Friday, May 5, 2017

Lifestyle Choice with Dialysis

   When I was diagnosed with end stage kidney failure, I was given an orientation to help me choose the kind of treatment that would fit me.  The choices were peritoneal and hemodialysis.  

From: http://kidney.org.au
   “In peritoneal dialysis, the inside lining of your own belly acts as a natural filter. Wastes are taken out by means of a cleansing fluid called dialysate, which is washed in and out of your belly in cycles.”  This means that a catheter (plastic tube) is installed in the belly by surgery.  Then a cleansing fluid is pumped into the belly through the catheter.  That is the filtering process.  When that is done, the fluid leaves your body through the catheter.  

   I did not choose the peritoneal dialysis because the catheter will remain dangling on my belly 24/7 until it’s removed by surgery.  Keeping it clean would be a chore.  If I should mess it up by some carelessness it could kill me.  I will not be able to soak in the tub which I love or go swimming in the hot springs and beaches of the Philippines.  Soaking in water could infect the catheter or allow bacteria to run through it and kill me.  However, this one is painless after the surgery and convenient because I can do it at home or while traveling.  I can do it at night so I can get employed during the day.  I can bring the supply of cleansing fluid with me so travel and vacations are not encumbered. 

   I chose the hemodialysis.  I will have to go to a dialysis center three times a week, stay three hours and fifteen minutes plus the time it takes to hook me up to the machine and to pull me off it.  This choice involves pain from two big needles used to hook up and painful occasional Fistulagram, a procedure to remove blood clot from the dialysis access vein or graft.  

From: http://www.nephrologynews.com/
   With hemodialysis I can’t travel to places where I won’t have a dialysis center.  Vacation days are interrupted by dialysis treatment every other day.  So when I fly to the Philippines, my dialysis is arranged with a center for the duration of my stay.  Medicare does not pay outside of the US so the dialysis while traveling is paid out of pocket.  

   With the pain, expense and inconvenience of in-center hemodialysis, why did I pick it?  I don’t have a bathtub in California.  On a trip to the Philippines, I get to swim once if I’m lucky.  Are pain, expense and inconvenience worth not having a catheter dangling on my belly that no one else is going to see?  I guess it’s just me being me.

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