Have any of you gotten any stomach flu? Was it very hard to deal with it and doing dialysis?
As you know being on dialysis and having a stomach flu can get things worse as nutrition is not getting to the body normally. According to recommended guidelines on caring for stomach flu you think this same rule applies to people on dialysis?
Good question!
I haven’t had one yet, but I did have one of those head colds that seem to last for 2 weeks. I wasn’t at home yet though. It happened while I was training. My nurse was easy on me and she didn’t make me do much during that time, beyond just setting up the treatment - which was good, because I really didn’t feel like doing anything at the time.
This is one major disadvantage of unassisted home hemodialysis in my opinion. It’s one thing to go to the dialysis centre rain or shine, when you are already sick, because only have to sit there and suffer, but I think it’s quite another matter to be at home when you are sidelined by a bad flu. You still have to sit or lie there and suffer, but you also need to be alert enough to setup and monitor your own hemo treatment. I’m sure the motivation factor goes way, way down. And you can’t really take any medications that might make you sleep, because you still need to be reasonably alert.
I suppose if a person were sick enough, but not sick enough to be admitted to hospital, they could always get dialysis at the centre for a day or two. However, I suspect that in practice, it’s not so easy.
I tend to have summer respiratory allergies, and already I find that on nights when it’s bad, it’s not much fun to be on dialysis all night. Of course, it’s still better than the alternative.
Pierre
I have wondered, too, how home patients who do not have a caregiver/tech handle things when they are either really tired from a full day or feeling too ill with a flu, or other problem, to conduct their txs.
When you do nocturnal hemo 6 nights per week, you can always skip a treatment without any problem when you really have to - as long as you’re not like 3 kilos overweight already that night. That wouldn’t leave you with much drinking room for the next day, which is really the only problem with skipping a treatment.
Pierre
I don’t know what the situation is in Canada, and although clinics may not be thrilled to have an unexpected patient, when a US dialysis clinic gets certification from Medicare to offer home dialysis training and support, it agrees to provide in-center dialysis to its home dialysis patients.
I’ve worked in dialysis clinics that trained and followed home hemo patients. It was not common for them to come in-center because, like all of you, most who do home dialysis prefer to do their dialysis at home, not in a clinic. However, there were times when people needed to be in-center. Sometimes a partner was gone or needed a break. Sometimes the patient was unstable and needed more attention. Sometimes there were machine problems that couldn’t be resolved quickly. Sometimes a patient needed a drug or something that could only be done in-center.
If you’re ill and don’t feel confident in your ability to do your treatment safely, you definitely should call your home training nurse and ask to come in-center temporarily. A good home training nurse will advocate with the clinic on your behalf to make sure that this is possible.
In one clinic where I worked, home hemo patients sometimes did their dialysis treatment in the home training area instead of in the clinic area. I’m sure this would only be possible if 1) the clinic always had a machine there 2) there was no other patient training, and 3) if the home training nurse was going to be there to help the patient.
There was one day I really didn’t feel well and had a fever, well when you do 6 days a week, missing one day really isn’t that big a deal. I skipped that night and felt better the next day. I think I’d have to be pretty sick to absolutely be unable to do treatment, once you’re on you pretty much rest. I can do 95% of my set up sitting down, and in a pinch, my 11 year old knows how to do the water testing and fill the bicarb jug and get my supplies which is all that requires getting up and down, well I do need to weigh and wash, but that would be it.
I’d have to be pretty sick to ask to go in center, but I know that they would find a way to accommodate me if I was really ill. I’m on to my 1 year count down and still have never dialyzed in center.
Cathy
self home hemo 9/04
PKD
I would be able to get my dialysis in at least one of the 3 hospital hemodialysis centres in a pinch. The home dialysis unit is part of the overall system. It’s all the same department. All I’m saying is that the first day, I would probably be told to just skip the treatment and see how I feel the following day. And it would end up being a short daily (2 hour)treatment. I suspect that many people are like me, in that I don’t think I would throw in the towel and ask to go in just because of a flu. In practice, I would probably just suffer through it and do my dialysis regardless.
Pierre
Back at my clinic (WellBound) they have 3 training rooms, one reserved particularly for PD and the other 2 for Hemodailysis users who are training. They handle 2 trainees per month. I was told that they wanted to create an extra room for that purpose, to provide temp dialysis in-center for their current homehemo dialysis patients when needed. However, there’s also a dialysis center next door (Satellite Dialysis) partners.
Like Pierre said I guess most of us will try to handle this on our own but if it’s just too hard then there’s our last option to take.
One of the things that also concerns me is of a pandamic virus or where all patients doing homehemo get all sick at same time. Are we prepared for this kind of things?
In answer to Jane’s question about being too tired to start a treatment…
I kind of face that almost every evening. You can’t start a nocturnal treatment too early in the evening, or else you will be taking yourself off at 4 in the morning or something like that. By the time I start setting up, I often get extremely sleepy. So far, I just make myself a coffee, and it seems to give me just enough of a boost to put myself on.
As I already mentioned, I haven’t actually had the experience of being ill with a flu or anything like that.
One night a couple of weeks ago, I was really sleepy by the time I started assembling my treatment. I started around 10:00, because I had actually dozed off earlier. After testing the carbon filters and then rinsing the R/O, I started my setup. Once I got to putting the dialyzer on, I opened the package, and I looked for the caps I have to screw onto the dialysate connections on the dialyzer. They weren’t there. No caps. So, I look in the rest of the dialyzers I got on the last delivery (2 whole boxes). None of them have the caps. What the heck! You can’t proceed without those caps. While trying to decide what to do, I realize that, "Hey, these are F7NRe’s, not F70NRe’s. They sent me the WRONG dialyzers! The numbers are so similar, and the colour and design of the label is identical, so I never noticed when I got them. So, I call the duty nurse, and she arranges for me to pick up a couple of dialyzers at the main hospital dialysis centre - which luckily is only a 10 minute drive away. But I still had to park in the big parking garage, etc. By the time I get back home, it’s getting later and later. I begin thinking that maybe, I’m too tired to do this at this point. But, once I had the right dialyzer, I continued with the setup, and I was finally on treatment a little after midnight. I didn’t want to skip that treatment because it was the first one after the preceding night off. In the end, sleepy or not, you just do what you have to do. After doing some 100 home hemo treatments now, it’s becoming pretty routine to set it up.
Pierre