Rachael M. here. PD is one of those unusual things that people might not even know about unless it becomes a part of their lives. When I tell someone that I do dialysis, they immediately think of hemodialysis and the machines that clean blood. PD is my chosen dialysis format, and I don't mind telling people about it because it usually surprises them. I have so much more personal freedom with PD.
If this is all new to you, let me try to explain a little bit about it. A surgeon places a catheter in your abdomen. It extends from the abdominal cavity to outside your body. The outer catheter is a short tube with a plastic connection mechanism. That catheter is used to fill the abdominal cavity with solution that works with the principal of osmosis to draw out the toxins from the body. Since the kidneys aren't functioning, this process will pull the toxins out through the peritoneum (the membranes that make up the wall of the abdominal cavity) and then flush them out of the body.
PD can be done manually with a bag of solution hanging from an IV pole. Some people do several manual exchanges each day and then sleep at night with dialysis solution in their body, draining that in the morning. Some people use a cycler machine to conduct all the dialysis exchanges while sleeping. This leaves the day completely free of dialysis exchanges and allows a person to do whatever they would normally do during the day without the thought of dialysis. When I started on PD, I did manual exchanges for a few months and then switched to the cycler.
After my acute kidney failure, I had a neck catheter placed for hemodialysis. I went to the hemo clinic for a couple months and decided that it was not for me. I had the PD catheter surgery and started on PD as soon as it was possible.
The various strengths of solutions and the number of exchanges needed really depends on each individual patient. Some people are still able to urinate, meaning that they might need less dialysis to do the work for their kidneys. Some people have very little kidney function and need dialysis to do almost all of the work. I can tell you what my system is, but remember that everyone is different and a Nephrologist (kidney specialist) will help figure out exactly what works for each patient.
I use the automated dialysis machine called the cycler. This does four cycles of dialysis while I sleep. I connect my catheter to the tubing of the machine and set up bags of solution to fill and drain from my body during the night. I use two six-liter bags of solution with a 2.5% strength of dialysate. I fill with 2500 ml. of solution for each cycle, then drain it out. For the last fill of the evening (the one that will stay in my body all day), I fill with 800ml of solution. Depending on my schedule, I might set the machine to do all of this in 7 hours, 8 hours, or even 9 hours. This flexibility is so important and allows me to fit the dialysis into my schedule - the dialysis does not become the focus of my schedule. It doesn't dictate my life and my activities.
If this is all completely new to you, this probably sounds like a bunch of very confusing information. But if you are looking into PD as an option for you, the more you read about it, the more this will make sense.
Essentially, I connect to a machine that warms the solution and does all the work of dialysis for me while I sleep. Then I wake up the next day and do whatever it is that I do and don't think about my need for dialysis. This is a HUGE advantage over going to a hemodialysis clinic three times a week for up to four hours per session. And later on in this blog, I will give you my personal experience with hemodialysis and explain why it just was not right for me.
So, don't think that the idea of self-care with dialysis is scary. Or that you can't do it. Or that you're not able to figure it out. You can absolutely do this. The amazing thing that happens when you start PD is that you become extremely knowledgeable about your own body and your own needs. And protective of the system that helps you function. After doing PD for just a couple of months, I could not imagine letting someone else control my dialysis. It seemed wrong, somehow. I liked being able to limit the number of people who actually put their hands into the mix. It's empowering.
I'm sure Rachel and I will talk more about the specific details of all this and we'll add photos and things as we go. But ask any questions and we would be happy to clarify anything.
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