Question about control over Hemo

[Xbandito]

This is something that is going round and round my head at the moment, who has absolute control over how your Hemodialysis session is run, ie..how long on machine, pump speed, whether or not to withdraw fluid ??.


I am only asking because, it is our body and we know how we feel before and after a D session and myself, on Sat had a D session from hell and I refuse to go through that again. So I am going to be polite at first and request that I go back to the settings that "seemed" to work with me, 3hrs at pump speed of 250 and no fluid withdrawal. That I can cope with, yes I felt a little washed out but not to an extent of real bad headache, light head, feeling sick and nose bleeds.
If polite wont work, I will have a paddy and stamp my feet and  some nurses

[dwcrawford]

There are times when you feel you've given up all control of your life.  Then we need to be assertive and just take it back.  Do you have a nephrologist that you feel really has your best interest at heart.  That's usually my first step when I see technicians taking over.  One technician overrides instructions from the nurse and the nephrologist.  It really doesn't give me much of a sense of security.  And when you put your foot down they start spouting out things in their native language.  I'm recommending that they all learn not only to speak English (in this country anyway) but to practice in a diction that the rest of us understand.  Politically incorrect?   Maybe.

So stomp or whatever you have to, but hopefull you can get a head nurse or you nephrologists to back you up.  You understand what your body can an cannot take after all...

[Xbandito]

  right wheres me steel toe caps then 

That's just it, I still have yet to work out who is who over here, I know who the sister is (dark blue uniform) but for the rest... .....some have dark blue epaulets and some have light blue epaulets.....ahh google comes to my aid, dark blue = senior staff grade nurse and light blue = band 5 nurse 
Though on thinking about it, I get stuck by a band 5 nurse most of the time.
Yes I have a Neph but talking to him and getting what I want never really happens.

[dwcrawford]

Phil, I get stuck by a Technician with at least two weeks training (for real) unless I throw a little stomping fit.  Had to go to Neph (who is basically part of the Davita board) and leads but now I have a nurse or a 20 year experienced tech. 

Good  luck.  Keep Kicking

[Xbandito]

Stuff that....I'd do it myself before letting someone that inexperienced do it.
I am just going to ask if it can be as it was and if they say no, then I will ask to speak to sister or higher, for I prefer to come home from D feeling washed out but alive, than lightheaded with a headache, sick and a boxers nose.

[KICKSTART]

If you read my thread this is exactly the trouble im having ! Im sick of people reading text books then applying it to me ! Because basically this is all it is. None of these people have tried what they expect us to go through and just because they studied it it must be right ! Oh i would love to put them in a chair and subject them to all we have to go through, i would just love to see them sit in that darn chair for 4 hours plus!

[Xbandito]

That is it, text book, NO patient is the same, NO patient has come to dialysis down the same route, SO how the hell does the Text book cover all of that  . Plain and simple, IT DOES NOT.
I came to dialysis through polycystic kidney disease, which has me at 13% kidney function, still urinating, still feeling ok'ish, which is completely different from a person with acute kidney failure, who does not urinate and feels really ill. 

Kickstart....I take it you would use the biggest bluntest needles out there 

[sullidog]

I have techs that lie to me and say they won't take off any fluid, which they end up doing for whatever reason (I'm not a gainer at this point) One time my neph even wrote an order of no UF and this same tech still would take off fluid! It's like what part of no don't you understand!
Good luck
Troy

[cdwbrooklyn]

I'm feeling you guys as I have cursed out a couple of techs and nurses for trying to follow the book than listening to what I'm tell him or her.  However, you are in charge of your treatments.  One thing to do is study the machine.  Learn how it operates and let the tech know exactly what you want.  If this tech does not apply to your wants, be sure to tell the nurse or doctor.  However, do not give up fighting for what's right for you because I've learned that some techs and nurses do not have a clue.   

[RichardMEL]

I *always* double check the machine settings for myself, and ask to have the machine turned towards me so I can. No matter what someone says they've done *I* wan to be sure the setting is too my liking.

As for who is in control? Gee, that's a tough one. Some would say your neph is in control of setting such things as dry weight and other settings - but I don't think that is reasonable. I mean dialysis is a day to day thing and needs can change quickly - certainly more quickly than a doctor can evaluate. In my unit if we desire to challenge our dry weight, or if to use a profile or not then sure the nurses will go with that - as long as it's reasonable.

The only thing where they will not budge is length of dialysis. Only the primary care doc can change the amount of dialysis perscribed (and doesn't matter how awesome my clearance gets he won't budge me from five hours so I've given up asking ).

I've found that nephs don't care about the day to day stuff like what bath you're on, or machine settings, pump speed, flow rate, profile etc... they just care about the labs and other stuff and leave the machine stuff to the dialysis stuff.

For me, I like to have as much control as I can over MY treatments because it is MY body and nobody cares about it more than I do. So like I said I double check settings and talk to the staff about changing things I feel need to be changed - but it's usually a process of consultation - to leverage their experience and knowledge mixed with my own and the feelings of my own body and what it is telling me. Most of the time I think we make a fairly good team.

[dwcrawford]

What's this about control over something?