meal times around dialysis treatments. In units that do not allow eating during treatment, patients usually bring in juice, a high protein/caloric nutrition drink (or other supplements), and snack meals for after treatment.
Nurses who do not support eating during dialysis have some very persuasive arguments for their position. One point often made concerns the issue of postprandial hypotension. When food is consumed, blood is shunted to the gastrointestinal track to aid digestion. Blood flow in the splanchnic and hepatic circulation is elevated. This shunting of blood reduces systemic circulating blood volume that may result in a decrease in systemic blood pressure (Kinnel, 2005). Patients who eat during dialysis have often reported experiencing nausea and vomiting, or some may have episodes of diarrhea. These types of complaints may lead patients to request to discontinue their treatments prematurely. When treatment duration is shortened, adequate solute clearances, dialysis adequacy, and outcomes are affected.
A serious blood pressure drop can occur when the shunting of blood to aid digestion is coupled with the treatment's fluid removal goal. In response to hypovolemia, the body may respond with an increased heart rate and vasoconstriction to improve venous return. Cramping may occur, and, if vomiting occurs, it may increase the risk of aspiration. Drops in systemic blood pressure may jeopardize the efficacy and/or duration of the dialysis treatment as well as adequate organ and tissue perfusion.
A point that may be made by individuals on the con-side is that eating during dialysis may lead to less-than-desired Kt/V results. They hypothesize that, when blood is shunted to the digestive organs and away from the systemic large vessels, clearances are affected. This implies that the circulating blood in the digestive organs reduces the amount of available blood to be circulated through the dialyzer, and therefore diminishes clearances.
Yet another point for not allowing food consumption during hemodiaysis focuses on the question of liability. Nonsupporters contend that when patients are allowed to consume food during their dialysis treatments, there is the possibility for litigation to occur. This now becomes a question of safety. Hypotension is the number one complication that occurs with hemodialysis, and allowing situations that may induce or exacerbate a known risk factor creates a potential for liability. This particular issue has been raised in website chat rooms, such as AllNurses.com (2003) and AllExperts.com (2005). The suggestion is that physicians and nurses may be liable if they permit patients to actively engage in a behavior that we know has the potential of causing harm.
Bringing food into the unit may require preparation, for example, heated by microwave or arranged for the patient's convenience. This assistance takes time away from the dialysis staff during an already busy schedule to stop and "play waiter or waitress." Nurses employed in units that do not permit food to be eaten during the dialysis treatment time have pointed out the burden of potential trash that staff has to clean up related to drink spills, food wrappers, and emesis.
Conclusion
The question of whether patients should eat during or just before a hemodialysis treatment is one with many facets and warrants more research. Patients who miss meals regularly may jeopardize their nutritional health status. Allowing eating during hemodialysis may pose immediate safety and infection control concerns as well as long-term treatment outcomes. The legal implications indicate that facilities need to establish policies for their patients concerning food intake during hemodialysis. Research studies have not directly answered the questions related to patients eating during hemodialysis except the risk of hypotension and related physiological responses. Until that occurs, facilities will need to develop policies, inform patients of the risks and rationales, and ensure that those policies are being followed.
References
AllExperts.com. (2005). Eating on dialysis. Retrieved February 1, 2008, from http://en.allexperts.com/q/Nephrology-975/Eating-dialysis.htm
AllNurses.com. (2003). Eating on dialysis. Retrieved February 1, 2008, from http://allnurses.com/forums/f48/eating-dialysis-33787.html#post411278
Centers for Disease Control and Prevention (CDC). (2001). Recommendations for preventing transmission of infections amongst chronic hemodialysis patients. Morbidity and Mortality Weekly Report, 50(RR-5), 1-43. Retrieved February 1, 2008, from http://www.cdc.gov/MMWR/ PDF/rr/rr5005.pdf
Kinnel, K. (2005). Should patients eat during hemodialysis treatments? Nephrology Nursing Journal, 32(5), 513-515, 568.
Helene Christner, BSN, RN, is Director of Patient Care Services for Dialysis, James B. Harrigan Center for Kidney Dialysis, Sterling, CO. She is a member of ANNA's High Country Chapter and of the Hemodialysis Special Interest Group.
Monica Riley, BSN, RN, CDN, is employed in acute care dialysis services, The Ohio State University Medical Center in Columbus, OH. She is President-Elect of ANNA's Buckeye Chapter and a member of the Hemodialysis Special Interest Group.
COPYRIGHT 2008 Jannetti Publications, Inc.
