I Hate Dialysis Message Board
Dialysis Discussion => Dialysis: General Discussion => Topic started by: AshtonsMuse on June 22, 2017, 10:03:18 AM
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Have any of you ever experienced your treatment center discontinuing your time slot with little to no notice? My husband was hospitalized recently for 3 weeks due to a severe infection in his graft and after he had been back for a week, the center said they were cutting out his time slot. He is employed and he can't just change his days/times off without it being approved by his two supervisors and the hr department. The center also cancelled his treatment several months ago (for mardi gras tuesday) because they said they didn't have any other patients that day. I find it really hard to believe that its ok for them to do that. There are signs all over the place about how important it is not to miss your treatments, but they don't seem to have to adhere to the same policy. They're also trying to get him to switch to pd so he does it at home. Not really sure that's for us. He doesn't want a tube in his stomach. I'm still very concerned about the services at this center and home pd might alleviate that.
Thanks
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This doesn't sound right... My clinic has adjusted times within the shift to make things work better. For instance, one patient needed to run for 4 hours and 30 minutes and we had to shift some times by 10-15 minutes to accommodate his time. We have also moved people to TTS second shift for non compliance to open up morning shifts for patients who come to every treatment. You can try reaching out to your ESRD Network if you are in the States to see if they can do anything. Or you can even find a different clinic in your area that is more willing to work with you. PD is great, but not for everyone. If you have qualms about it and would rather do in center HD, you should be able to do that. I would complain to the area manager or regional vice president about this.
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That will give us some options. I thought about filing a complaint, but then what happens to his treatment. I'd like to change centers but it doesn't appear anyone else offers a work shift. (I'll need to look into this more) Plus, I'm not sure his doctors go anywhere else, and we want to stay with this dr. if possible. I spoke to the administrator about it, and she said she would see what they could do, but now the nurses just call every treatment day to try to get him to come in early. He can't, and I'm getting tired of politely explaining to them over and over. We aren't even through our first year, and he's been hospitalized 8 times. I am pretty exhausted from this, and I know he is physically worn out too.
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How awful!! I am so sorry you are going through all this!! Definitely call the ESRD network in your area. They can give you the names of clinics in your area to call and check on treatment time options. Dialysis centers are supposed to give priority to patients who work. It is in their best interest as those patients generally have commercial insurance as their primary. I would remind them of that he has commercial primary insurance. That is how dialysis centers make money. Medicare and Medicaid do not generate revenue like commercial payers. I have told my patients who are transferring to other facilities this so they can get better chair times (I am not supposed to, but anything to help the patient).
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Thank you for the info. That's good to know about the work preference. He does have commercial insurance. They all just act surprised he's working. We're young(-ish), and he doesn't want to stop working. He even works on his dialysis days up until he leaves to go to the clinic. Is the area manager or regional vice president generally closely tied to the clinics? There is no respect for privacy in the center, so I worry about how he'll be treated if I complain. I'm guessing they know I don't know much since we're new and they're banking on me not speaking up. I just want my husband to survive this first year, and it has not been easy.
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I assume you are with Fresenius or DaVita. Both of those should have something similar to an area manager who is over all the clinics in a specific area. You probably could ask at the clinic for the number. Sometimes it is posted in the lobby if you look hard enough. I give all my patients the number for ESRD Network, Area Manager and RVP.
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I can't give you any advice or anything concerning the weird position 'they' are putting you and your husband in (as I'm in the UK) but what smartcookie is advising sounds like a sound plan of action.
Lots of love, luck and strength, Cas
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We're with Davita. And we're with network 13 in Louisiana. I did find that in the lobby. I'll try to look around the lobby to see if they have the area manager or RVP listed. Most of the info I can find online is old for the clinic.
Right now, they're pushing hard for my husband to switch to home pd. He's starting to think its a good idea because the clinic has not been good. He's been against it up until now, and I have to say I feel like he's only caving to their pressure. they are relentless. Calling every dialysis day to switch times wears me out and it makes his blood pressure rise. It just feels so wrong.
