Saturday, April 1, 2017

Life of a Dialysis Patient

      Life is a journey; it may take you anywhere to start a new adventure and a family of loved ones. As in any adventure, you will follow your dream, you will experience joy and sadness, success and failures; and yet you must stand for what you believe no matter what adversity you may encounter as you continue with your journey in life. Push on till your heart say you have reached the end.

 Before, when I hear about or see person(s) having dialysis I feel pity at the same time fearful with regret because they say that dialysis can be afforded only by the rich since one session cost five to six thousand pesos; and done one to two times per week depending on the damage of the kidneys. Not to mention the pain the patient has to go through and the long dialysis session of four hours. When my doctor in Cebu Doctors Hospital told me that sooner or later I will undergo dialysis, I began to worry about the financial burden it would bring to my family and the thought that I am not fit for dialysis and will only suffer while in dialysis. I began to be frustrated for a while but realized later that I should not worry because it is up to the will of the Lord if I could overcome my fear of dialysis; and live a new life having a mission to share to others my experiences while in dialysis for other dialysis patients to learn ways in coping up with their disease. Also, my mission may include other healthy people to be aware about the importance of their kidneys and learn ways to protect their kidneys from damage by avoiding unhealthy practices. That was five years and six months ago, I started having dialysis on September 29, 2011, and with the grace of the Lord I am still healthy in mind although not quite healthy in body but coping well.

       The first month of my dialysis sessions was entrusted to the doctors, nurses and technicians of the Hemo-Dialysis Unit (HDU) of the Gov. Celestino Gallares Memorial Hospital (GCGMH). I did not know much about dialysis then and all I can do is obey what I am told. One time, while on dialysis I experienced Hypo-tension or very low blood pressure. I had cold sweat, blurring of vision and almost passed out. This also happened in some dialysis sessions and I had darkening of my finger nails due to lack of oxygen brought about by my very low blood pressure. Now, with months and years of continuous Google search I finally found out that my tendency to have hypo-tension is due to my low sodium level in my blood, we have a monthly laboratory tests of our blood consisting of Sodium, Potassium, Phosphorus, Calcium, Blood Uric Acid, Blood Urea Nitrogen (nitrogenous waste in the blood), Complete Blood Count (CBC) to determine the level of Hemoglobin, Red Blood Cell (RBC), White Blood Cell(WBC) and possible sign of infection, Creatinine (how much blood waste) and Albumin (help in stabilizing fluid volume; lack of it will cause Edema or swelling of legs, arms and abdomen). My low sodium in the blood before was due to lack of salt in my diet (bland or not salty). I have found out that with low sodium in the blood of a dialysis patient, he/she will be prone to low blood pressure and cramping while having dialysis which is aggravated by too much drawing of fluid or water from his/her body by the dialysis machine. In my case, now I know how to set the right volume of water to be drawn from my body based on my dry weight (this is my optimum obtainable weight after dialysis where my blood pressure is normal). If I set a low water volume way above my dry weight, less water is drawn resulting to swelling of my legs and arms or stomach since my urine output is already very low. This means that I have to set just enough water to be drawn from my body. I will also know if I have set too much water volume because I feel uneasy and my toes seems very dry and they are twitching so I will tell the nurse to decrease my set goal before I experience Hypo-tension. On the other hand, high sodium level in the blood while in dialysis cause high blood pressure because the arteries and veins are constricted and the heart should exert more effort to pump the blood. 

     Before, I used to experience high blood pressure and I had Pneumonia (lung infection) in my left lung. I have to take strong anti-biotic that made me more sick and I cannot sleep well. Six hundred ml. (that was the findings of the Radiologist in my ultrasound) of water have accumulated in my left lung. I have difficulty in breathing and I have to sleep with two pillows in my back since I cannot lay flat on my back. My doctor said that I should not eat salty food. Thankfully I was given Catapres (Clonidine), medicine for high blood pressure, and my blood pressure went back to normal and there is no more water in my lungs. That experience has taught me to wear a face mask while in the dialysis room or in places where there are many people and not to eat salty foods because it can cause high blood pressure, Edema and heart disease. 

     When I had my first dialysis session in Capitol Dialysis Center in Quezon City, once in a while we take a vacation in our house in Quezon City to visit our daughters, I have seen that the doctor and nurse will adjust the sodium level in the dialysis machine (determine how much sodium to be released during dialysis) depending on the condition of the patient. In one of my dialysis sessions, I have experienced cramps and my blood sodium is low, the doctor then instructed the nurse to increase the sodium level of the dialysis machine to compensate for my low blood sodium. This is not practiced in GCGMH in Tagbilaran City, Bohol. The doctors are playing safe because the nurse or technician might set the sodium level of the machine too high or too low to the detriment of the patient. There is no regular doctor (whole day basis) on duty inside the HDU and cannot supervise the nurses and technicians; unlike in Capitol Dialysis Center, they have a doctor inside the dialysis room the whole day.

                                                                                                            (to be continued)

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