COPYRIGHT 2008 Gale, Cengage Learning
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So the past couple of treatments, when I have ate anything my blood pressure has dropped. I haven't had this problem before and am wondering what snacks people bring to dialysis or eat during treatments at home? I always thought that eating raised blood pressure. Maybe I am eating to much, although usually its a sandwich and an apple.
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litigation!? Holy crap what is this world coming to??? When did (some) people stop being responsible for themselves and decide to blame others. For crying out loud! I reckon if I eat food on dialysis and I am aware of potential issues (like bp dropping etc) then I take that risk and should deal with the reprocussions not jump on and sue the freaking unit because *I* decided to eat!! Ridiculous IMHO!
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Just eat after you leave. That way it's not their problem. You're driving home and are so hungry you have a snack in the car. Now your digestion kicks in and you crash into a tree.
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I have no idea why this question is ticking me off so much... Gawd I need a kidney!
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It tick you off because it is a direct conflict with patient autonomy. We are for the most part grown ups and allowed to do as we please until we get to the dialysis center. Then it is rules, rules, rules and it sucks!
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Thats it!!!! Even today I had to get rude to get them to up my dry weight, for christ sakes, I know me better then any other of the 600 billion people on this earth..
Pass me a sandwich Kit :sir ken;
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Okay, here goes. Did I ever tell you guys about the dialysis dinner parties I used to have when I was on home hemo many years ago? Well, I like cooking and I was teaching and doing dialysis at home in Wolfville Nova Scotia. We had been used to having dinner parties on a regular basis but then D interfered a lot since I did 5 hour sessions X3 weekly. Not sure how it happened but we soon started a regular thing, maybe every two weeks, I'd prepare a nice dinner and some modified renal friendly things for me, then I'd hook up and we'd all have a great meal with no dishes for me to do since clearly I was busy. LOL. These dinners were usually for about 6 people maximum and we had an enormous kitchen which is where I did D. Everyone sat at the table but I was able to join in and the time passed really quickly. In three years I never choked, vomited, passed out, died or sued anyone but I did follow some strict precautions. I never got drunk or even had any alcohol at all whereas if I were in a food-free clinic I might well have to take up booze to maintain my generally sunny disposition. :rofl;
I also used to do some extra remedial tutoring for some of my students during the first two hours on D. My department chairman allowed me to count three hours a week of this at home time as three of my regular weekly office hours and students could drop in then if they needed to. No cell phones back then and the students always found talking in French on the phone harder than in person anyway, so those little "visits" were also good time passers.
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wow monrein, you mean you could chew as good on the machine as you could off the machine... wowsers! what next, the skies the limit!
P.S. Wolfville is beautiful :)
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wow monrein, you mean you could chew as good on the machine as you could off the machin e
:rofl; :rofl; :clap; :clap;
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So the past couple of treatments, when I have ate anything my blood pressure has dropped. I haven't had this problem before and am wondering what snacks people bring to dialysis or eat during treatments at home? I always thought that eating raised blood pressure. Maybe I am eating to much, although usually its a sandwich and an apple.
Eating will drop the BP, because when you eat, the blood is diverted to the gut to aid in digestion. That is why some clinics don't allow it.
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litigation!? Holy crap what is this world coming to??? When did (some) people stop being responsible for themselves and decide to blame others. For crying out loud! I reckon if I eat food on dialysis and I am aware of potential issues (like bp dropping etc) then I take that risk and should deal with the reprocussions not jump on and sue the freaking unit because *I* decided to eat!! Ridiculous IMHO!
Think in this day and age it has gone to blame everyone else except yourself. Forgot where I heard that from originally, but has ben used by many now. Maybe George Carlin?
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people should be aloowed to eat and drink as long as they are responsible about it.
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When I was in clinic, I was on dialysis for 6 hours - right after work. I'd pick up something sensible on my way there, and have a light dinner after being hooked up. I couldn't get off work before 6:00 pm, and there simply was not enough time to eat before hook-up time. I couldn't schedule a later hook-up time, because I had to get some sleep before getting into work early in the morning. So, eating during dialysis only made sense and was necessary. The clinic was very understanding with all of us, because everyone there during that time had pretty much the same issues. There was one guy there that would order a pizza and eat the entire thing. That would kind of bother me, because I as trying to be sensible, and that pizza smelled good! But, I'm a grown-up, and could get over it. Not that big of a deal, but when he'd break out the potato chips....