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Cas,
I see in your post you've done both pd and home hemo, do you mind if I ask what your preference is, and could you share any insight to both? We've watched the davita video, and talked to the pd nurse. He is concerned about infection - peritonitis - since his last hospitalization was so serious. He's also not crazy about the tube in his stomach. He's already lost a graft to infection and yet to get a fistula, so we're kind of in limbo.
Thanks,
Andrea
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I have also done both PD and HD. I currently do PD and find it much preferable to HD. I used to be offended by the belly catheter, but now I don't even notice (except to take care of it). As far as infection goes, it's all about scrupulous technique and keeping your hand both clean and away from the tips of connectors. By using the cycler at night, I have cut down-- by a lot-- the number of connections I make daily and the odds of contamination. I don't have a hugely long track record, but I've been doing PD for about a year and half with no infection (knock on wood). I absolutely HATED in center HD and might go into hospice before doing it again. I have seen some fistulas that are far more repulsive than a belly catheter.
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Dear Andrea, I never wanted PD either, but the fistula didn't work, so I crash landed into PD.
I was scared about infections too. But PD was so much easier and less restrictive in diet etc that I found it like 'no dialysis'. I did get an infection after about 2 years by being complacent I suppose. The last peritonitis was caused by an infected cerebral drain.
But CAPD where you do 4 or so exchanges per day was cool. I could still work (in a garden centre and a tearoom, so a lot of standing and being social :angel; ) I could do exchanges while the car was parked up when we went on day trips or something.
When I had the Cycler it was even more cool. You only connect once a day (before you go to bed) and disconnect when you get up. I think I did 10 hours as I have no kidneys at all.
The boxes are a lot, but you can use both arms again.
The biggest problem I had then was how my body had changed into a 9 months pregnant lady.
But I felt good. I think that if you both read as much info about the cleaning procedure etc that it could be a good choice.
Lots of love, luck and strength, Cas
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Thank you for the info. That's good to know about the work preference. He does have commercial insurance. They all just act surprised he's working. We're young(-ish), and he doesn't want to stop working. He even works on his dialysis days up until he leaves to go to the clinic. Is the area manager or regional vice president generally closely tied to the clinics? There is no respect for privacy in the center, so I worry about how he'll be treated if I complain. I'm guessing they know I don't know much since we're new and they're banking on me not speaking up. I just want my husband to survive this first year, and it has not been easy.
If they think you and your insurance might leave they will get scared and try to help. One way to approach it sort of gently would be to ask the social worker for a list of centers nearby that have the shift you need since that center is not able to meet your needs. Personally I don't' think you need to worry about treatment, if anything they will be told to be extra nice to make you happy. (This is assuming you have nearby centers.)
But you do need to be ready to switch doctors possibly. You might also complain to the doctors, if they have an ownership stake in the center they will have some pull.
Keep working if you can and continue what you are doing to get the center to work and meet your family's needs.
(by you I mean your loved one on dialysis and you...)
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I have also done both PD and HD. I currently do PD and find it much preferable to HD. I used to be offended by the belly catheter, but now I don't even notice (except to take care of it). As far as infection goes, it's all about scrupulous technique and keeping your hand both clean and away from the tips of connectors. By using the cycler at night, I have cut down-- by a lot-- the number of connections I make daily and the odds of contamination. I don't have a hugely long track record, but I've been doing PD for about a year and half with no infection (knock on wood). I absolutely HATED in center HD and might go into hospice before doing it again. I have seen some fistulas that are far more repulsive than a belly catheter.
Thank you for sharing your experience with me. I appreciate it!
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Dear Andrea, I never wanted PD either, but the fistula didn't work, so I crash landed into PD.
I was scared about infections too. But PD was so much easier and less restrictive in diet etc that I found it like 'no dialysis'. I did get an infection after about 2 years by being complacent I suppose. The last peritonitis was caused by an infected cerebral drain.
