How to assist to clean the blood whilst on dialysis?

[kristina]

Having used diet to lengthen the time I was in ESRF before dialysis,
I am now thinking how can I assist to improve the state of my blood
to make the dialysis cleaning–process even more effective?
Again, this might be with diet, precise liquid-intake-control or the control of something else?
Is there anything else that could be very important?
Has anyone any thoughts about this?

Thanks from Kristina.

[Michael Murphy]

Once you have started dialysis the body needs change and you need more protein then you did before. 

[obsidianom]

Having used diet to lengthen the time I was in ESRF before dialysis,
I am now thinking how can I assist to improve the state of my blood
to make the dialysis cleaning–process even more effective?
Again, this might be with diet, precise liquid-intake-control or the control of something else?
Is there anything else that could be very important?
Has anyone any thoughts about this?

Thanks from Kristina.

You should see the renal dietician at your clinic. Things like phosphorus , potassium , protein , calcium etc all need to be monitored.  Your lab values are also important to see where you are.

[cassandra]

I also read a while back that doing exercises during D increases the clearance (hence the cycle the use sometimes in some clinics)

[Michael Murphy]

Actually the advice to talk to the dietician is good advice,  I have noticed that many patients at my clinic don't take the opportunity to seek the dieticians advice about what to eat and not eat to improve thier results.  My clinics dietician is a font of helpful info on food and drink options.

[kristina]

Thank you very much for your kind replies, Michael Murphy, obsidianom and Cassandra,
it is very much appreciated and is very helpful.
I have asked to see the dietician and during Christmas and New Year it is a bit of a difficult time,
but as soon as possible, I shall clear these points up with the help of the dietician.
Thank you very much again from Kristina.

[kitkatz]

When it comes to the renal diet be reasonable with it.  It can be very restrictive.  Watch for potassium and phosphorous the most.  Potassium affects the heart and phosphorous affects the bones in the body.

[kristina]

Thank you very much kitkatz.
I have kept an eye on my blood-results and my last blood-results
showed that my potassium is at the moment on the very low side.
All the other blood-results were normal.
But I have to keep an eye on my blood-pressure,
because at my last dialysis-session my BP suddenly went very low
and I had to call the nurse for assistance.
My blood pressure was always very regulated before I started dialysis
but unfortunately that has changed now
and suddenly it fluctuates from almost normal to very low to very high
despite my taking my anti-hypertensives every day at the same time as I have done for years.
It certainly is a journey of practically learning and taking in a lot in a very short time.
Thanks again from Kristina.

[cassandra]

Dear Kristina being on D is a different ballgame. It might be a good idea to take your BP tabs after D. Especially in the beginning as your dry weight is probably fluctuating. Its also poss that some BP tabs dialyse out. You also might want to find out what your potassium (K+) is in your dialysate. Till you've spoken with the dietitian eat some more pulses or a small banana, but check first if the K+ in the dialysate is the same as when they took your bloods. And don't take the fruit or pulses in your 'weekend'

Good luck my darling,

Lots of love, Cas

[kristina]

Thank you Cassandra for your kind thoughts and advise. I have really tried hard to see a dietician urgently, but I had no luck yet at "my" dialysis-unit.
They don't seem to put that much emphasis on diet and seemed surprised about my urgent quest for a dietician...  so I had no luck yet...
Unfortunately I had some very bad news yesterday just 4 hours before the New Year, which really messed up my start to the New Year ...
I was told yesterday 4 hours before the New Year that I have to "join" another dialysis-unit in another hospital ...
Unfortunatly this "other" hospital is a hospital which I must avoid under all circumstances  because of my terrible experiences there
when I was unfortunately exposed there to severe mental and medical abuse on my person some years ago...
...  Naturally I have deliberately avoided this hospital ever since ...  but yesterday I was told
that I have to go to this very hospital for my dialysis-sessions from next Tuesday onwards ... 
...but...  there is no way that I shall ever enter this hospital again... especially not, if I desire to "hang-on" to my life...
At this very moment I am in a terrible state about this matter and I can see me having a big job to do tomorrow morning
to find a desperate way out of this terrible dilemma ... I shall have to be on the phone tomorrow morning to find a way out of this ...
Life is never easy... a few days ago I thought it was all set up and now it has all changed again and it is serious trouble...

[cassandra]

I'm sorry to hear your bad news Kristina. Make sure you ring. Ask firstly for the name, and address including email address of the Medical Director of the hospital you are in now, write it down, only than make a scene if 'they' don't get it. Don't forget the Advocates from the NKF either.

