Excercise ////// come on you slackers

“…Blood flow through the tissue is increased when exercise using lower extremity muscles allows capillaries to open up more to provide a greater surface area for exchange of substances from tissue to blood, researchers say. …”

Wouldn’t raising the room temperature do the same thing?[/quote]
Good thinking… the laws of gravity using room temperature… Heat causes expansion while cold causes restriction…hmmm, I never read any articles about that BUT I do know that many many clinics are very cold inside…

I don’t know it for a fact, but you might have to have the temperature high enough that you would sweat. Because dialysis patients are usually anemic, patients seem to feel cool when their family members are comfortable. Therefore, to get the temperature up high enough to open capillaries like exercise does, I’d be willing to bet that everyone else in your house would be smothering. Anyone who has worked in or dialyzed in a dialysis clinic knows that they are typically never what you would call warm (unless the air conditioning breaks):D.

Its easily doeable, only the room you dialyze in has a small heater, but that can also pose a problem for the dialysis machine power supply overheating.

As for dialysis clinics beeing cold its a fact. I asked them why they have it cool all the time and the answer was to keep germs down at a safe level… I guess they mean the pothogens.

I never heard that one about keeping germs down…but that’s an interesting excuse. I think you’d have to keep it much cooler than what clinic temperatures are set at to keep germs down. I’ve always heard from staff that the reason it’s cool in the clinic is because they have to wear long sleeve barrier garments to keep any blood spills off their clothes and they get warm because they’re moving a lot of the time. People on dialysis are cool because a cup of blood is out of their bodies circulating through the lines and dialyzer, they’re sitting still, and vents may even be blowing on them. The suggestion I’ve always heard for patients who were cool was to bring a blanket. Some patients in my old clinic brought hats and gloves too…which lets you know how cool they thought it was.

I had never heard this story. Before people think that this happened in the U.S., I did an Internet search and found that it reportedly occurred in Kuala Lumpur in May 2005.

The patient who wanted it cooler apparently used a machete to slash and kill the patient who complained it was too cold. http://www.hindustantimes.com/news/7242_1374610,00180008.htm

As a follow-up, the patient who committed this crime was on the lamb, not getting dialysis, and was found unconscious and died a few days later.

Morals of the story:
– Dialyze at home where you have control over the temperature.
– Missing dialysis treatments can kill you.

I don’t know about anywhere else, but here, the dialysis centres operate under strict hospital infection control rules. This means the temperature is deliberately set lower to help prevent bacterial growth. This is why I always froze while dialyzing in-centre, but I’m perfectly comfortable at home.
Pierre

Hehehe,… :lol:

Nothing like home, its a Godsend beeing at home…

Since raising the room temperature is not feasible for various reasons, would having patients dress very warm and use blankets to raise their body temperature dilate capillaries and make dialysis more effective???

I think the question is will it work? I never saw any research in this but who knows…

On the contrary, do steam rooms work? You know those hot steam rooms where people go inside and sweat…

http://www.buyamag.com/portable_infrared_sauna.php

In a case of injury, heat stimulates vassadilation of peripheral blood vessels, bringing oxygen to joints and extremities, relaxation of stiff muscles, speeding the healing of sprains and strains. The increased blood flow helps aching and injured muscles recover faster because the stronger blood flow, the quicker metabolic and toxic waste production purged from the body, through the skin during perspiration. The skin known in Chinese medicine as the third kidney, because it is believed to be responsible for eliminating up to 30% of body waste.

As a patient, neither being too cold or too hot is comfortable and can make it exceptionally difficult to bear the tx. The tx. is tortourous enough in itself without patients being subjected to freezing temperatures. As far as the unit being kept cold like hospital operating rooms, the Medicare regulations do not support this. It states that the temp. in the unit should be set for the comfort of the patients, not staff. Freezing patients is ridiculous and cruel. To anyone who wants to understand this issue and is not a patient, turn your thermostat up until you are freezing and sit in a chair for about 4 hours covered up with blankets, hat, gloves. Then tell me how comfortable you are. This is not sensible- it is ignorant. Those who are not on dialysis lack insight into what this about. It is about staff putting their comfort above patients. I have been in units where fairness prevails and the air conditioner is set at a level that both staff and patients can live with. That’s all it took to open my eyes to the mistruths staff fed me about why previous units had been kept so cold. Sad to say this goes on, but it is very common and I believe units have been cited for it.

All NKC dialysis stations have individually controlled radiant heat panels above each chair so that dialyzors can have some control over their environment. Reading this thread I remembered a time I was dialyzing in El Paso and the air conditioning did go out. It had to be 90+ degrees in the unit. I was driving around the country at the time and had clothes in my car so I changed into shorts and a tee shirt. I was sweating the whole run and I remember thinking that I was getting doubly cleansed.

Lorelle might be on to something. I know the Norwegians include regular saunas as part of the dialysis prescription maybe the next step would be sweat dialysis.

Bill writes:

I know the Norwegians include regular saunas as part of the dialysis prescription maybe the next step would be sweat dialysis
.