But CAPD where you do 4 or so exchanges per day was cool. I could still work (in a garden centre and a tearoom, so a lot of standing and being social :angel; ) I could do exchanges while the car was parked up when we went on day trips or something.
When I had the Cycler it was even more cool. You only connect once a day (before you go to bed) and disconnect when you get up. I think I did 10 hours as I have no kidneys at all.
The boxes are a lot, but you can use both arms again.
The biggest problem I had then was how my body had changed into a 9 months pregnant lady.
But I felt good. I think that if you both read as much info about the cleaning procedure etc that it could be a good choice.
Lots of love, luck and strength, Cas
I'm still trying to understand the difference between the two types of PD. One is at night, and the other several times daily? And what do you do with the exchanged bags? Like no dialysis would be good. This has been a hard 10 months. The hemo has definitely taken its toll on his body.
Thanks for the info, I'll share it with my husband.
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Thank you for the info. That's good to know about the work preference. He does have commercial insurance. They all just act surprised he's working. We're young(-ish), and he doesn't want to stop working. He even works on his dialysis days up until he leaves to go to the clinic. Is the area manager or regional vice president generally closely tied to the clinics? There is no respect for privacy in the center, so I worry about how he'll be treated if I complain. I'm guessing they know I don't know much since we're new and they're banking on me not speaking up. I just want my husband to survive this first year, and it has not been easy.
If they think you and your insurance might leave they will get scared and try to help. One way to approach it sort of gently would be to ask the social worker for a list of centers nearby that have the shift you need since that center is not able to meet your needs. Personally I don't' think you need to worry about treatment, if anything they will be told to be extra nice to make you happy. (This is assuming you have nearby centers.)
But you do need to be ready to switch doctors possibly. You might also complain to the doctors, if they have an ownership stake in the center they will have some pull.
Keep working if you can and continue what you are doing to get the center to work and meet your family's needs.
(by you I mean your loved one on dialysis and you...)
I like your approach. I've been speaking with the social worker lately and I could bring it up gently. We have several other options nearby that take his insurance. Thanks for the info.
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I'm still trying to understand the difference between the two types of PD. One is at night, and the other several times daily? And what do you do with the exchanged bags? Like no dialysis would be good. This has been a hard 10 months. The hemo has definitely taken its toll on his body.
Thanks for the info, I'll share it with my husband.
You fill the gut with bags of sterile dialysate (premixed in bags), let sit, and then drain the liquid from your gut into a toilet, sink, shower, etc. The cycler does this for you several times during the night automagically.
I am on home hemo, but would have loved to been able to stay on PD. As to the belly line - when it is finally removed (transplant or transition to hemo), it leaves a little scar. Much less invasive than a fistula or graft.
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I'm still trying to understand the difference between the two types of PD. One is at night, and the other several times daily? And what do you do with the exchanged bags? Like no dialysis would be good. This has been a hard 10 months. The hemo has definitely taken its toll on his body.
Thanks for the info, I'll share it with my husband.
You fill the gut with bags of sterile dialysate (premixed in bags), let sit, and then drain the liquid from your gut into a toilet, sink, shower, etc. The cycler does this for you several times during the night automagically.
I am on home hemo, but would have loved to been able to stay on PD. As to the belly line - when it is finally removed (transplant or transition to hemo), it leaves a little scar. Much less invasive than a fistula or graft.
Ok, I didn't think of that. Good to know you've done both and prefer PD. Not sure why the hubs thinks he'd prefer home hemo. I'll help with either. It's completely up to him. I just want him to make a well-informed decision.
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I did 3 1@ years on PD. The first year doing 4 manuals daily, then switched to using the Cycler at night. Connecting once, watch TV, go to bed and sleep. Disconnect after I got up and drained in the morning.
