It's going on 15 years I been on dialysis and I'm still kicking it live.
Quote from: cdwbrooklyn on April 24, 2014, 09:16:45 AMQuote from: Hemodoc on April 23, 2014, 03:54:17 PMIf the patient is referred for access too late, then you are stuck with a catheter. Unfortunately, that is the norm in America while in Japan it is very much frowned upon. If you have CKD followed by a nephrologist, is there really any excuse for not placing an access in a timely manner? No, I don't think so. If you are a patient in that situation with the need for dialysis, you have no choice. But, you need to get the access working as quickly as humanly possible and pull the catheter to minimize long term risks.Hemodoc, I do understand your posting above; however, most people do not realize they have kidney failure until the syptom starts to show. Most people do not go to the doctor once or twice a year if nothing is wrong. Usually, when a patient finds out he/she has kidney failure, he/she is in an immediately need. America is different from Japan and most of the time Americans do avoid seeing a doctor every year. Most patients are starting off with a catherer until they access is ready to use. Yes it can get infected but the goal is to use it until your access is fully ready. To tell patients its dangerous to use a cahterer is a little to much because catherers is what Amercia uses at first. Now if you choose to stay with the catherer then yes is can be dangerous because of infections. See, what I'm starting to notice about you that if a patient does not do as you then he/she is doing it wrong or in danger. I remember when I first started dialysis and I went to my primary doctor office for my yearly check-up, he told me that I will only live for five years because that's the expanded time for dialysis patients. I laughed at him in his face because he is not God and can't determine when I am going to die. It's going on 15 years I been on dialysis and I'm still kicking it live. I feel great better now then in-center. However, what I'm trying to say is that everything your read is not so. Sometimes it is good to have an open mind when it comes to dialysis because technology is changing every year. What happened back in the days is no more nowadays. No disrespected attended, just letting you know how I am feeling. Have a wonderful day.You my dear are an inspiration for going on 15 years. Good for you. Keep it up. I think what Hemodoc was writing was most patients know they are getting into near dialysis well before they reach GFR of 20 to 25 which is when he wrote fistulas should be done. By that point they have some symptoms and have to see a doctor. His point is the doctors should get things going sooner. That happened with my wife. (I should have known better too). . Our nephrologist just watched her kidneys go downhill and didnt mention a fistula until we were just about ready for dialysis . We should have done it 3 months earlier. WE also heard the line about dying soon on dialysis from the first vascular surgeon. He told my wife she had a 50% chance of dying that first year. REAL NICE!Needless to say we went elsewhere for her fistula. The staistics on people starting on catheters is not good. Even if they switch over quickly they seem to have very high % of fairly serious problems. So Hemodoc is correct it is not a good way to go and can be avioded if the nephrologists would move quicker to get patients to have fistula surgeries.
Quote from: Hemodoc on April 23, 2014, 03:54:17 PMIf the patient is referred for access too late, then you are stuck with a catheter. Unfortunately, that is the norm in America while in Japan it is very much frowned upon. If you have CKD followed by a nephrologist, is there really any excuse for not placing an access in a timely manner? No, I don't think so. If you are a patient in that situation with the need for dialysis, you have no choice. But, you need to get the access working as quickly as humanly possible and pull the catheter to minimize long term risks.Hemodoc, I do understand your posting above; however, most people do not realize they have kidney failure until the syptom starts to show. Most people do not go to the doctor once or twice a year if nothing is wrong. Usually, when a patient finds out he/she has kidney failure, he/she is in an immediately need. America is different from Japan and most of the time Americans do avoid seeing a doctor every year. Most patients are starting off with a catherer until they access is ready to use. Yes it can get infected but the goal is to use it until your access is fully ready. To tell patients its dangerous to use a cahterer is a little to much because catherers is what Amercia uses at first. Now if you choose to stay with the catherer then yes is can be dangerous because of infections. See, what I'm starting to notice about you that if a patient does not do as you then he/she is doing it wrong or in danger. I remember when I first started dialysis and I went to my primary doctor office for my yearly check-up, he told me that I will only live for five years because that's the expanded time for dialysis patients. I laughed at him in his face because he is not God and can't determine when I am going to die. It's going on 15 years I been on dialysis and I'm still kicking it live. I feel great better now then in-center. However, what I'm trying to say is that everything your read is not so. Sometimes it is good to have an open mind when it comes to dialysis because technology is changing every year. What happened back in the days is no more nowadays. No disrespected attended, just letting you know how I am feeling. Have a wonderful day.