LOL sweat dialyis- that’s a good one! But not while on the tx unless there’s a big pool to jump into afterwards :lol:

As far as the unit being kept cold like hospital operating rooms, the Medicare regulations do not support this. It states that the temp. in the unit should be set for the comfort of the patients, not staff.

Jane, you’re 100% right about what the regulations say and I agree that it’s wrong for clinics to have the temperature set for staff. I always told staff to wear lighter clothes if they were hot when wearing the barrier garments.

It’s important for patients to speak up about how cold they are if the surveyor is at the clinic and talking with patients. Patients can ask to have the surveyor call them at home if they don’t feel comfortable talking in the clinic. If the surveyor doesn’t know, the clinic won’t get dinged for having an uncomfortable environment.

I can remember some of my previous in-center days that even staff members were so cold that they went to their lockers and get their coats on… :lol:

I just throwed the blanket over my head and breathe my warm air in there… hehe… :lol:

That’s ridiculous that it was that cold and making people so cold they had to throw the covers over their head to keep warm enough is unsafe. If staff can’t see people, they may not notice if someone has passed out or if a needle has become dislodged or is leaking.

Why didn’t the staff turn the thermostat up?

You just won’t imagine, the only common answer we patients would get is “Bring a blanket next time”…

Sad is the instances when a new patient arrived and had no blanket and all they’ll do is give them a disposable medical gown… :?

The thermostat itself is would be locked up in a box and I would at one point ask who has the key?

However, once patients brought blankets then it wasn’t that much of a problem…

Beth writes:

Jane, you’re 100% right about what the regulations say and I agree that it’s wrong for clinics to have the temperature set for staff. I always told staff to wear lighter clothes if they were hot when wearing the barrier garments.

It’s important for patients to speak up about how cold they are if the surveyor is at the clinic and talking with patients. Patients can ask to have the surveyor call them at home if they don’t feel comfortable talking in the clinic. If the surveyor doesn’t know, the clinic won’t get dinged for having an uncomfortable environment.

Beth,
I really thank you for acknowledging my feelings on this subject. Can’t tell you how many nephs and staff have given me the royal runaround when I’ve confronted them about freezing cold unit temps. It really has disheartened my spirit to observe the lack of concience in so many who should consider it their responsibility/duty to protect patients’ comfort. It has brought healing to me that a few nurses in my current unit are so thoroughly honest, that they would not dare deny when the unit gets too cold and compassionately take care of the matter by adjusting the thermostat in response to patients concerns.

I always say that the worst thing I have gone through with kidney disease has not been the disease, itself, but the thoughtless and cruel behaviors that go on sometimes in the units. I have never understood how unit staff can see a precious little old lady, someone’s grandmother, shivering from the cold unit conditions with extra blankets, scrungy little snow hat, winter gloves and not have compassion for the discomfort they are putting her through. I have suffered, myself, from cold conditions many times, but this is an image I will never be able to get out of my mind. I feel it is my solemn duty to expose such situations and work for change.

Re reporting this situation and others to the state surveyors, I feel patients are in a Catch 22, because to report such a situation can cause a patient to be “dumped”. Even if they report, anonymously, it always comes back to the one or two educated patients in the unit and I can tell you they will harass or dump those who report them. I want to see patients totally protected from harrassment/dumping should they report a unit violation or file a grievance. In our current system most patients will not come forward, because they are not sure if they will be protected.

I strongly agree with you there, that’s what I’ve seen…its very difficult situation. Making a complaint doesn’t always solve the problem, the problem continues resulting putting the patient in further danger… In the eyes of the clinic its like saying “You ratted us out!!”…“You problem maker!”…and so on… they won’t like you anymore.

If a clinic tries to discharge a patient for expressing to the surveyor his/her thoughts about the quality of the care in the clinic, my suggestion would be to tell the clinic that if it threatens discharge, you’ll be contacting the state survey agency and ESRD Network to file a complaint. You may also contact a lawyer to see what legal rights you have. I bet that last threat would move your complaint to a higher level in the chain of command (to risk management people) who will have better judgment than those in the clinic who are emotionally involved. Discharging someone because of complaints about a cold clinic is pretty ridiculous.

The ESRD regulations state that patients have the right to file complaints and grievances without fear of retribution. The ESRD regulations do not allow a clinic to discharge a patient for expressing his/her opinion. Reasons listed for discharge include if the patient is dangerous, if his/her medical needs are beyond what the clinic can provide, or if the patient refuses to pay fees.

I think because patients are dependent on dialysis for their lives, so they worry about repercussions that in most cases never happen. However, as long as clinics can make someone fear they’ll be discharged, patients won’t speak up and those clinics that use this fear can continue to provide substandard care in an uncomfortable environment.

If I were in this situation, I wouldn’t want to stay in a clinic that provided poor quality care and where staff treated me disrespectfully. Some patients don’t have many options. However, anyone on dialysis who has the capability or has capable loved ones should consider home dialysis so they can have help to dialysis from someone who cares for them in a comfortable environment.

And there needs to be a good way that surveyors can find out what really goes on in clinics without patients having to fear retribution.