I’ll be starting home dialysis in a few months (once the fistula matures and I get training) and the current plan is the Baby K. I’m a bit annoyed the Baby K has been dumbed down with many status screens missing (no Kt/V tracking screen) and no UF profiles.
My questions:
Does Fresenius ever do home hemo with one of the regular machines (2008k, 2008k2 or 2008t) ?
What options turn back on when you change the “home/in-center” flag in service mode from home to in-center ?
Hey,
I don’t mean to derail your thread, but I was wondering if you could speak briefly about how you mentally prepared yourself for your fistula surgery. At first I was a bit repulsed by the idea, because I thought that getting a fistula would mean having something foreign installed into my arm. But it’s just that the skin hardens as it matures, right? I’m still a bit repulsed by the idea that one of my arms will be impaired and I may have to give up weight training. I’m not sure what other limitations I should expect as far as physical exercises/ability goes.
I have the AVF surgery in 8 days. A fistula is nothing foreign (unless you were born overseas, in which case you entire arm is foreign), it’s just a connection of an artery and a vein to form a supervein big enough to support dialysis blood flow. I don’t like the idea, but I’ve read enough of the potential complications of a long term central venous catheter like I now use to understand that it is medically the best from a risk/benefit standpoint. Allowing me to continue to remain undead also provides great incentive. I tried PD, but that didn’t work well for me. From what I hear the big limitations are in the first 3 months or so while it matures (max 15 lbs lifting with that arm), and the need to avoid blood draws, blood pressure, injury, tight clothing, etc. on that arm.
The “foreign installed” is a graft, which is considered less desirable and shorter lasting that a fistula.
A fistula is created when the surgeon connects your artery and your vein together. The skin doesn’t harden over the fistula, but the vessel gets larger. This allows dialysis needles to be inserted so extra wastes and fluid can be removed from your bloodstream. Dialysis needles have to be large enough to remove these wastes and fluid without damaging red blood cells.
Talk to your vascular surgeon about what activities you’d like to do and how you can do them safely. Also ask specifically when you can start doing those activities. I’ve known patients who had fistulas or grafts and still lifted weights once the access had time to heal. Warnings they always give hemodialysis patients is to not let any pressure be sustained over the fistula or graft that could cut off the blood flow and cause the access to clot. This includes not allowing anyone to take your blood pressure in your arm where you have a fistula (or graft). Also, don’t let anyone use your fistula (or graft) for anything other than dialysis.
Oh okay, I just seen a video of this woman showing her fistula and the skin was really raised in that area so I wasn’t exactly sure what to think (in which case your entire arm is foreign - you’re funny). Yeah, PD doesn’t seem very effective to me. I tried water fasting and an extreme exercise routine for 90 days and my GFR number decreased 6 points. But I was also taking prilosec during this time, which has been known to cause acute renal failure (now I know).
Good luck with your surgery. What is your expected healing time, 3 months?
[QUOTE=AlbertDog;22809]I have the AVF surgery in 8 days. A fistula is nothing foreign (unless you were born overseas, in which case you entire arm is foreign), it’s just a connection of an artery and a vein to form a supervein big enough to support dialysis blood flow. I don’t like the idea, but I’ve read enough of the potential complications of a long term central venous catheter like I now use to understand that it is medically the best from a risk/benefit standpoint. Allowing me to continue to remain undead also provides great incentive. I tried PD, but that didn’t work well for me. From what I hear the big limitations are in the first 3 months or so while it matures (max 15 lbs lifting with that arm), and the need to avoid blood draws, blood pressure, injury, tight clothing, etc. on that arm.
The “foreign installed” is a graft, which is considered less desirable and shorter lasting that a fistula.[/QUOTE]
Thanks, Beth. The potential of being able to continue with weight training does give me hope. I was seriously considering refusing dialysis. In the event that I am able to continue with weight training, I would imagine it would be preferable to get the fistula in the lower part of the arm rather than the upper.
[QUOTE=Beth Witten MSW ACSW;22810]A fistula is created when the surgeon connects your artery and your vein together. The skin doesn’t harden over the fistula, but the vessel gets larger. This allows dialysis needles to be inserted so extra wastes and fluid can be removed from your bloodstream. Dialysis needles have to be large enough to remove these wastes and fluid without damaging red blood cells.