If the patient is referred for access too late, then you are stuck with a catheter. Unfortunately, that is the norm in America while in Japan it is very much frowned upon. If you have CKD followed by a nephrologist, is there really any excuse for not placing an access in a timely manner? No, I don't think so. If you are a patient in that situation with the need for dialysis, you have no choice. But, you need to get the access working as quickly as humanly possible and pull the catheter to minimize long term risks.
Quote from: cdwbrooklyn on April 24, 2014, 09:16:45 AMIt's going on 15 years I been on dialysis and I'm still kicking it live. Love it!
Quote from: kristina on April 24, 2014, 06:39:27 AMMy body is still recovering from this severe emergency situation and my GFR has improved from 6.1 to 7.2 (Cockcroft-Gault),Mind you, I am still building up but I feel better.Does anyone know if it is possible to start off with NX stage (that is first having a fistula and later NX stage training at a centre) without going through a period of regular haemodialysis at a dialysis centre before starting NX stage training ? I try to avoid the catheter and I also try to avoid regular “standard” haemodialysis at a dialysis centre...... and I try to take the “middle of the road approach” to get "my" NX stage fistula and NX stage training... Is this route possible and has it been taken ?Thank you from Kristina.Kristina - Theoretically, there is no reason why you can't start with NxStage when finally going on hemodialysis. When you get the training, you're also receiving treatment. HOWEVER, if you wait too long and are extremely ill when finally starting dialysis, then you might have to receive a few weeks worth of treatment incenter to become stabilized. And, if that is the situation, then you will probably be starting dialysis with a catheter for waiting too long before getting a fistula established. (BTW, just to make sure you understand, there is no difference in a fistula used for NxStage or any other form of hemodialysis treatment.)What Hemodoc and Obsidianom fail to take into consideration with their advice is you are in the United Kingdom. NHS works in a totally different manner with gatekeepers and more red tape than here in the States. Also, NxStage is not yet offered universally in the UK, so depending on where you live, there actually might be a waiting list and you will have to do incenter dialysis for awhile. For these reasons alone, it is imperative to be more proactive and get things lined up. If the GFR number mentioned above correlates to U.S. measurement, you truly are treading on thin water with kidney function of less than 10% - at least in the ability to clear toxins from your body. I don't recall reading anything about how well you are still making urine, so don't know if you are retaining fluid. However, the vast majority of esrd patients start dialysis when GFR falls to 10-15. So PLEASE go ahead a schedule an appointment with a vascular surgeon who has experience working with patients who have compromised vascular systems and get your fistula placed! With all your additional medical complications, you do not need to deal with the potential problems that can come with a catheter. Yes, in the short term it might not give you any problems or cause infection. However, why chance it? Do everything possible not to have one! Kristina, you've given this a better fight than most ever could. However, in terms of the grieving process towards the death of your kidney function, you seem to be in the bargaining stage. Yet, please realize it's now time to take the next step by getting your fistula placed and maturing. Yes, it will be depressing, but will go a long ways in helping you to get to acceptance of needing to be on dialysis. And, as I've stated before and believe with all my heart, if you expend the same amount of pre-esrd energy into learning to live well with dialysis, I have no doubt you will once again enjoy activities you have had to give up over the last couple of years.All my best ~ Noahvale
My body is still recovering from this severe emergency situation and my GFR has improved from 6.1 to 7.2 (Cockcroft-Gault),Mind you, I am still building up but I feel better.Does anyone know if it is possible to start off with NX stage (that is first having a fistula and later NX stage training at a centre) without going through a period of regular haemodialysis at a dialysis centre before starting NX stage training ? I try to avoid the catheter and I also try to avoid regular “standard” haemodialysis at a dialysis centre...... and I try to take the “middle of the road approach” to get "my" NX stage fistula and NX stage training... Is this route possible and has it been taken ?Thank you from Kristina.
