Are there not other ways my body can get rid of poisons?
Why of course. You can sweat, blow out some (ketones/CO) through your lungs, and take medications that make you defecate until your anal sphincter is swollen and redden. But with the kidneys (and you only need one!) Dialysis Diabetes Diet DIE… that‘s exactly what will happen when you no longer have a efficient way to remove the toxins from your blood stream.
Dialysis is an attempt to do just that…rid the body of toxins when the kidneys can’t. I already mention the types of dialysis in earlier articles. But people are still coming to dialysis units daily. So let’s be blunt:
What poisons or toxins I am talking about?
There are many. But to keep it simple so you can then follow the dietary restrictions, one must understand the 5 basic things the kidney does. 1) Control blood pressure, 2) balances minerals like sodium (salt), potasium, phosphorus, other acids; 3) makes vitamin D work; 4) removes fluid-urine; 5) prevents anemia.
And when these minerals and acid is not properly balance, the toxins oozes from your sweat and breath, your skin itches and your breath smells like urine.
My appearance will change?
See section on what’s a dialysis center/unit. But you will need some type of surgery to create an ‘access’ to hook you up to the machine. Whether it is hemo- or peritoneal – dialysis. Various places on your body: your neck, groin, abdominal wall (NO, not your stomach. Food goes there), your lower or upper arm, your thigh. And guess what? There is no guarantee that after you go through with the surgery, that the access is even going to work properly enough to place you on the machine. Why? Not the fault of the surgeon, but the diseased calcified veins/ arterials you have destroyed with the past ‘umpteen’ years of poorly controlled diabetes, high cholesterol and hypertension (high blood pressure).
Can I still take Vacations?
Fortunately you can still do this. Even travel outside the country on cruises, especially if you have private insurance. However some of these insurance companies after 2-3 years switch to Medicare-type coverage and various HMO/PPO programs as well. We will wait for Obama-care to see how that goes.
Can I still work?
Again, it depends on your company and insurance. It’s difficult maintaining a job if you have to be somewhere else three times out of the week. And hopefully your graft doesn’t clot off; no drop in your blood pressure; etc. etc….this mean frequent hospitalizations!
I do have some patients who still are able to maintain a job. They drive themselves to the dialysis center and usually have the last shift of the day. They do quite well and are so motivated that I recommend they go on the transplant list. I also had a few patients, unfortunately, whose insurance plan changed at their job and were no longer able to receive dialysis at their home. They now have to change their routine and go to a dialysis center three times a week.
Can I still drink beer?
Well if your legs are swollen and you barely urinate now, where do you think all that fluid is going to go? All the various organs in your body will be stress with this extra fluid. Your heart—congestive heart failure, heaviness in your chest. Your abdominal cavity—It will stick out and you will feel bloated. And those lungs, well let’s just say patients drowning in their own fluids. The lungs will not be able to get enough oxygen.
Can you eat fruit to try to regain the function?
Now you want to try and eat healthy. Well you can’t eat watermelon. It’s loaded with fluid (see above) and potassium. A level too high makes the heart stop. Normal potassium is 4mg/dl. Avocado, potatoes, tomatoes, bananas….all are high in potassium.
What other diet restrictions?
Dry fruits and nuts are high in phosphorus. If you want to cheat and eat chocolate or some ice cream…high in glucose and phosphorus. Calcium too, in that cheese and milk you like to drink at night before going to bed. Without the kidney making enough vitamin D, the high phosphorus load now binds with the circulating calcium in your blood. Why is this bad? Calcium and phosphorus hardens and strengthen your bones. Do you want your arteries harden? No. Or the calcium-phosphorus binding to your tendons, heart valves in or around your joints? No. These can calcify (harden) and now you have ‘calciphylaxis’.
You say I can’t even take a shower?
If you are on Peritoneal dialysis with a Tenchoff Catheter exiting from your abdominal wall…you can’t swim. Especially in public pools. Or if you are on Hemodialysis and for various reasons have a tunnel dialysis catheter, you can’t swim either nor take a shower. The continue exposure to various bacteria/fungi in the water, is a set up for entry into your body’s blood stream. Just like ants that fine those cracks/or openings in a cookie jar, the bacteria will find that crack/opening in your skin all the way to your blood stream. This leads to infections/sepsis ….even death. These lifestyle changes are the rule rather than the exceptions.
How long does it take to do hemodialysis? What’s a dialysis center/unit?
A patient usually starts dialysis in a hospital. But by the time they are discharge, the social worker/MD have found a unit hopefully near their house. And one that the insurance will pay for! Oh yes, dialysis is not free. Some centers work with patients who are not US citizens and no other resources….$400-$600 per session.
Dialysis centers are usually in shopping strip centers where a patient goes to get connect to a machine and have their blood clean. Usually the patient is sitting in a waiting room lobby anywhere from 10- 15 minutes. After all the patient ahead of him or her has to be taken off of the machine, has his/her blood pressure check/gets a post dialysis weight and make sure the place where the nurses pulled the needles out (how you are connect to the machine) on your body is clean and not oozing blood. Oh yes, two large needles (one for the artery, other for the vein..large).
Most treatment times are 3.5 to 4 hours. Count the one hour to get to and fro your center. And no timely code blue in your center/everyone showed up for work/no interruption from the city water supply from construction down the street….
That ‘s about 6-7 hours out of your day. Three times a week.
Can I visit a dialysis center?
Most centers welcome you to come by for a visit because you are bringing them a potential client. You or a love one. But to witness what I am talking about, one must park outside a unit and see for yourself. I am sure there is one near you! Watch the patients. The ambulances, wheelchairs…the truck loading the vending machines. Yes, as of this article I talked so bad about the vending machines selling root beers and cokes inside the dialysis unit that most facility administrators removed them. One administrator was even bold enough to tell me she had them removed so strangers from the THRIFT shop next door would stop coming into the waiting room to buy a soda. NOT because of the dietary implications!!!
Drive around the back or peek along the side of the building and see how many of the health care workers are smoking.
This is the reality of my dialysis world. Oh and let’s not forget who ask for the vending machines in the waiting room in the first place. Yes, the patients. Affordable, yet, poor diet choices.
Conclusion: Dialysis indeed save lives. If it wasn’t for this technology people who were in motor vehicle accidents leading to abdominal injury to the kidney arteries, diseases from bites/scratches from their pets, or complications during surgery/pregnancy would probably have not survived. But I am focusing on the disease that is controllable. Something you can make a change and for the better…and that is better choices when it comes to buying at the grocery store.