Tuesday, September 19, 2017

Transonic Monitoring for Dialysis Access

   The Transonic Hemodialysis Monitor uses ultrasound Doppler and ultrasound dilution (Transonic) as an addition to typical vascular access monitoring done in hemodialysis centers.  The monthly transonic test shows the access blood flow.  Knowing the access flow helps to watch out for blockage and measure the function of the fistula/graft in aid of making the access serve longer.  This equipment is attached to the line while the patient is on dialysis as seen on the photo.

   A fistula can last up to 35 years, however, maturation takes three to six months, in rare cases, can take up to a year which is too long to wait for someone requiring dialysis.  For some patients, the fistula may never mature.  Mine refused to mature.  It was abandoned and a graft was placed instead.

   Grafts have a lifespan of approximately 4 to 6 years but can last longer, up to 10 years with proper care.  Thanks to Davita’s Transonic lady, Maria Tancioco, I get information that my 7 year old graft, through Transonic shows pretty good function.  According to Maria the typical blood flow for graft is 500ml per minute, mine is consistently at 1400ml per minute as per recent test.  

   “Measurement of flow could reduce thrombosis, increase thrombosis-free and secondary patency in arteriovenous fistulas, and reduce vascular access-associated costs”.  Vascular access maintenance such as Fistulagram, an X-ray procedure to check for blood clots or blockages and Fistuloplasty, a procedure to open blocked or narrowed fistula by stretching with a special balloon are expensive and painful.

   The sad thing is that I’ve been with several different dialysis centers managed by different providers and I found the Transonic Hemodialysis Monitor only in Davita.  That means a greater number of centers are not fully equipped.  

Postscript in video

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Sunday, September 10, 2017

A Glimpse of Taiwan

    Taiwan from my plane window.      
   On my recent flight to the Philippines, I got the chance to try EVA Airlines.  EVA is a Taiwanese international airline based at Taiwan Taoyuan International Airport near Taipei.  I had been in Beijing, Bangkok, Hong Kong and Saipan airports but I had never landed in Taiwan before.

   From the Chinese Civil War between Chiang Kai-shek's Republic of China and the Communist Party of China led by Mao Zedong, ROC was established in Taiwan.  Chiang Kai-shek moved the ROC capital to Taipei.  Under the One-China Policy of the PRC, ROC is not recognized as an independent representative of China.  

   As the world ignores Taiwan, I didn’t know what to expect at the Taoyuan International Airport.  I thought it was admirable that the airport has a library, a reading area and wall décor that encourages reading.  

   I was impressed that the Taoyuan Airport devoted a space for prayer that had three prayer rooms, one for Catholic, one for Muslim and one with a swastika on it.  

   I couldn’t read the Chinese characters beside the controversial symbol which has become known as the emblem of the German Nazi Party.  Good thing my walking Google of a daughter enlightened me. 

   That actually, “the symbol has been used by Hindus, Buddhists and Jains for millennia and is commonly assumed to be an Indian sign.” (www.bbc.com)  The oldest swastika pattern has been radio carbon-dated to 15,000 years ago.

   In fact the swastika was used by American military during World War One. The nonthreatening uses came to a halt when the Nazis used the swastika to symbolize the Aryan race, a white god-like superior race.  Ukraine National Museum of History has exhibits of swastika engraved treasures.  A number of phallic objects shows that the swastika pattern was used as a fertility symbol.  

   World War Two gave the swastika a dark meaning.  It became the symbol of suppression, and extermination of the Jews in Europe called Holocaust.  Back then it was used against the Jews, in today’s world it’s against any nation of color.  Swastika is now an emblem of hate, racism and evil.  

   “Consequently, Jehovah saw that man’s wickedness was great on the earth and that every inclination of the thoughts of his heart was only bad all the time.” (Genesis 6:5)  

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