Quote from: cdwbrooklyn on April 24, 2014, 09:16:45 AMQuote from: Hemodoc on April 23, 2014, 03:54:17 PMIf the patient is referred for access too late, then you are stuck with a catheter. Unfortunately, that is the norm in America while in Japan it is very much frowned upon. If you have CKD followed by a nephrologist, is there really any excuse for not placing an access in a timely manner? No, I don't think so. If you are a patient in that situation with the need for dialysis, you have no choice. But, you need to get the access working as quickly as humanly possible and pull the catheter to minimize long term risks.Hemodoc, I do understand your posting above; however, most people do not realize they have kidney failure until the syptom starts to show. Most people do not go to the doctor once or twice a year if nothing is wrong. Usually, when a patient finds out he/she has kidney failure, he/she is in an immediately need. America is different from Japan and most of the time Americans do avoid seeing a doctor every year. Most patients are starting off with a catherer until they access is ready to use. Yes it can get infected but the goal is to use it until your access is fully ready. To tell patients its dangerous to use a cahterer is a little to much because catherers is what Amercia uses at first. Now if you choose to stay with the catherer then yes is can be dangerous because of infections. See, what I'm starting to notice about you that if a patient does not do as you then he/she is doing it wrong or in danger. I remember when I first started dialysis and I went to my primary doctor office for my yearly check-up, he told me that I will only live for five years because that's the expanded time for dialysis patients. I laughed at him in his face because he is not God and can't determine when I am going to die. It's going on 15 years I been on dialysis and I'm still kicking it live. I feel great better now then in-center. However, what I'm trying to say is that everything your read is not so. Sometimes it is good to have an open mind when it comes to dialysis because technology is changing every year. What happened back in the days is no more nowadays. No disrespected attended, just letting you know how I am feeling. Have a wonderful day.Actually, you have misunderstood my information. I am not stating everyone needs to do as I do, but instead what the medical literature reports. That is what I am relaying to you, not my own personal choices.In addition, I have met many dialysis patients with long standing CKD who started with catheters because of failed attention by their nephrologists. That is the reason I have relayed what is the optimal approach to renal access. And no, a significant number of patients with known CKD also end up with catheters which is simply wrong. Lastly, I have discussed the international norms. I no longer treat patients so if folks don't want to take the information I have learned from international studies especially, then that is up to them, but I am not in the business of telling patients what is right and wrong. I will on the other hand take issue with the way American nephrologists treat their patients for sure.
Our dialyisis nurses are now pushing Nxsatage on all home hemo patients as they see the big improvement from standard 3 day per week on the way patients feel.
Yup, got the usual warning: Warning: 'this topic has not been posted in for at least 120 days. Unless you're sure you want to reply, please consider starting a new topic. ' I do go through a full string of topics / posts and find them quite informative.Yes, I could start a new topic and post a link to this topic.Wonder how many would actually follow through, and read all of the comments !
Quote from: talker on January 10, 2016, 06:44:46 PMYup, got the usual warning: Warning: 'this topic has not been posted in for at least 120 days. Unless you're sure you want to reply, please consider starting a new topic. ' I do go through a full string of topics / posts and find them quite informative.Yes, I could start a new topic and post a link to this topic.Wonder how many would actually follow through, and read all of the comments !Hello again, talker,... Whilst it might be interesting to bring back topics from the archives,it also can be very upsetting to read the thoughtful support of lovely people, like for example dear Traveller1947who sadly is no longer with us because she has lost her battle with ESRF... ... or ... re-reading the support and lovely thoughts of IHD-members, who have not been on IHD for a considerable timeand the reader is left guessing what might have happened to them ... whilst hoping they are alright ...... It can be quite upsetting to come across it completely unprepared, and it certainly "brings home", how very vulerable and fragile ESRF makes us ...
.................. (few month shy of 90) is irrelevant,.............Good Lord willing and the creek don't rise, be seeing ya.
Quote from: talker on January 10, 2016, 06:44:46 PM.................. (few month shy of 90) is irrelevant,.............Good Lord willing and the creek don't rise, be seeing ya.I never would have taken you to be near that old. I guess it is just further proof that wisdom is acquired through age.Creeks were out of their banks here last week.This week they are frozen.Mid-Missouri. They have a saying about weather changing.