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No More Free Coffee**
I got the last word! :bandance; :cheer: >:D
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No More Free Coffee**
I got the last word! :bandance; :cheer: >:D
No soup for you!
8)
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I am disappointed in the direction that the other thread went. We should be able to discuss and disagree on topics while still being polite, reasonable and respectful.
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Stick to the topic and we'll be fine.
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I have no idea why this question is ticking me off so much... Gawd I need a kidney!
It's ticking me off too and I am a home patient. Ok I am on PD but that is still dialysis. Currently I am sitting at my desk drinking a cup of tea and nibbling on a few dry biscuts. ohhh and doing dialysis!! I am doing an exchange. It's the same every afternoon.
I believe as adults we have the right to decide when to eat a snack. I would not last sitting for hours without a snack. (maybe thats another problem :shy; )
I can understand saying no to pizza deliveries or KFC but most people would be reasonable with what they bring in.
When I go in for an iron infusion they always get me a drink and a few sandwiches. And that makes me one happy camper! ;D
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When Rob was in-center, he could never eat on the machine, it made him sick. However, his center allowed people to eat. He had awesome Nurses and Techs, still visits his old center to see how everyone is. It would suck for him to eat at 9:00 pm, then go to bed. Being a type 1 diabetic, his sugars were nutty. Especially since he leaves the house at 5:30 am and wouldn't get home until 9 or 10 pm after a session.
Now that he does home dialysis, he is able to eat on the machine. Which he does eat his dinner on the machine on most work nights. The center that his home hemo nurse is at doesn't allow food or drink at the station. I asked why and she said it was a health code violation. I said hmmm, then why do I see a nurse at the station sipping coffee? She had no excuse for that. I told her that it was crazy to expect a person not to have anything on the machine, especially in the winter! The heat is so dry and what if you have a freaking cold and need to drink or suck on a cough drop? I told her I wouldn't put up with that and I doubt my husband would. Thankfully he doesn't need to worry about that, but still.
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I'm against bringing any food or drink into the center. I have had to kill 9 ants at my seat in the past 3 weeks, one of which was crawling all over my permacath! Also, what I see being brought in, such as Cheetos, Jack in the Box, Burger King, dark sodas, etc., are simply not good for us due to high sodium and/or phosphorus content. If I can arrange my eating schedule around my dialysis, I don't see why everyone else can't.
i get up at 4am to be ready to leave the house at 4:30 my on-time is 5:30. i can't face food at that hour, never could. however by 6 am i'm hungry. if my center didn't allow food i would be sick by 10 am when i would be able to eat again. no one and i don't care who you are is allowed to make me sick! i take breakfast, some protein and fruit. and i eat my breakfast. some people bring things that i wouldn't consider renal friendly but that's their choice. the center staff are not our keepers and don't have the right to tell us how or what we should eat. even the dietitian can only make suggestions and believe me i've heard some really weird ones. we are not children and shouldn't be treated like it. diabetics often don't have the choice of when to eat, a no eating at dialysis policy puts them in danger.
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What aggrivates me more than anything is hearing a tech say "God, I'm thirsty", and walk over to a counter in full view of all of us, pick up a Big Gulp (48 oz cup) and drink. :Kit n Stik; and we are not supposed to eat or drink. Friday I crashed big time and asked for a packet of salt in warm water and charge nurse said "Oh we don't have any of that here"..... I just want to push all the buttons myself and enter all the info so I know what's going on but nooo, can't do that either. :Kit n Stik; :Kit n Stik; :Kit n Stik;
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thegrammalady
we must have the same hours
I tried to eat that early --- right after 4am and it did not go over well
plus I have the lap band and should eat very slowly
this just sucks
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Twirl, can you get a letter from your lapband doctor that would state that you need to eat very slowly. Not large quantities or anything but if there are medical reasons perhaps your clinic will see reason. Just a thought.
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thegrammalady
we must have the same hours
I tried to eat that early --- right after 4am and it did not go over well
plus I have the lap band and should eat very slowly
this just sucks
try getting a "note" from your doctor stating that you are "required" to eat small amounts of food every 2 hours. the center can't really ignore medical requests. you might also remind them that ignoring your doctor's orders, and it doesn't have to be a neph. open them to legal action. of course do all this in writing to the head of the center, they won't be able to ignore you.
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I wanted to post this to the other thread but obviously can't. It's relevant here though...
