How To Make The Transition To Your Life On Dialysis

Undergoing dialysis treatment is something that will definitely change your life. As we have mentioned here on numerous occasions at Joe Cosgrove’s blog, living with dialysis has a lot to do with adjusting to the new definition of what you consider normal in your daily routine and the way you look at life in general. With that being said, it doesn’t mean that everything you enjoy doing has to stop because of your treatment and that you simply have to adjust to a life that excludes you from things like traveling, eating anything you want and working like everyone else. Dialysis simply becomes part of who you are and the way you go about those activities that bring you joy is just a bit different, even more fulfilling at times.

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One of the biggest challenges of living with dialysis is probably one of the things that has to do the least with the treatment itself, and that is accepting it. Dialysis is a big word that conjures up images of sickness, needles, hospitals and pain; most of that has to do with a bad reputation that it has acquired over the years and just the ignorance sported by the general population when it comes to kidney disease. These types of treatment exist to make you better and every single day there are brilliant minds and large amounts of resources working hard at advancing this processes even more with the aid of cutting-edge technology in an attempt to give patients a better quality of life and a warmer acceptance of what living with dialysis means.

Today on our blog, we want to talk a little about the beginning of your life with dialysis and what you should expect in the first couple of months while you get used to it so you can make the best out of this challenging time in your life.

Understand the alternative

Dialysis is a relatively new treatment and before that, there was nothing that you could do for patients with kidney failure, something that pretty much meant that you were looking forward to an extreme decline of your health and most likely dying from your condition. Today dialysis can not only keep you alive, but it can do with while giving you a considerable quality of life as it becomes such a manageable part of you, that you will simply come to live with it seamlessly.

The dialyzer has limits

The machine that is helping you clean your blood during the dialysis treatment is not a magical device that can completely replace your kidneys. Kidneys are truly remarkable organs and are able to withstand a lot of damage before failing, they are truly irreparable and no machine exists that can do what they do as well as they do it. Understanding that is crucial for you to realize that while internally there isn’t much else you can do to help your kidneys other than undergoing the treatment, externally there is a lot you can do to compensate for the dialyzer shortcomings. Things like eating healthy, exercising and taking care of yourself so as to alleviate the stress your body has to go through are great ways to making sure that all your efforts are directed towards making the treatment work as well as it possibly can.

Find ways to make yourself comfortable

Yes, you are just lying down and reading or watching TV waiting for the treatment to be over, but as you are apparently relaxed and not doing much, your body is working overtime dealing with everything that is going on. Your blood is being extracted, cleaned and then pumped back into your body constantly during a session that may last up to four hours, this means that your body has to take all these in and push itself to compensate. It is very common to feel tired even if you think you did nothing during the day. Give your body time to get used to the changes.

Lean on your support network

Give the people in your life who care about you the opportunity to be there with you and to participate in whichever way you think it will make the process easier for you. Those around are also affected in their own way, so make sure you don’t neglect this support network and allow it to help you get through the tough times. People in the dialysis community are also very supportive of new members and will answer your questions and take you in if you need anything. You should take advantage of their experience and knowledge dealing with dialysis and even share with them the ways that you are making it work for yourself. Remember you are not alone in this and the condition can be a bonding experience with your family, friends and other loved ones.

What is it like to live with dialysis?

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In the United States at least 217,000 patients need to live with dialysis. This represents national costs for over $11 billion dollars every year. This procedure needs to take place when the kidneys are unable to filter fluids and their full capacity is lost. Sometimes, patients who need to live with dialysis have to do so because they were born with a kidney condition and they cannot afford a kidney transplant.

Statistically speaking, this is a dramatic situation for thousands of people in the United States. However, most patients seem to believe that dialysis is not such a terrible thing and they have adapted to a “new normal life”. But, what does it means to live with dialysis? In this article, Joe Cosgrove will share some details related to the way patients learn to have regular lives while they depend on dialysis to survive.

The Experience

First of all, when a patient decides that it is time to go under dialysis treatment it is because its kidneys are not able to do their job. This means that dialysis becomes the only alternative to survive. Keeping this in mind makes it easier and more motivating to people who need to go under treatment.

During a regular dialysis routine, the patient needs to come to the dialysis clinic and meet the nurse at the counter. Papers and forms will be filled out and a short checkup will take place. Since most patients have done this a thousand times, the process usually doesn’t take long.

After the checkup, the patient settles into one of the comfortable recliners inside the room where the process usually takes place. The patient may be the only one in the room or not, depending on the day and time it decides to go and get the treatment.

After settling, the patient will need to prop its left arm, allowing the technician to slip a couple needles into its blood vessels (close to the wrist). One of the needles is in charge of removing the blood and the other one is in charge of taking it back to the body. These needles are attached to plastic tubes that at the same time are connected to the dialysis machine.

For the next three hours, the needles will do their job and the patient’s blood will be filtered. All this is possible thanks to the dialysis machine that stands still next to the patient’s recliner. Most patients bring a book or spend this time watching a movie or a TV show on Netflix. Sometimes, this is even the perfect moment to take a nap.

Besides from the initial moment of the procedure, when the needles need to be stuck on your veins, the dialysis process doesn’t hurt. Sometimes patients may feel dazed and their blood pressure can drop. But, other than that, the process takes place in a comfortable way.

