The Dialysis Experience
For over a month after his
Wegener's diagnosis, Ben had dialysis every other day.
It is more important to know
what sort of person has a disease
than to know what sort of disease a person has.
Hippocrates
The kidney biopsy showed 'minimal' scaring and severe inflammation. The steroids job is to reduce inflammation. There is no predicting how the inflamed tissue will heal. As inflammation is reduced the tissue will either scar leaving no kidney function or heal to regain kidney function or do something in between. (Ben's creatinine level has dropped faster than expected (YEA!). He hasn't had dialysis since August 25, 2003.)
An artificial kidney keeps the blood levels balanced so life can continue. Ben was on hemodialysis. That is where the blood flows through a 'temporary' catheter on his chest through a machine that filters out the waste products and extra fluid. The clean blood flows back into his vein. If this becomes a chronic condition in the future, he may be able to do dialysis in Mt. Vernon, Everett or at home. Home dialysis can be hemodialysis but is most often peritoneal dialysis. In peritoneal dialysis, the belly is filled with a special fluid. The fluid collects waste products and extra water from the blood. Then the fluid is drained from the belly and thrown away. This can be done as you sleep to free up your day.
Dialysis can cause nausea, cramping and blood pressure problems. Ben tolerated dialysis well even when 3 liters of fluid were removed from his blood to get to his dry weight. The treatment usually makes him shivery and sleepy. The last two dialysis treatments caused a rise in Ben's pulse and blood pressure indicating that he might be too dry.
Establishing Ben's 'dry weight' was a problem since he was dehydrated when he came to the hospital and had lost weight over the previous nine days. Dry weight is the base for calculating how much fluid is being retained. The fluid has to be removed to keep the heart from over working and keep fluid from collecting in the lungs. All of these measurements are done in the metric system so we are finally learning the conversions.
Dialysis
access: (click to view off site
description)
The type of catheter Ben used gives direct access
to an artery just above his heart valve and his jugular vein. They
call it a 'permacath.' With this type of catheter there are tubes that hang out of
the patient's chest. This type of access is highly susceptible to
infection. The good part is blood can be drawn without a poke. Ben's main concern
was that there can be no water sports. Even showering is tricky.
With this catheter installed skimboarding, innertubing behind the boat,
and overnight kayaking trips are not possible.
If dialysis is long term, a patient can have a surgery to connect an artery to a vein in his arm creating a more permanent access. That would require poking needles at each dialysis visit but would allow water activities on non-dialysis days.
More about kidney failure. A person can have 50% function and still have an acceptable creatinine level. That is why a person can donate a kidney for transplant. There is an 8 hour test done in the dialysis unit that can test function. Ben may have this test in the future.
Life size permacath
(our show and tell version)
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