Quote from: kristina on January 11, 2016, 10:10:11 AMQuote from: talker on January 10, 2016, 06:44:46 PMYup, got the usual warning: Warning: 'this topic has not been posted in for at least 120 days. Unless you're sure you want to reply, please consider starting a new topic. ' I do go through a full string of topics / posts and find them quite informative.Yes, I could start a new topic and post a link to this topic.Wonder how many would actually follow through, and read all of the comments !Hello again, talker,... Whilst it might be interesting to bring back topics from the archives,it also can be very upsetting to read the thoughtful support of lovely people, like for example dear Traveller1947who sadly is no longer with us because she has lost her battle with ESRF... ... or ... re-reading the support and lovely thoughts of IHD-members, who have not been on IHD for a considerable timeand the reader is left guessing what might have happened to them ... whilst hoping they are alright ...... It can be quite upsetting to come across it completely unprepared, and it certainly "brings home", how very vulerable and fragile ESRF makes us ...Hello Kristina,Sorry if I had caused you any upset.The perils you mention were addressed in some of my earlier posts.Does quite often bring on a sadness wondering what has / had happened.When I found that some had passed, A prayer was offered.Other instances were responded to by other IHD members, with 'what had happened to that person'.Often with out further information available about a 'missing' person, I again offer a prayer to the Universe, giving thanks for their having been here.Brings to mind an old saying ' Gone , but not forgotten'.So in a hundred years, perhaps some one will ask ' Hmmnn, wonder what happened to that Talker guy'.
1 - Why is one so sensitive to certain events?2 - Does one really 'ask' for certain experiences?3 - Who in their 'right' mind would even ask for multiple illnesses and problems?4 - Is reincarnation true or not?5 - Is anything regards the Zodiac and reincarnation factual?6 - Is my 'Personally, I tend to believe that the a soul, is experiencing at least (12) twelve, simultaneous physical life manifestations' right or incorrect?7 - Is my 'So, as I see it, what one is feeling / experiencing at this moment in time, is by our choice to experience it. However horrific, beautiful, dull, or exciting as it may be, in the experiencing, one needs to consider that ‘We’ our-self, may have actually written the script for the current drama involved in our life.', right or incorrect?8 - To what extent 'do we / can we' control our fate?9 - To what extent do we actually have' free will' ?10 - If I'm responsible for any of my experiences, can I undo it?11 - Do those souls that have passed on say ' Wow was one hell of an experiencing ride'.
Questions like:Quote1 - Why is one so sensitive to certain events?2 - Does one really 'ask' for certain experiences?3 - Who in their 'right' mind would even ask for multiple illnesses and problems?4 - Is reincarnation true or not?5 - Is anything regards the Zodiac and reincarnation factual?6 - Is my 'Personally, I tend to believe that the a soul, is experiencing at least (12) twelve, simultaneous physical life manifestations' right or incorrect?7 - Is my 'So, as I see it, what one is feeling / experiencing at this moment in time, is by our choice to experience it. However horrific, beautiful, dull, or exciting as it may be, in the experiencing, one needs to consider that ‘We’ our-self, may have actually written the script for the current drama involved in our life.', right or incorrect?8 - To what extent 'do we / can we' control our fate?9 - To what extent do we actually have' free will' ?10 - If I'm responsible for any of my experiences, can I undo it?11 - Do those souls that have passed on say ' Wow was one hell of an experiencing ride'.I will give these a shot....1. Certain events may reverberate through your life as lessons you need to learn or lessons you are teaching to someone else.2. I think when you are talking with the universe you decide the things you will learn in your life lessons while in this plane.3. I do not think it is a"right mind" set when you are deciding these things. Lessons that are learned by your soul can often be learned or taught quicker through experiencing difficult things in your life.4. I think souls progress through different realms here on earth. I do not think our souls become animal souls. Maybe animal souls progress into humans souls.5. I do not know enough about the Zodiac to give an answer here.6. 12 physical lives may be a possibility. We do experience things in our lives on different levels as we learn throughout life.7. Yes, I think we decide for ourselves.8. We can make choices to change things in our lives, so yes fate can be changed9. We have free will in all of our life decisions. However free will stops when it intersects with another person's life.10. I think once you have experienced something as a life lesson and truly understood what it was all about you will not have to experience it again. If you want to change experiences I think you can by changing your decisions.11. Oh hell yes. My soul will say it I am sure.
"We have free will in all of our life decisions. However free will stops when it intersects with another person's life." ... Many philosophers have stated, that as soon as people start to consider "point 9" seriously, that is the start of civilized society ...
Quote from: kristina on January 14, 2016, 01:27:45 AM "We have free will in all of our life decisions. However free will stops when it intersects with another person's life." ... Many philosophers have stated, that as soon as people start to consider "point 9" seriously, that is the start of civilized society ...The problem with free will is in those persons with no common sense. They that care not for their fellow man, but only for themselves.Thus, we have Politicians.I don't think I like which way this is headings. So I'll bow out.Take Care,Charlie B53