I could eat and drink ANYTHING, and as much as I felt like, which wasn't a whole lot. The constant fluid in my belly caused me to reduce pigging out, actually improved my eating so much, cutting back and NOT over eating, that I LOST 100 pounds of excess weight that I had gained over the last 15 years since injuries changed my work.
Alas, a very nasty infection caused me to lose my cath and forced me into Hemo.
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I did 3 1@ years on PD. The first year doing 4 manuals daily, then switched to using the Cycler at night. Connecting once, watch TV, go to bed and sleep. Disconnect after I got up and drained in the morning.
I could eat and drink ANYTHING, and as much as I felt like, which wasn't a whole lot. The constant fluid in my belly caused me to reduce pigging out, actually improved my eating so much, cutting back and NOT over eating, that I LOST 100 pounds of excess weight that I had gained over the last 15 years since injuries changed my work.
Alas, a very nasty infection caused me to lose my cath and forced me into Hemo.
And that's my biggest fear, since we have just come through a very nasty staph infection in his graft, that stopped his heart during surgery, and had him hospitalized for three weeks with sepsis and double pneumonia. I realize that it's probably different infection sources, but this was by far the worst on him physically and we almost lost him. At the same time, hemo is draining the life out of him too. He's lost 45lbs and barely eats as it is. He does have some residual kidney function, and I don't know if that would help him with the amount of time he has to do pd. Thanks everyone for sharing your experiences with us.
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Residual function helps a LOT on PD.
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Residual function helps a LOT on PD.
That's great news!
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Hi your husband is being badly treated. First by law the ADA, your husbands employer needs to make reasonable accommodations for his schedule. Second, if your husbands treatment is moved because of a holiday that's fine canceling it is a CMS violation. Every year for Thanksgiving, Christmas, and New Year my clinic is closed but the treatment is not canceled, schedules are changed instead M.W, F. I might be switched to M, W, Sat. This way every one gets their treatments and the Staff gets there holiday. CMS is the Center for Medicare and Medicaid Services and would take your complaint about canceled treatments and harassment over starting times. Good Luck
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..............hemo is draining the life out of him too. He's lost 45lbs and barely eats as it is. He does have some residual kidney function, and I don't know if that would help him with the amount of time he has to do pd. Thanks everyone for sharing your experiences with us.
Setting the correct 'dry weight' is critical to doing well on Hemo. Going too 'Dry' leaces the patient sick,, overly week, cramped, and remains like that until the circulating system reconstitutes until the blood viscosity becomes more fluid and able to circulate much easier.
At least that is my theory. My clinic had initially set my weight far too low. I wasn't P'ing. I still have residual kidney function and I Believe this is what helps keep my labs so well balanced within mid-range.
We argued but the Clinic agreed and raised my weight a total of THREE Kilo's, one or one-half at a time, until I felt so much better, NO cramping after treatments. I am not knocked out and sleeping 5 to 8 hours immediately after treatments. I do have some very slilght swelling in my ankle but NOT every day so I Believe my weight is very near perfect.
Blood pressures alone are not the best indicator of how much water weight to take off, although pressure drops ARE a pretty good indication when too much has been taken off.
I your Husband has chronic high pressures such as I do then the clinic cannot use pressure as an indicator unless they take off too much. Leg swelling and how he 'feels' may be better indicators.
Talk to his Dr about this immediately.
Excessive take-offs can 'stun' the kidneys and heart, causing the kidneys to lose the residual function, causing heart attacks to those person susceptible. Setting a far better dry weight is critical to him feeling much better.
This isn't going to be resolved over night. This is going to take some time to figure out.
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In setting my dry weight I have it challanged, try to take 3 to 4 kilos, when I start getting mild cramps in my fingers I have then stop pulling fluid and my New dry weight is set. Every one is different and the secret is to learn how you react and learn the early warning signs of too much fluid is being removed.
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I had problems with my time being changed without warning or consultation. Unfortunately, they are allowed to make those changes and there really is little that can be done. No, it is not fair, but it is fact. My time was changed without warning and with absolutely no regard to the fact the time was originally scheduled due to my need to take an autistic child to school and pick him up.
