5 Days without Dialysis ????

[nursey66]

The Dialysis center had my husband go into the hospital to have his central line removed. He was using the fistula about 3 weeks,and they said the line was clogged up so had to come out. Anyway it was pulled on Thursday, and would't you know, the fistula infiltrated right away on his Friday run. So they scheduled him at anouther center for today,{Sat.} because no one does it around here on Saturday. So we drive 100 miles early AM, and the nurse had this "it's not going to work" look on her face. And 1 try and 2 minutes later he is told "it's not going to work" and he is sent home !!!!   He is told to return to his regular Dialysis unit on Monday. His scheduled time is 1:30 PM.  No Dialysis since Wednesday ?? That's 5 days, no bloodwork done ,what about Potassium ,that will go through the roof !  I am really worried. Isn't it dangerous to have 5 days between runs ?  I thought he should of been sent to the ER and anouther central line put in, and the dialysis done, but maybe this is the standard of care !! Just because it's the weekend, they send someone out for anouther 2 days without TX   Should I be watching for anything ? He doesn't urinate either,so 5 days seems too long to let it go .

[Angiepkd]

Five days does see like a long time.  I would be on the phone with his nephrologist.  Most have a service and will call you back on the weekend.  The fluid overload alone would be too much for me.  Hope you get things resolved!

[Desert Dancer]

I have gone 5 days without dialysis twice - not intentionally - and I am still here. However, I get really good dialysis at home so that probably gives me a bit of a 'leg up' to start with. But even in my case I was feeling very, very unwell by the fifth day both times and I will never go that long again if I can help it.

I would say that your husband needs to stick to the emergency diet as strictly as possible between now and Monday. (Especially no bananas, tomatoes, potatoes due to potassium, and watch the sodium intake carefully so as not to worsen fluid retention.) Also if he wears rings, have him take them off NOW. Nothing like worrying that your fingers are going to turn black and fall off because you can't get your rings off due to fluid overload.

Of course, try to get in touch with his neph but it's already Saturday and I'm doubtful he'll be able to dialyze any time before Monday anyway now.

[obsidianom]

I agree that is not good.  I had a similar problem with my wife awhile ago and pushed for a catheter quickly . We got it done immediatly and saved her going through what you are dealing with. I always push people to call their doctors immediatly in situations like this to try and get an emergency catheter or have dialyisis in the hospital (even on a Sunday).  Call your doctor today

[Rerun]

Lesson for all of us.  If we have access trouble just be careful what we eat until the light is green.  Watch fluid intake, potassium intake.

If you hear shortness of breath or observe muscle weakness then take him to the ER.  They have to address the situation.

[NDXUFan]

I agree that is not good.  I had a similar problem with my wife awhile ago and pushed for a catheter quickly . We got it done immediatly and saved her going through what you are dealing with. I always push people to call their doctors immediatly in situations like this to try and get an emergency catheter or have dialyisis in the hospital (even on a Sunday).  Call your doctor today

ND:

If you and I agree, call that Nephrologist, immediately!!!!

[amanda100wilson]

Definately call tour doctor.  Talk to the after hours people to get hold of him if necessary.   If you cannot get hold of him and are really concerned, suggest a trip to the ER.

[Dman73]

My fistula failed after the weekend and I had to have a balloon arthroscopy performed to get it working again.
Before they could work on it my potassium had to be below 6.0 so they gave me sodium polystyrene sulfonate (e.g.Kayexalate) to drink and some VENTOLIN HFA (albuterol sulfate) to inhale which lowered my potassium to normal levels.

I would think after 5 days high potassium would be a real concern.

 

[nursey66]

He saw his neph on Monday, and had successful dialysis as well on Monday. He did go on the 'emergency' diet, and got some SPS for Potassium on Sunday. His Neph said the arm didn't look as bad as he thought it would. He is scheduled  next week for a procedure to look for and remove any clots. Thanks for all your answers to me. I appreciate it.