“I Don’t Know About This!”( A Patients Initial Dialysis Treatment) Pt 6

So if you came everyday, you wouldn’t have to come here. You may not have known this or have been informed , but did you know as a Renal Patient you have options? The option to do Dialysis here which is In-Center( Chronic Hemodialysis Outpatient Facility) or at Home!”..( HHD- Home Hemodialysis)“ Dwelyn I can do this stuff at home???? How???? Sign me up!! !! I can start next week !!! ( AW is determined to get out here ,LOL). “ Well hold on AW, ( as I said it with excitement and a bit chuckle) it’s great that you’re highly interested in taking control of your treatments as well as your life, however there a certain amount of steps to take in order for you to do Dialysis at home. For example you will have to go through proper training and possibly have someone with you during your treatments like a family member. Keep mind that doing dialysis at home is a great deal of responsibility. Just imagine doing the work we do here and giving yourself your own treatments. “ So I will have to be doing all this running around and stuff?”, “ No , lol , however you will be required to setup your machine, organize your supplies, and keep a record of your treatments and it’s documentation. Also while maintaining a highly clean environment to reduce the risk of infection. The good thing about doing your treatments at home is you have complete autonomy of when you do it during the  time period of your choice rather it’s during the day or at night, and the the comfort of your own home is grand, and less stressful as far as waiting for someone to do things for you. Overall it is basically you as a Renal Patient taking more control of your health and life. 

You also asked about this Solution Stuff and where it is. Now if you were doing your treatments at home like I said earlier you would have it delivered to your home. Since we are her in the clinic , let me paint you a picture and take you on a somewhat chemical journey. Your dialysis prescription or order prescribed by the Nephrologist states that your K bath is 2K and your Calcium is 2.5 ……  “ Dwelyn what is K?, “ K Bath stands for Potassium. “ Your Potassium and Calcium bath or solution plays a major part in your treatment. Prior to your prescription, you were possibly screened for your body’s electrolyte balance . Meaning you may have had your blood drawn and the test results were determined. As far as Potassium concentration determination if your potassium in your blood had a reading of 4.5 – 5.0 , then chances are your doctor suggested you be on a 2K bath. Sodium concentrate can be determined if you or a patient is hypernatremic( which is a high concentration of sodium in the blood) this comes from individuals not drinking enough water rather it’s impaired thirst or mental judgement. “ You ever here people say,”Water is nasty?”, Well it’s the best drink ever!” My opinion 🤓😬 . So let’s talk about Bicarb or the proper term Bicarbonate. This determination is calculated if the patient is alkalotic ( this comes from the term Alkalosis which is the result of a process reducing hydrogen ion concentration f arterial blood plasma ( alkalemia). In addition to acidemia( which is serum pH ranging from 7.35 or possibly a lower value) . Alkalemia occurs when the serum pH is higher than normal (7.45 roughly or higher)… So not to confuse because I know this is a bit much. What I’ve said to you overall is Dialysis is made to create Balance. Kind of like balancing the world as we follow our moral compass. Or a gymnast walking on a balance beam . A trapeze artist walking on a tight rope. “ Ah I see Dwelyn , kinda … Or like a drunk guy walking a white line ,” lol, oh wait that’s a bad example, but it’s sort of registering. Even though I’m not a chemistry expert like you, it kind of makes sense. “ Well Thank you AW, but I’m definitely not a Chemistry expert and I had to research this myself in order for me to know what I’m doing as far as your treatment and quality of care. It’s important that we make sense of what this process is to our patient so they can overstand . “ Ah you mean dumb it down , huh Dwelyn!” LOL….. AW I hate that word ( LOL)….. AW let’s talk about Dextrose concentration. This isn’t common in a dialysis setting due to their isn’t any in the dialysate solution. It’s important because in your case you’re a Type 2 Diabetic. With that being said, the addition to glucose to the dialysate solution reduces the risk of hypoglycemia. This is kind of one of the reasons why we strongly suggest no eating while on dialysis. This can cause hypoglycemia for the simple fact that their isn’t any glucose in the dialysate solution. Especially if you’re a diabetic, no eating , but personally I feel a light snack should be allowed. However in my opinion diabetics are more at risk due to imbalance of their blood sugar if they’re not heavily monitored Or controlled.  “ Dwelyn you raise an interesting point , because I thought everyone on Dialysis had Diabetes. “ Well Diabetes is the number one cause of Renal Failure, followed by Hypertension ( High Blood Pressure), so I can see why anyone would think that as such. 

