how many days and why ?

[7piglets]

Ok I have a pd catheter in since Feb which dr's cant get to work..Last week they put the catheter in my neck and Fri they did a fistula in my dominent arm (whch i am now reading is not the best place) and in the crease of my arm..
I am just clueless and now just getting frustrated...
I am to start dialysis tomorrow and dr said I will need 3days a week for about 3-3.5 hrs each time..
Here is my question WHY? If I have been going on with nothing why dont they increase gradually why not do dialysis 1 or2 xs first and they gradually increase to the 3days How is it everyone needs it 3days ....
thanks in advance

[karen547]

Well, 3x a week is the standard amount of time- Any less than that and I don't think the blood would be as clean and you would feel grose. I had my time reduced from 3.5 to 3 hrs because of my good labs. I am doing HEMO with a fstula. Good luck!

[monrein]

Three days a week is pretty much the minimum for hemo and your numbers aren't good so they most likely want to get your blood cleaner ASAP.  To do that you'll need to put in the time.  What they might do is run you at a lower pump speed to help your body adjust to dialysis. 

Hang in there and you should feel better soon I hope.
 

[flip]

When I first started, I went 2 hrs  and gradually worked up to 3.5

[Jess21]

I started at 3.5 hours and went up to 3 hours 45 minutes because of my height it was not enough at 3.5

[David13]

I believe much depends on your nephrologist.  I have heard of some nephrologists who start patients out slowly and gradually determine how much they need and then there are others who simply start every one of their patients at 4 hours 3 times per week.  Personally, I think each patient should be considered as an individual and should get the amount of dialysis that they need, not some standard prescription that does not apply to all.

[twirl]

everyone I talk with at dialysis started out three times a week with three - four hours each time
I think you are making a good point and I would check into it
wish I would have asked

[IUNurse]

7Piglets,
     Three times weekly is really just a starting point.  However, I wouldn't expect it to be any less.  The amount of time you run is a little more negotiable.  In other countries they do dialysis daily and longer treatments.  And believe it or not, those patients actually do better.  You asked why not work into it or whatever.  First off, hearing a little bit about you in your other blogs I would guess you have actually passed the "ease into it" phase and are being forced to "dive in".  Also, doing dialysis three times per week really is not doing all that much.  I mean, normal kidneys work 24/7 and dialysis will provide "kidney function" every other day for a few hours.  That is really just the minimum if you think about it.

[flip]

Medicare only pays for 3 treatments per week so that's what most people get. Reducing someone to two treatments means having an empty chair on one day. At my center the nurses are paid based on the number of patients in their section. If a seat is empty, the pay is less.

[Stacy Without An E]

Some clinics across the nation are giving patients a chance to do what I do: six days a week Dialysis/two hours a treatment.  Yes, it's twice as many days but I feel a helluva lot better.  I do skip a treatment every now and again due to Dialysis fatigue, but the six days seems to be more agreeable to my physical well being.

[thegrammalady]

when i was diagnosed i was hospitalized and had dialysis every day for 3 days for 3 hours then 4 hours then moved to incenter 3 days a week for 4 hours each time. the center i use when i visit my folks in oregon run visitors 3 hours each time. ok my doctor says for a time or 2 but he wouldn't authorize it because for a month (time i spent there this visit) because it would have screwed my labs and made me very sick.

[IUNurse]

Basically from what I have learned over the years, the more dialysis a patient does, the better they do, and it significantly increases their lifespan.  It seems to me that medicare will pay for the minimum.  That saddens me.  I do think that short daily dialysis (6 days, 2 hours) would be better.  If you think about it, it would almost eliminate the "UP's and DOWN's" of hemodialysis every other day.
However, I am sure that not everyone here would really volunteer to do dialysis every day either (I don't even think I would)!

[Robby712]

When I first started, I went 2 hrs  and gradually worked up to 3.5

Same here.  They told me that compared to the function I had at the time I was started dialyzing that 2 hours would make me feel much better and not be a "shock to the system" but after a week I would need to get it to 3.5.