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If it were me or my husband, we'd be writing a letter and giving copies to his neph, the FA, nurse and dialysis provider (Fresenius). We'd be very specific about why we chose the clinic, whether it was because of his neph, the location or the hours, etc) and then express our concerns and/or disappointments about them changing the schedule. We really do have to be our own advocates otherwise they will do whatever the &%# they want. My husband now goes in-center but back when he was doing home-hemo, I once had to write a letter about the delivery method they were using for supplies. Putting things into writing seemed to have gotten their attention and the problem was remedied.
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Call CMS for unless you are being shifted because you are always late they will at least listen and may make the clinic accomadate she your needs
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Hi your husband is being badly treated. First by law the ADA, your husbands employer needs to make reasonable accommodations for his schedule. Second, if your husbands treatment is moved because of a holiday that's fine canceling it is a CMS violation. Every year for Thanksgiving, Christmas, and New Year my clinic is closed but the treatment is not canceled, schedules are changed instead M.W, F. I might be switched to M, W, Sat. This way every one gets their treatments and the Staff gets there holiday. CMS is the Center for Medicare and Medicaid Services and would take your complaint about canceled treatments and harassment over starting times. Good Luck
After reading your advice, and others, I plan to file a complaint in writing. They outright just cancelled his treatment. And after I complained to the social worker, I haven't heard any more about them making him move his days. I'm still going to file a written complain over the straight up harassment and over the tech sticking him with 102.5 degree fever. We're still waiting to hear about our ADA application with his HR dept.
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..............hemo is draining the life out of him too. He's lost 45lbs and barely eats as it is. He does have some residual kidney function, and I don't know if that would help him with the amount of time he has to do pd. Thanks everyone for sharing your experiences with us.
Setting the correct 'dry weight' is critical to doing well on Hemo. Going too 'Dry' leaces the patient sick,, overly week, cramped, and remains like that until the circulating system reconstitutes until the blood viscosity becomes more fluid and able to circulate much easier.
At least that is my theory. My clinic had initially set my weight far too low. I wasn't P'ing. I still have residual kidney function and I Believe this is what helps keep my labs so well balanced within mid-range.
We argued but the Clinic agreed and raised my weight a total of THREE Kilo's, one or one-half at a time, until I felt so much better, NO cramping after treatments. I am not knocked out and sleeping 5 to 8 hours immediately after treatments. I do have some very slilght swelling in my ankle but NOT every day so I Believe my weight is very near perfect.
Blood pressures alone are not the best indicator of how much water weight to take off, although pressure drops ARE a pretty good indication when too much has been taken off.
I your Husband has chronic high pressures such as I do then the clinic cannot use pressure as an indicator unless they take off too much. Leg swelling and how he 'feels' may be better indicators.
Talk to his Dr about this immediately.
Excessive take-offs can 'stun' the kidneys and heart, causing the kidneys to lose the residual function, causing heart attacks to those person susceptible. Setting a far better dry weight is critical to him feeling much better.
This isn't going to be resolved over night. This is going to take some time to figure out.
Thank for you sharing your insight into the dry weight. They routinely take off way too much leaving him weak and as you described, even to the point where he's nauseous and vomiting between treatments. I'm sure they have him set too low. High blood pressure is the reason behind his kidney failure we were told. Interesting about the excessive take-off being a cause of losing residual function, as when he was hospitalized, his GFR went from a 4 to a 14, every day or so he gained a point. I have yet to get to talk to the dr about it, but his dialysis treatments in the hospital were different. I just wish I knew how. I know I can't get my hopes up, but seeing him feel better, and knowing his GFR went up that much makes me wonder a lot. And it makes me very suspicious of the clinic, because when he started, his GFR was above 10, tho I can't quite recall the exact number. Of course, not that he's getting off dialysis, I just want his quality of life at home to be better than its been.