I spoke to my primary nurse about this issue yesterday and she said something interesting that I don't think anyone else has covered. As NurseW says, eating drops your BP because the blood moves around your body to aid digestion. My primary (who was all for eating on Dialysis incidently) made the point that in the US and probably other places they tend to run for shorter sessions (eg: 3-4 hours) at higher pump speeds up to 500 and thus eating would have a bigger effect on the body's system with the movement of blood and fluid around the body. Down here (and I think in the UK too) we run at slower pump speeds for longer sessions (I do 5 hours @ 350 and I'm on the highest speed they'll allow) and thus the effect of eating is less. My nurse suggested because of the shorter sessions and higher pump speeds in the US that might be what is causing some to be sick and some centers to ban food.
She however was all for it (of course she was eating one of my musk stick candies when she said this!! :) )
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RM - That's consistent with a point made in the article I posted yesterday in this thread:
"A point that may be made by individuals on the con-side is that eating during dialysis may lead to less-than-desired Kt/V results. They hypothesize that, when blood is shunted to the digestive organs and away from the systemic large vessels, clearances are affected. This implies that the circulating blood in the digestive organs reduces the amount of available blood to be circulated through the dialyzer, and therefore diminishes clearances."
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KT/V is how Medicare judges how much to pay the center. That is why they have to have high clearances. That is why I told Twirl to go a head and let them kick you off early. It only hurts them in the long run. I feel no different if my KT/V is bad sometimes. I'd rather be comfortable and have my comfort snack.
It all boils down to MONEY and time for the staff. At DaVita the staff got bonuses if our clearances (KT/V) were good. So, if eating cuts into their wallet then NO FOOD.
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But, doesn't the Kt/V ultimately determine how well dialysis is cleaning your blood?
I noticed that the wording is "they hypothesize" not "they have demonstrated." I take this to mean that the jury is still out regarding this issue.
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But, doesn't the Kt/V ultimately determine how well dialysis is cleaning your blood?
I noticed that the wording is "they hypothesize" not "they have demonstrated." I take this to mean that the jury is still out regarding this issue.
Kt/v does measure the clearances of the blood, therefore the effectiveness of the dialysis one is receiving.
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When Len was in center, he was the baby in the place and was so critically ill that the nurses would actually tell me to go get him something to eat. They would slow the flow rate down while he was eating and the tech would sit with us while he ate. FMC did have signs posted that food and drink weren't allowed in the treatment area but doctors and director made a exception of Len because all his numbers were in the toilet. The other patients never said a word and would also ask if Len was putting on any weight. Monthly labs were the hardest because he couldn't have anything before draws and he didn't get on machine until 11 or after so I always made sure I brought something for him to have as soon as they took labs. One we started training for home, it was intirely different, the training nurse sat and ate with us. Once at home, Len ate at every treatment we did with no problems. His blood pressure would run high during treatment and wouldn't go low until about an hour after he was off. Len never did anything according to the book or so all his doctors told us. This is just my :twocents; worth and what worked for Len. I understand that everyone is different. :cuddle;
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This is kinda running in a new direction but the dietician told me Monday I might want to shorten my run times because my kt/v was high. That bothered me. My potassium and phosphorus are very high and I have problems with my legs etc etc. I am also using a catheter and am not convinced that I am not recirculating the same blood. One of the reasons I am eager to start home dialysis in a couple of weeks is to be able to have MORE dialysis. I was surprised at the recomendation to reduce my time in light of the fact of my labs.
Another question. My current (new) nephrologist as well as the home hemo nurse questioned the blood flow rate that I have been running at (500). My neph said that is very high for a catheter and questions the adequacy of the cleaning at that rate. The home hemo nurse wondered if that rate could be causing problems with (destroying) my platelets.
Any thoughts on any of this?
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My center was unhappy with the thought of any pump speed over 450 as well, although the nxStage rep who was there during my training said anything up to 500 would be fine. We've sort of compromised at about 470. I've even done up to 480 at times, but to me, it's uncomfortable, just because it feels like my arm is about to vibrate off at the higher speeds! (The machine makes too much noise for me to stand, too.) None of the concerns were about platelets, though - it was all about damage to my graft. Why don't you try running at 450 for a week or two, just to see if there's any difference in your labs or how you feel? It really doesn't add that much more time to the run to downshift by 50.
Okay, sorry we hijacked the post!