Lots of good luck, and strength, and love, Cas

[amanda100wilson]

Kristina, just be a use you had bad experiences at a hospital doesn't mean that you will do so again.  You cannot  make a gross judgement about all doctors in that hospital based on a 'few bad eggs'.  Having worked as an RN in the past in the UK, to put it bluntly, there are some real arseholes in the medical profession, there are also some very good ones, and there is a cross-section in each hospital.

You can manage your diet in terms of phosphate and potassium, and obviously eat a healthy diet in other respects, but clearance is ultimately down to the clearing by the dialyzer, be that on your machine, or your own peritoneum.  Adequate protein intake is important.

[kristina]

Thank you Cassandra and Amanda for your kind advice.
I have phoned "them" first thing this morning and it seems that "things" are getting on their way to be sorted out.
I have explained my situation very clearly, that under no circumstances could I ever face this particular hospital again.
Fortunately "they" understood and promised me to get things "under way" to get everything sorted out.
At my next dialysis-session I also have an appointment with the coordinator and that gives me another chance to make my position very clear...
I agree with you Amanda. It is true that there are some "bad apples" in the medical profession
and there are also some very good doctors and nurses who do everything for patients and even go out of their way to assist patients.
My experiences are though, that bad doctors (evil one's) seem to flock to each other in a bad hospital, make it a bad hospital
and then they back each other up on a regular basis, as soon as their wrongdoings are being exposed
which could get these bad doctors into serious trouble. That could explain why bad hospitals are really very bad with hardly any good luck for a patient ...
... And then there are excellent hospitals who provide the best medical care for patients,
because good doctors "flocked to each other" to make a good hospitals extremely excellent...
... The dialysis-unit where I am still at the moment is a very excellent dialysis-unit with excellent patient-care in an extremely good hospital,
but unfortunately it is an Accident and Emergency Dialysis-Unit and they have to move dialysis patients on to a "regular" dialysis-unit
as soon as the patient's medical condition is stable enough to move them into a "regular" dialysis centre.
Hopefully my current situation is getting sorted out very soon. That would give me a chance to appreciate this New Year.
Thanks again from Kristina.

[cdwbrooklyn]

HAPPY NEW YEAR TO ONE AND ALL 

Hi Kristina,

You did the right thing.  Go with your mind if your heart is telling you something.  Our first mind is always what we are feeling and most of the times is correct.   

For example.  My dad died in a hospital where a vascular surgeon wanted to do my new fistula.  When I told my family they were not pleased with it.  The hospital may have killed my dad but we do not have proof.  I did not feel comfortable with that so I did not approve of it.  I've learned in life to go with my first mind (what you think first) because most of the time you are right. 

Are you a home patient or in-center patient.  I'm confused because I read in-center on some posts and home (PD) on others.

Hope everything turns out well!

[kristina]

Thank you cdwbrooklyn and a Happy New Year to one and all from me !
I feel exactly the same and always go with my first thought,
we call it here in England to go with your "gut-feeling"or to go with your "gut-instinct"...
... "Gut-instinct" works sometimes in very strange ways, but it is always right and may on occassion save our lives....
... To answer your question: I am still a newbie to dialysis and "only" had nine dialysis-sessions so far.
I am going three times a week in the evenings to an accident and emergency dialysis-unit which is attached to an excellent hospital,
and they will refer me as soon as possible to a "regular" dialysis-centre which is not Accident and Emergency anymore
to keep the Accident and Emergency dialysis-unit for complete newcomers to dialysis.
Thanks again from Kristina.

[JW77]

Coming on a bit late to this thread.

Too many variables that can effect BP on dialysis, including medication, dialysate concentration, amount of fluid to loose. Electrolyte levels and whether or not profiling is used during the session. Everyone seems to react differently to heamo.

I would suggest getting hold of a renal cardiologist to discuss BP meds, or at least a consultant renal doc.


As to mental issues surrounding dialysis, bad experience leaves scares. Be that from 1 nurse or a whole unit. I once walked out of a unit to save my mental, and physical health.  Dangerous management abuse and other issues, which I won't go into detail about.

Exercise on dialysis, better circulation during dialysis means better clearance. This is scientifically proven.

If you can do a few minutes of regular hand and foot exercises , seated/lying Chi Kung (QuiGong)exercises are perfect for this, it will help with clearance. 

Example of finger/hand exercise.. He's actually doing them far far too fast. Its better to do as slow as possible.
https://www.youtube.com/watch?v=7P9EiooL3Ck

There are similar exercise for feet, ankles, wrists etc.

[kristina]

Thank you very much JW77 for your kind thoughts and the great link to the finger-exercises.
I shall learn more about these exercises and particularly the finger-exercises have already proved to be very relaxing.
I shall also try to see the renal cardiologist and shall try all the other exercises as well and shall continue with my daily walks
and keep strictly to my vegetarian diet plus restricted fluid-intake.
Thanks again from Kristina.