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Hi your husband is being badly treated. First by law the ADA, your husbands employer needs to make reasonable accommodations for his schedule. Second, if your husbands treatment is moved because of a holiday that's fine canceling it is a CMS violation. Every year for Thanksgiving, Christmas, and New Year my clinic is closed but the treatment is not canceled, schedules are changed instead M.W, F. I might be switched to M, W, Sat. This way every one gets their treatments and the Staff gets there holiday. CMS is the Center for Medicare and Medicaid Services and would take your complaint about canceled treatments and harassment over starting times. Good Luck
After reading your advice, and others, I plan to file a complaint in writing. They outright just cancelled his treatment. And after I complained to the social worker, I haven't heard any more about them making him move his days. I'm still going to file a written complain over the straight up harassment and over the tech sticking him with 102.5 degree fever. We're still waiting to hear about our ADA application with his HR dept.
Good for you! Stick to your guns! Hope you get the results you both are needing. It doesn't have to be a nasty-gram but be firm and to the point. You won't regret it. :thumbup;
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Dry weight is not a science and my first 6 months on dialysis were not good. It took my visit to the doctor with a horrible BP of 75 over 45 that's when my dry weight was adjusted up by 5 kilos.
sp mod Cas
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Hi your husband is being badly treated. First by law the ADA, your husbands employer needs to make reasonable accommodations for his schedule. Second, if your husbands treatment is moved because of a holiday that's fine canceling it is a CMS violation. Every year for Thanksgiving, Christmas, and New Year my clinic is closed but the treatment is not canceled, schedules are changed instead M.W, F. I might be switched to M, W, Sat. This way every one gets their treatments and the Staff gets there holiday. CMS is the Center for Medicare and Medicaid Services and would take your complaint about canceled treatments and harassment over starting times. Good Luck
After reading your advice, and others, I plan to file a complaint in writing. They outright just cancelled his treatment. And after I complained to the social worker, I haven't heard any more about them making him move his days. I'm still going to file a written complain over the straight up harassment and over the tech sticking him with 102.5 degree fever. We're still waiting to hear about our ADA application with his HR dept.
Good for you! Stick to your guns! Hope you get the results you both are needing. It doesn't have to be a nasty-gram but be firm and to the point. You won't regret it. :thumbup;
Thanks!
Agreed, I just want to have my concerns in writing, direct and to the point, but no need to be nasty.
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Call CMS for unless you are being shifted because you are always late they will at least listen and may make the clinic accomadate she your needs
Thanks for the advice, I didn't know I could call them. He's very timely, and hasn't missed any sessions unless he's been in the hospital, and then received dialysis there.
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Dry weight is not a science and my first 6 months on dialysis were not good. It took my visit to the doctor with a horrible BP of 75 over 45 that's when my dry weight was adjusted up by 5 kilos.
sp mod Cas
Wow, that's low. My husband had an 80/49 last week and he was not well. He's usually too high tho, and that's always a concern.
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It was low enough the doctor almost panicked they put my butt on a gurney and ran me over to the urgent care center, I go to a medical group that is huge and have their own emergency clinic.
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It was low enough the doctor almost panicked they put my butt on a gurney and ran me over to the urgent care center, I go to a medical group that is huge and have their own emergency clinic.
That's nice, that everything is close together. Here they turn to the Emergency Room for everything, and our town is kinda spread out, nothing close together. Urgent care tells us they can't do anything for him. His blood pressure is all over the place. Usually nice and low, 120s/70s. But when it shoots up, its 230s/110s now. That makes me nervous. It's like the highs are higher and the lows are lower.
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Got a call yesterday morning as I was getting ready to leave. "Miss so and so who shares your chair decided to show up late this morning, so your time will be two hours late." Gee thanks. Rule should be you have a designated start time AND a designated off time. If you are late, you lose part of your run time or come on a different shift where there is an opening.