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I am on dialysis in Dax,South West France and after approximately 2 hours through my session,( starts at 7 o clock in the morning ) we have a continental breakfast ie; baguette,butter, jam ,tea, coffee, juice or hot chocolate. Its all free and I think without anything to eat I would feel ill by the end of the session. also it breaks up the time and gives you something to look forward too. I have been on dialysis for 1 year now and only in France,and the treatment I have had has been 2nd to none, after reading some stories in IHD I feel very lucky I am here. I wish it were the same for you.
Roy Manser
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Just up until last week, we could eat and drink at our clinic but they have stopped it now due to the fact that several techs and nurses have seen people die from choking on something in their mouth because of their blood pressure going so low. They said some people do have warnings that their blood pressure is going low but unfortunately, some people don't. Yeah, I was REAL pissed at first but the more the nurses talked to me about it, it's just not worth it really. Just my :twocents;
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1. You can't talk on a cell phone, because it will make the machine do terrible things...
2. You can't go on the internet because it will interfear with the machine
3 You can't eat because you will choke....
I think it's all bulls*** , I have been on dialysis 3 years and haven't seen one choking... anyone else see a choking??
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Are you serious about not using cell phones or the internet? Northwest Kidney offered laptops to their patients for internet use. We also use our cell phones all the time at both Davita and Northwest Kidney. I did see at the gym no cell phones on the cardio machines because it 'ruins the heartrate monitors'.
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Most of us are on cell phones a lot, nothing said. I run at 500, KT/V is great, phos 3.3 but migraines so today we increased dry weight a bit cuz I give off too much fluid and Dr. said might give IV Magnesium since low Mag can cause migraines as well and I think we have to start Iron again, sorry off track.
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Are you serious about not using cell phones or the internet? Northwest Kidney offered laptops to their patients for internet use. We also use our cell phones all the time at both Davita and Northwest Kidney. I did see at the gym no cell phones on the cardio machines because it 'ruins the heartrate monitors'.
EXACTLY!!! Thats just what I am talking about, lets make up rules as we go, loosey goosey, welley nelley , this crap is ticking me off, how can you do something in one place and it would be horriable to do that very smae thing in another place, give me a break.
STUPID RACKIN BACKIN &^%$%^& :shy;
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Kim - you are exactly right!
:thumbup;
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Yeah, what Kim said!
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No issue here with cell phones. I use mine all the time to annoy people with texts (except those with Hawaiian numbers who aparently don't get them :rofl;) has never been an issue never once has the machine interference thing been suggested. I use my laptop all the time too (no wireless/internet though) without issue. I did ask the first day I went in about cell phones to be sure it was OK and they said no problem.
We don't really follow Kt/V as a good measure of clearance. Down here we use pre and post bloods and compute URR and use that.
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I can understand telling a patient to lower their voice on their cell if they were too loud, but to prohibit cell phones and laptops? Please, the centers are treating the (mostly) adults like pre-schoolers. What's next, not talking at all because you might disrupt the other patients? Limiting the tv stations to view only the public access channels?? ::)
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There is no mention of dialysis clinics, but this link provides some info re. electronic interference in airplanes and hospitals:
http://electronics.howstuffworks.com/question230.htm
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I don't really see how anyone could have any appetite in my clinic. Clinically Obese Guy always takes his shoes off and stinks up the clinic. Bulbous Balding Guy alwasys brings in Lays Potato Chips and eats the whole bag while making the chips fly into the air and hit me in the side of the face. Scary Old Guy seated across the way never wears underwear, so that image makes me want to vomit. And Gassy Bulbous Guy farts during the whole treatment, waking himself up due to the volume of his gaseous emissions.
If I come in early, Bad Afro Woman craps her pants. Pig Pen Dude hasn't showered since the electoin.
Most days when I come in at night, there's crap wiped on the floors and walls of the bathroom.
Eating at Dialysis? No thanks.
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Stacy I'm so sorry but the way you write gives such vivid images I have to laugh because it's pretty funny :rofl; but not funny for you!
A guy eats salty potato chips while on dialysis??? Don't they tell him how dumb that is for him? Sounds like a dietician's heart attack.
It also sounds like your unit has choice induhvidiuals... d'oh!
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I would hate to be at Stacey's clinic by the sounds of it. If there's a mess in the bathroom, that would make me sick and complain and if they don't do anything about it, report them. However I would look into another center if possible, but your still gambling with who you get there.
Sounds like they need to limit their eating policy, a underwear policy, a no shoes, no shirt, no pants, no service policy. But now this image of his center is gonna haunt me the rest of the day and I definitely don't want to go to sleep with that image in my head. :puke;
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Sounds as though Stacy's clinic needs a no nastiness policy. No food or drink seems like a minor concern in light of all that other yuckiness.