Talk to your vascular surgeon about what activities you’d like to do and how you can do them safely. Also ask specifically when you can start doing those activities. I’ve known patients who had fistulas or grafts and still lifted weights once the access had time to heal. Warnings they always give hemodialysis patients is to not let any pressure be sustained over the fistula or graft that could cut off the blood flow and cause the access to clot. This includes not allowing anyone to take your blood pressure in your arm where you have a fistula (or graft). Also, don’t let anyone use your fistula (or graft) for anything other than dialysis.[/QUOTE]
PD can be very effective for many patients - I’m not sure where you got the idea “doesn’t seem that effective”. It certainly wasn’t based on studies, lab results, and data.
The healing of a fistula only takes a couple of weeks. The 3 months is for it to mature, which is a separate issue from healing. The vein has to stretch out and become larger so it can be used for access.
Since you know you have chronic kidney disease, it’s important to talk with your kidney doctor (hopefully you have one) about all medications and/or supplements you take now and before you take anything new. Limiting your fluid intake and exercising a lot probably caused you to get dehydrated, which put extra stress on your kidneys. People on dialysis usually need to limit their fluid intake because dialysis can only remove so much fluid safely when kidneys aren’t making urine or as much urine. However, people with CKD should not limit fluids or change their diet unless their kidney doctor recommends that. If you don’t have a kidney doctor, ask your doctor to refer you to one that you can see periodically to provide kidney-specific advice about meds, diet, fluid, etc.
Well, you are basically flushing some part of your stomach with a water solution almost like an enema or something whereas Hemo-dialysis you are cleaning the actual blood at 1 liter per minute. I haven’t read up much on PD, but from the animation I watched on youtube that is the impression I get. Plus, don’t you have an access hanging from your stomach at all times?
Why didn’t PD work out for you?
[QUOTE=AlbertDog;22823]PD can be very effective for many patients - I’m not sure where you got the idea “doesn’t seem that effective”. It certainly wasn’t based on studies, lab results, and data.
The healing of a fistula only takes a couple of weeks. The 3 months is for it to mature, which is a separate issue from healing. The vein has to stretch out and become larger so it can be used for access.[/QUOTE]
[QUOTE=Ad am;22826]Well, you are basically flushing some part of your stomach with a water solution almost like an enema or something whereas Hemo-dialysis you are cleaning the actual blood at 1 liter per minute. I haven’t read up much on PD, but from the animation I watched on youtube that is the impression I get. Plus, don’t you have an access hanging from your stomach at all times?
Why didn’t PD work out for you?[/QUOTE]
Yes, there is an access (tube) handing from the stomach at all times. Pretty easy to get used to.
PD did no give me the waste clearancae I needed due to the particular characteristics of my peritoneal membrane.
Just to make sure no one gets confused about the PD info you provided, the machines mentioned in the subject line are Fresenius machines used for hemodialysis either in-center or at home. The Baby K is the 2008K@home, which is the machine that people who use Fresenius products use at home. The other machines are used in-center from what I understand.
PD is a different treatment option. Fresenius and Baxter make cycler machines for automated PD (CCPD) and supplies for CCPD and manual PD (CAPD).
There are message boards specifically for PD patients and PD professionals.
[QUOTE=AlbertDog;22921]1. Yes, there is an access (tube) handing from the stomach at all times. Pretty easy to get used to.
!!!
Cool, so how is dialysis going?
[QUOTE=AlbertDog;22800]My questions:
I can’t speak to your second question, Albertdog. You might pose it to Dr. Agar in our expert boards.
But I suspect that, due to FDA approval of the Baby K machine for home treatment (and lack of that approval for other Fresenius machines), the clinic may not want to send you home with a k2 or a t. But, it can’t hurt to ask, if you’re interested in the additional bells and whistles. It’s possible that a Kt/V screen may be available on the Baby K for clinician use (I truly don’t know) and, if so, perhaps your clinic would have a way to give you access to that information. Your knowledge is impressive, and I’m sure you’ll do well with whatever machine you end up with!