Sunday, June 29, 2008

Peritoneal Dialysis

This post is written by my sister-in-law, Kitty. She married my brother when I was eight years old so I can honestly say, I have known her as long as I can remember. Kitty is one of my dearest friend and also one of the most creative and talented people I know.

In 2004, I was about to lose my kidney function, so the doctors at Mayo in Rochester, MN strongly suggested that I try to find a donor as well, I was put on the National Kidney Donation List. I was very lucky to have my sister-in-law, Mary (the writer of this blog) donate me a kidney. Unfortuneately, one and one-half years later, I had to start dialysis.

I would like to explain the two types of dialysis that I have done. I did Hemodialysis for one and one-half years. Hemodialysis is a process, which cleans your blood by tubes injected into a fistula, (a fistula is made by a surgeon, mine is in my upper arm by my left elbow. The first one I had put in was near my left wrist, but it quit working, so I had to have a second one put in). Three days a week; Monday, Wednesday, and Friday, I went to a dialysis center and a nurse injected the two tubes into the fistula in my arm. I sat in a recliner chair for four hours while my blood flowed through tubes into a filter (large machine) to clean out wastes and extra fluids. The newly cleaned blood flowed through another set of tubes back into my body. This treatment can also be done at home.

I decided a year ago that I didn't like the 45-minute drive to the dialysis center and with the cost of gas, I chose to take training to do my own dialysis. This type of dialysis is called peritoneal. First, I had to have a tube (catheter) surgically put into my abdomen for the solution (dialysate) to get in and out of the abdomen. There is no blood exchanged in this process. The dialysate solution draws the inpurities and fluids from blood veins in the abdomen. I have a machine, which is the size of a large typewriter, which holds the dialysate bag on, which keeps the solution warm. There are two other bags (storage bags), which are also connected to this machine. After I use the warmed dialysate, the machine pumps the dialysate from the storage bags into the bag on the machine to keep it warm.

My schedule:

I like to hook up to the machine early in the evening (I have to be on the machine for nine hours). It first drains out the dialysate, which I have in my abdomen (into a large container) and refills the abdomen. Every (approximate) two and one-half hours this process repeats (four times). It takes about 30 minutes each time. The first thing I do each morning is check my blood pressure, take the readings off the machine, weigh myself, and dump the used dialysate. This information is given to my dialysis nurse. My nurse and doctor keep very close tabs on me. I talk with my nurse at least once a week and I go in to see the doctor once a month and have blood work done.

After I get up in the morning, my husband helps me and we strip the machine of tubes, etc. and reset it for another day. My first exchange is between 7:30 a.m. and 8:30 a.m. I disconnect from the machine and I am free to go about my day. Between 1:30 p.m. and 3:30 p.m., I take another bag of dialysate, which is heated and do a manual exchange. I have an I.V. pole, which I hang the full bag on and there is an empty bag connected, which is laid on the floor. I use a clamp to shut on the full bag until I have emptied into the empty bag. Then I remove the clamp on the full bag and clamp the tube to the used dialysate bag until the dialysate bag is empty. I'm done now until I hook up for the night.

I feel much better with the peritoneal dialysis. When I was on hemodialysis, I would feel so punk after the treatment, that I usually just wanted to go home and lay down. Also with the peritoneal dialysis, I can eat and drink most whatever I want. There are a few restrictions, but I'm handling the diet pretty good.

There definitely are some pros and cons with the peritoneal dialysis. Perhaps one of the cons would be having mega boxes of dialysate to store. My last shipment, which is delivered to my home once a month, was a total of 54 boxes. This requires lots of storage room. I use seven different sizes and strengths of dialysate.

Dialysis kind of cramps my social life, but I try to make the most of the situation.


I have one more comment to make. While the outcome of the transplant attempt for Kitty was not what we hoped it would be, I would like make people aware that there is such a thing as "living donors". There are many, many people on transplant waiting lists, and I can speak from experience that there are no adverse physical problems resulting from being a donor. It is something to think about...