Transplant Athlete
Friday, August 07, 2009
  I Will Not Be Helpless

I just read an old article from Dialysis & Transplantation Magazine titled, "Why Home Hemodialysis?" by Jim Curtis, CHT.

Points he made:
1) long interdialytic times (up to 68 hours on the weekend) for in-center patients allow waste to accumulate, then it gets ripped out in a four hour session.
2) A study presented at the 2008 NKF Spring Clinical Meeting found that Standard in-center dialysis leaves patients in a state of kidney failure (CKD Stage 5 - no kidney function), whereas long nightly dialysis leaves patients in a state comparable to CKD Stage 3 (which is like having some kidney function). Obviously, a transplant would leave the body in a state of full kidney function.
3) In-center dialysis encourages "learned helplessness" - everything runs more smoothly if patients show up on time, do what they're told, and leave right after treatment.
4) The center reminds them they are sick, they are around other sick people. According to the article, there is sometimes a waiting list for favorable times and days (apparently, M,W,F mornings are the most requested).
5) There's an ad out lately, I think it's by DaVita that says, "90% of physicians would prefer home dialysis for themselves if they needed dialysis."

I can certainly relate to the first point. I felt like crap after most of my in-center treatments, but after a good nights sleep, I bounced back. I couldn't do dialysis in the morning, my whole day would be spent recovering. It's a very aggressive form of dialysis.

As to point 2, I certainly feel better, I'm not just alive, I'm living. It's not as convenient as a transplant, but I'm getting back to my regular activities.

After seeing point 3 in print, it was no surprise that I didn't really get along back at the center. I need to be in control. I avoid alcohol because I don't like the loss of control. Sailing on larger boats is very hard for me because I don't like the loss of control. I am fine in something small like a Force 5 where I can control the rudder and the sail, but my dad's 17' Islander and later his larger boat got my fight or flight response going. I dislike rafting, but I like kayaking, it's a control issue. I'd also like to point out that it was hard getting answers to questions when dialyzing in-center. You see the doctor once in a blue moon, there are nurses there, but most of your interaction is with technicians, some of whom know little more than how to set up the machine and cannulate a patient (which they do very well).

In an earlier post, when I described my first dialysis experience, I think I mentioned the other patients, who looked like they were one step ahead of the grim reaper. There are patients like that in-center, people being wheeled in on gurneys, in wheelchairs, hobbling in on canes. There's the occasional coughing and vomiting. It's not a very optimistic place.


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I've gone through kidney failure twice. The first time in 2000, my mother donated a kidney; and again in 2008, I'm on dialysis waiting for a breakthrough in immuno-suppression medicines before seeking a new kidney.

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