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The clinic I go too has started tell late patients that they will be shifted. To TTS and a later shift. It is a mater of fairness, in over 4 years I have never been late.
Although one time the RO water system was down and we. Started a hour and a half late the moron who follows me came in while I was still hooked up and began to abuse me for being late. Back in the early 70's I worked on a AT&T loading dock and I used to make truck drivers blush. I called the moron every name in the book. He complained but was told he had no business coming on the floor and harassing me.
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Got a call yesterday morning as I was getting ready to leave. "Miss so and so who shares your chair decided to show up late this morning,
If the clinic staffer actually mentioned so & so's name it was a HIPPA violation.
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I think calling Guest Services at DaVita may give some results. When we were in Florida (where Dialysis Techs are barely trained) and the Fac. Admin was totally inefficient we talked to them several times. I told them of the infractions and emphasized they would not get a true picture if they simply interacted with the FA. They needed to send someone in to observe. The FA is no longer there but since we are snow birds I can't say what has changed at that location. We are back in Ohio where our specific center is relatively well run and personable. A simple thing like having packets made up for each patient instead of in FL someone running from chair to chair (24 of them in center) laying down 2 syringes, then next trip gauze, next trip mask, next trip etc etc - total lack of organization and time management.
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Probably so Simon, but at our clinic we have the same seat each time and you pretty much know who you share a seat with because you see them.
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someone running from chair to chair (24 of them in center) laying down 2 syringes, then next trip gauze, next trip mask, next trip etc etc - total lack of organization and time management.
The "Chinese Fire Drill" approach to supply deployment. Distributing in the manner you suggest may be more time efficient than preparing packets, and a tech making a trip for each packet.
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someone running from chair to chair (24 of them in center) laying down 2 syringes, then next trip gauze, next trip mask, next trip etc etc - total lack of organization and time management.
The "Chinese Fire Drill" approach to supply deployment. Distributing in the manner you suggest may be more time efficient than preparing packets, and a tech making a trip for each packet.
My unit fills a plastic tote bin, one for each patient, with all the supplies needed to set up the machine and put the patient on and off.. it's specific for each patient, like what kind of dialyzer they use, or whether they have a fistula or central line.. they also do up packs with things like needles, saline syringes, gauze, for the on packs.. then for the off packs, they have bandaids and gauze.. the packs are wrapped in the paper that they put under your arm, and the ones for fistulas have a tourniquet tied around it.. if they need anything extra, or anything that's not in the packs, it's in the drawers under the counters at each station.. in those there are bandaids, gauze, saline syringes, betadine and chlorahexadine swabs, bottles of betadine, gelfoam, steristrips and other kinds of dressings, like mepore, mesalt, and tegaderm..
I'm on the evening shift, so I see them setting up for the next day.. after they've cleaned the machine, and I'm usually still holding, they clean off the table, and set the tote and chart for the next patient on the table.. we don't sit in the same chair each time, so this is how they choose who is going to sit where..
the totes and packs are done up ahead of time, usually by volunteers. They have list on the wall saying what goes in each pack, and I think they have another list for the totes
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The clinic usually has all the supplies in a bag for each chair at the beginning of the session. But what's up with gauze and tape approach to everything? Right now, my husband has a chest/tunnel cath and the hospital puts these nice slim semi-waterproof bandages over it, meanwhile Davita only uses gause and tape, and when my husband asked if he could bring his own, they said they weren't allowed to use his - only gauze and tape.
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The clear bandage to which you refer is a Tegaderm, and costs somewhere around $.50 to $1.00, which is an answer to your question.
Fresenius will use Tegaderm but only with an order from your MD. I don't know what the DaVita policy is. When I though the tape was irritating my skin, I had no problem getting an order for Tegaderm back when I was on a cath. I suggest asking your doc if Tegaderm is an option and, if the clinic does not supply it, if (s)he can write an order for the staff to use patient supplied materials.