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Living with dialysis is supposed to make things easier for patients with End Stage Renal Disease (ESRD). However, the mortality rates in the United States remain to be considerably high compared to those in Japan or Europe since many patients choose to skip the procedure or don’t accept it to last for too many hours.

Related: How To Make The Most Out Of Your Time On Dialysis

How Dialysis Works

The best way to describe the dialysis process is as an artificial kidney. This means that dialysis should be able to do what your kidneys cannot do anymore. There are two different forms of dialysis: hemodialysis and peritoneal dialysis. At least 90% of the patients in the United States who live with dialysis choose to go under the hemodialysis treatment. This is the procedure that was described in the experience above.

When patients live with hemodialysis, their blood needs to be circulated outside of the body with the help of a hemodialysis device. This device cleanses the blood and then returns it back to the body of the patient.

Not everyone is a right candidate to get hemodialysis. This is why every patient needs to have the doctor’s approval before having an entrance or access (a minor surgery on the leg, arm or neck to access the blood vessels). This access is called fistula and the patient will need to keep it clean and usable for as long as it needs to go under dialysis treatment.

The fistula is something dialysis patients need to learn how to live with since it is the only way doctors have to access the blood in a fast and effective way. Fistulas are joints between arteries and veins located under the skin that form a larger vessel where needles are inserted.

When patients don’t need to live with dialysis and only go under a temporary treatment, they can get a catheter on their neck and there is no need for them to go under this minor surgery. In the case of the fistula, the wound needs to heal before the dialysis treatment takes place. However, in case patients use a catheter, they can go under the dialysis treatment right away and the procedure is slightly different.

Is dialysis always recommendable?

People who are currently on dialysis have different characteristics: although, as mentioned in previous articles by Joe Cosgrove, kidney failure may affect all kinds of people, adults aged 75 and older are seemingly the fastest growing group under the treatment. And while dialysis is, to some extent, the best possible solution to some stages of the condition, one question still lingers amongst patients: “How long can they expect to live?”

This has been a matter of study at Tufts University and other institutions. In a recent publication, the aforementioned institutions carried out a research regarding the topic and found that up to 95% of patients want to be given information about life expectancy. Such figure depicts the staggering growth of concern around dialysis and life expectancy: when compared to a similar study carried out in 2010, almost 90% of patients never really got to discuss the issue with their nephrologists.

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Now, universities alongside researchers, doctors, and physicians call for those who are not explaining prognosis to their patients to do so while addressing the topic by assessing the benefits and downsides of the treatment according to the patient’s expectations. Such premise has also been adopted by the Renal Physicians Association and the American Society of Nephrology but reality shows otherwise: such advice is being widely ignored in practice.

Several experts, in an attempt to address the topic of life expectancy versus dialysis, agreed upon the conclusions: older people on dialysis have a considerably shortened life expectancy compared with other people in such age group. This is substantially true when other diseases also accompany the condition: up to 33% of older people with severe kidney failure normally suffer from other illnesses such as hypertension, dementia, different heart diseases, diabetes, etc. Physicians agree that 70 to 75-year old patients on dialysis may expect to live 3.5 years on average, compared with almost 12.3 years for people of that age. For 76 to 79-year olds, the figures plummet to a drastic 3.1 years versus almost 9.1 years. As for 80-years old and older, the figures dropped to 2.5 versus 6.6, sometimes less. Nevertheless, it is important to point out that estimating such life expectancy depends upon a plethora of different factors, which is why there seems to not be a consensus regarding the applicability of these figures. Since some people may do it better and other may do it worse, it is hard to predict in a precise manner whether a specific patient will get to live such and such amount of time; however, it is unquestionable that the more conditions or diseases someone has, the less likely will their life expectancy be after starting dialysis.

Such circumstances become especially true in patients with ischemic heart diseases since the blood flow to the heart is reduced. In fact, physicians seem to agree upon the fact that that condition alone is enough to dismiss any potential benefit from dialysis in older patients.

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The research also concluded that older people who are unable to dress, go the toilet, bathe, eat on their own or get out bed in the morning are not likely to improve on dialysis. Such conditions raise the question about whether dialysis seems to be a wise choice in hopes of living more time; however, if someone seems to be relatively healthy, that is another matter entirely.

Since the likelihood of adding longevity to the elderly is, to some extent, still debatable, given the sheer array of circumstances that affect the chances of succeeding, another question seems to linger: “Can patients live longer on dialysis than on other types of supportive therapy?” Studies suggest that older people on dialysis will certainly live longer than those who dismiss the possibility of starting the treatment and choose instead to treat other pathologies like pain or nausea —which is commonly referred to as supportive therapy. According to a recent compilation of studies and reviews, patients who decided to start supportive therapy had a life expectancy of at least six months, which, compared with patients on dialysis, is far shorter. In general, the evidence supporting an advantage in the elderly on dialysis is somewhat weak, and there is definitely growing concerned amongst the scientific community that perhaps too many patients may be on dialysis without assured potential benefits. There has been a growing concern regarding overtreatment on older individuals, especially those who suffer from other diseases or depict the conditions mentioned above and are frail or have any sort of life-limiting conditions. Older patients and their families deserve to be given honest and precise information so that they can understand what they can expect when their primary physician recommends undergoing the treatment. Dialysis is without any question a very demanding and exhausting treatment; is, in fact, one whose potential benefits and burdens deserve careful assessment and consideration.