Should Dialysis Centers Allow Food and/or drink?

[Rerun]

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.

[pelagia]

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.

[monrein]

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.

[willieandwinnie]

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  worth and what worked for Len. I understand that everyone is different. 

[swramsay]

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?

[jbeany]

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!

[acer]

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

[TynyWonder]

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 

[kimcanada]

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??

[swramsay]

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'.

[G-Ma]

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.

[kimcanada]

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 &^%$%^& 

[Rerun]

Kim - you are exactly right!

                                     

[Wenchie58]

Yeah, what Kim said!

[RichardMEL]

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  ) 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.

[skyedogrocks]

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??   

[pelagia]

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

[Stacy Without An E]

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.

[RichardMEL]

Stacy I'm so sorry but the way you write gives such vivid images I have to laugh because it's pretty funny  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!

[Chris]

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.

[monrein]

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.

[kidney4traci]

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!!!!

[petey]

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!     This is another reason why we both love home hemo.

[kidney4traci]

   I really laughed out loud -
Marvin on dialysis with no britches!!!!!!!!!  Rock on Marvin!!!

[del]

Hey on home hemo let the sleep pants go too if you want LOL   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!!!  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.