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Oh man, Stace y I feel for you! I hate clinics!! My old clinic had a gross bathroom a few times, an I complained too. That is so wrong!! Not that I have to go much anymore, but excuse me, but do the nurses use that one too? Cuz there is no soap and I was just wonderin... EEWWW!!!!
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When Marvin was in-center, they had a "no food -- no drinks -- no ice" policy that I thought was rather strict. I wouldn't be in favor of people bringing in foods with strong odors -- but, come on, a drink or a cup of ice? Marvin used to "fake" a headache every now and then just to get a sip of water with the Tylenol they would bring him.
Now that Marvin's on home hemo, he sets the policy in his "clinic" (used to be a bedroom, converted to a mini-clinic). He allows all the food and drinks and ice the ONE patient (himself) wants -- though he usually only has a small drink and then eats the ice while he's on the machine. Oh, and by the way, the one patient in Marvin's clinic is allowed to have his treatments in his "sleep" pants -- with no underwear -- if he wants! The "nurse" (that would be me) doesn't mind! :rofl; This is another reason why we both love home hemo.
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:rofl; I really laughed out loud -
Marvin on dialysis with no britches!!!!!!!!! Rock on Marvin!!! :rofl; :2thumbsup;
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Hey on home hemo let the sleep pants go too if you want LOL :2thumbsup; Hubby is so happy to be able to do home hemo!! We make our own rules. No one sets our schedule or makes restrictions on what he can eat or drink. Don't have to listen to other people's gas emissions either!!! :yahoo; One thing that really used to bug hubby (and me) at his unit was this man that would bring in a walkman and listen to music with headphones on but he tried to loudly sing along(off key) with the music.
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My Home PD clinic has very similar rules:
1. Patient may eat or drink at any time.
2. Patient may dress as comfort requires.
3. Patient is required to tell nearby feline how handsome or pretty he/she is. (As needed and apples.) Kitty massages must be provided by patient.
4. Patient is required to work with tech (self) by resolving all machine alarms.
I cannot express how happy I am with my ability to do home PD. I don't miss going to the outpatient center 30 minutes from my home 3x a week.
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I WANT TO GO TO DIALYSIS AT THE MIKEY CLINIC
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If the clinic I use would say no to bottled water,i would comply. The man who sits acroos the pod from me has a porblem with high patassium so while on the machine ,his girlfriend will bring him a diet Mt Dew(also a diabetic).Diet Mt Dew has 2 types potassium as sweeteners.He will also eat porkrinds.
I use a very good clinic because the Doctors care.
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If the clinic I use would say no to bottled water,i would comply. The man who sits acroos the pod from me has a porblem with high patassium so while on the machine ,his girlfriend will bring him a diet Mt Dew(also a diabetic).Diet Mt Dew has 2 types potassium as sweeteners.He will also eat porkrinds.
I use a very good clinic because the Doctors care.
it's not the clinics responsibility to make sure people follow the necessary dietrestrictions. "you can lead a horse to water but can't make him drink" and unfortunately while the staff can't really force a patient to be compliant they have to deal with the fall out from those who aren't compliant.
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The thing that you gotta wonder about if a patient has problems with high K and they're in center and the staff see this guy drinking a K laiden drink wouldn't you think someone would say something to him?? Now OK if he and his gf don't want to follow that fine but sheesh. It's amazing what some people will do to themselves...
The worst part is in this day and age say something bad happens to this guy as a result of high K what bet they sue the clinic or doctors despite their obvious irrepsonsibility in the area..... That's the sort of thing that really annoys me. People who take no responsibility for their own actions but then blame others for it. Somehow it must be the clinc's fault or the doctors fault that they didn't follow their diet or had too much fluid or whatever....
*sigh*
Oh and by the way I want to make it clear I am hardly the poster child for great diet habits, but if someone said to me "your X level is high you should really avoid A B & C" I sure as hell would. I'm doing my best (within some limits) to take care of what's left of my body. Some people just don't.
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At my center there are plenty of people who sit there with a bag of chips and a large fountain soda. I talked to one gentleman about his diet and he said that he has been on dialysis for years and is not pursuing a transplant-he is going to live his life as he pleases. I guess that is his prerogative, but I am new to all of this and want to stick around a while :P I do have issues staying under my fluid intake level. I am used to having a large mug of iced tea full and at my side all of the time...gosh I am thirsty.