Disclaimer( As you’ve noticed throughout the conversation between AW and I we have a tendency to jump from one subject to another. That’s because I’m in the Dialysis world. There are so many loose ends and infinite puzzle pieces. Kidney Trails never end. That’s our agenda, goal , and purpose here for writing these stories, or if you will ….. Episodes)

You asked me earlier ,” Where is this stuff( solution)?”, Well take a look here behind the machine( as I gently and carefully moved her machine to the side) at this Red port and Blue port that’s plugged into this wall water box. See your red…….” Wait a minute Dwelyn, wall water box??? This looks like some plumbing thingy.! “ Yes!! AW it’s like plumbing for the body. This section here in the wall is connected to a socket device that has access to our Acid and Bicarbonate system that’s in our RO room. When I say RO I mean Reverse Osmosis( described as a process by which a solvent passes through a porous membrane in the direction opposite to that for natural osmosis when subjected to a hydrostatic ( hydrostatic meaning it’s relating to fluid or same pressure) pressure greater than the osmotic ( osmotic meaning it’s being applied to a solvent to prevent it from passage into given solution) pressure . So remember I said Balance. Keep that in mind because this is just a bread crumb of how we as healthcare professionals try to create Balance with the body chemistry for a Renal Patient. ,” Dwelyn this is intense and scary because this is all new to me and who would’ve thought of this?!”, “ So you still haven’t told me where all this is coming from!”,” Oh AW , you mean where in the building?”,” Yes!!! I see other patients and workers here running around and doing whatever. Is all this stuff in that machine?

To Be Continued…… Stay tuned for Pt 7 as AW is introduced to the Water (RO) Room

Published by DiabeTech77

Hello to all of you our wonderful Kidney Trail Hikers . My name is Dwelyn Williams, CCHT, Immediate Past President NANT . I would like to say Thank You for joining us on The Kidney Trails. A brief story of who I am . I started my Hemodialysis Technician career in January of 2000 in Charlotte,NC. During that time and now the present I have been a Traveling Hemodialysis Technician, a Chronic Preceptor, an Acute Preceptor, Kidney Smart Educator, proud NANT Board Member , and a Hemodialysis Technician Instructor. My current status is a proud employee of Fresenius Kidney Care- Arcadia as a Hemodialysis Technician CCHT/VAM and also an Acute Hemodialysis Technician here in the Phoenix, Arizona area. My involvement with dialysis goes back as far as the early 90’s. My mother was a ESRD patient during that time. We as a family contributed to her well being by assisting her with CAPD at home. After a year of doing a home modality, she ventured out into outpatient dialysis in a chronic setting of hemodialysis. With that being said , I developed not only a interest I dialysis but an extreme curiosity of what this disease was and its effect on my mother and our family. This placed a heavy matter on me due to the fact that it was beyond personal and it could happen to any of our loved ones. Serving as a NANT member and on the NANT Board has aloud me to express my concern and issues amongst others. The ability to possibly influence others. To share my passion within my profession alongside developing my craft. My goal is to encourage every Nephrology Clinical Technician that they are important in more ways than one, and to know that they matter in our patients lives. I hope to inspire more Nephrology Clinical Technicians to take on more leadership roles in their communities, clinics, and NANT. As a newly Author and Kidney Trails Family member it’s is my duty to deliver the most epic and profound stories of my vision of Renal World. What a great time none other than during this tough time we are having in the world today being impacted by the COVID 19/ Coronavirus. We hope as you hike with us along The Kidney Trails , that each step we take is with Essential Potential.

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