When I was in for a hip transplant, the dialysis RN got squirrelly when I took my own needles out of my laptop bag (I prefer the scab picker on the JMS needles to the ones on the Medisense the hospital used). The RN said "our policy does not allow you to use your own supplies". I said "fine" and continued to canulate. The issue was never raised in subsequent treatments.
The clinic usually has all the supplies in a bag for each chair at the beginning of the session. But what's up with gauze and tape approach to everything? Right now, my husband has a chest/tunnel cath and the hospital puts these nice slim semi-waterproof bandages over it, meanwhile Davita only uses gause and tape, and when my husband asked if he could bring his own, they said they weren't allowed to use his - only gauze and tape.
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When traveling, I always take my own supplies with me. I always take bandaid and gelfoam, because I know that a lot don't use them, just gauze and tape, and I have such a strong fistula, that I'd be bleeding forever with it. I know that the gelfoam isn't cheap either, to a point where I'm not sure that a lot of places use it. The last time I was in New York, I had gelfoam with me, and I had to show them how to use it. They'd never seen it before. They did have the same bandaids I did (sure seals) but they were reserved for people with insurance.
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I've been able to order Tegaderm on EBAY at a much better price than pharmacy charges. Since he's allergic and will end up with blisters from most other dressings we keep some on hand. VA will prescribe and supply if you need them due to reaction to other dressings and we then carry them with us. Neither of the centers we've been to (DaVita's) questioned us bringing our own. We simply said - Here is a Tegaderm the tape causes blisters.
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Y'all are scaring the hell out of me.
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I use SureSeals which are bandaids with gel foam attached instead of gauge. I get them on Amazon last price I got was 17.50 for a hundred. That's 17.5 cents a piece. But they get me out quicker so I buy my own.
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I use SureSeals which are bandaids with gel foam attached instead of gauge. I get them on Amazon last price I got was 17.50 for a hundred. That's 17.5 cents a piece. But they get me out quicker so I by my own.
Some of the centers I listed traveling used those and I liked them. I don't bleed a lot and could almost use a bandaid but since i'm so used to a ton of gauze at home its scary to use less, but every time the used those bandaids with gel foam it felt like enough and I didn't need to switch to a bandaid prior to going sightseeing.
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Y'all are scaring the hell out of me.
Situations like this are not the norm. Most dialysis patients will run into occasional scheduling issues, but nothing major. Also, dialysis companies try to keep costs down. It is always good to have things like Sure Seals, if you have a catheter, at home. Dialysis is like everything else nowadays, a bureaucracy. You have to go through some red tape to get things done sometimes. You will do great. Just take it one step at a time and take deep breaths!
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I've been able to order Tegaderm on EBAY at a much better price than pharmacy charges. Since he's allergic and will end up with blisters from most other dressings we keep some on hand. VA will prescribe and supply if you need them due to reaction to other dressings and we then carry them with us. Neither of the centers we've been to (DaVita's) questioned us bringing our own. We simply said - Here is a Tegaderm the tape causes blisters.
I buy Tegaderm on Amazon. It's about $75CAN for a box of 200, which is a heck of a lot better than what I'd pay at the drugstore. There I can get a box of 5 for $10. I think I'd rather pay 37.5 cents each than $2 each. I use them for when I put emla on my arm, to cover the cream.
I use SureSeals which are bandaids with gel foam attached instead of gauge. I get them on Amazon last price I got was 17.50 for a hundred. That's 17.5 cents a piece. But they get me out quicker so I by my own.
Some of the centers I listed traveling used those and I liked them. I don't bleed a lot and could almost use a bandaid but since i'm so used to a ton of gauze at home its scary to use less, but every time the used those bandaids with gel foam it felt like enough and I didn't need to switch to a bandaid prior to going sightseeing.
I use sure seals with extra gelfoam because my fistula is really strong, and sometimes the gelfoam on the bandaids just isn't enough to get the dang thing to clot. I will say that it's a rare thing for me to spring a leak when I've got the extra gelfoam.