Dialysis -The Last Resort
The Process of Dialysis
Date: 7/3/2008 2:04:03 PM ( 14 y ) ... viewed 7088 times
Many have heard of dialysis, but unless you know someone that depends on it to stay alive or you are fortunate enough to be one that doesn’t have to rely on it, you probably don’t know what it is and what is involved. Here is a basic primer of dialysis.
Dialysis is a treatment that is given to those who have, for whatever reason, lost their kidney function. The kidneys process water, salt and filter toxins in the body, (blood) sending the excess to the bladder to be disposed of. If your kidneys don’t work properly, or at all, you are in danger of being inundated with toxins that will eventually kill you.
I was ignorant of the dialysis procedure before my kidneys failed. I, like many, had heard of it, but I never paid much attention to the little bits of information that are available to the ‘un-initiated’. When my kidneys began to show signs of failure I was admitted to the renal ward of a local hospital. There, I saw many patients who were bed-ridden and suffering from numerous ailments due to the ravages of time and simple ‘wear-and-tear,’
which all of us are prone to in this life.
Many of these patients were in their seventies and eighties and would have to be wheeled - in their beds - to the dialysis unit three days per week for what is called ‘hemo-dialysis.’
This caused me considerable discomfort and dread, at the time, for I had been told by my doctors that I would very likely need to be on dialysis before very long and I assumed that they were saying, in essence, that I was going to be as debilitated and helpless as my poor fellow-patients seemed to be. I didn’t take into consideration the fact that I was much younger and did not suffer from the plethora of complications that my more elderly companions suffered from. Heart disease, diabetes, arthritis, dementia. No, my issue was a simpler one.
It began over fifty years previous to my present condition; when I was two years old, back in 1951, I developed pernicious anaemia. I was given a complete blood transfusion in order to save my life. In 1951 there was no knowledge of hepatitis C in Canada, and so, there was no screening of donated blood for that virus. Some of the blood I was given during that period was tainted with the hep C virus. It sat silently in my system for over fifty years, slowly destroying my kidneys as I lived my life, happily unaware, playing music for a living, making children, practicing and teaching Tai Chi, and generally living life to the fullest. But, like all things in life; change happens.
There are, basically, two kinds of dialysis. ‘Hemo-dialysis’ and ‘Peritoneal Dialysis.’ (‘P/D’)
Hemo-dialysis is usually done in the hospital or in neighbourhood clinics by trained, professional nurses. But, there are some who perform hemo-dialysis in their homes by themselves, or with a partner. This requires training and consistent attention.
All dialysis patients begin dialysis with hemo-dialysis.
Hemo-dialysis is a process that entails removing the blood from the body gradually, about one cup at a time, cleansing the blood through a filter, and returning the blood to the patient. This is done through the marvellous invention known as a ‘dialysis machine,’ which is connected to the patient through a catheter, (tube) that is inserted in the neck and shoulder area and sits over the heart, or, through a more permanent access known as a ‘fistula.’ A fistula is a surgically created vein that is formed by a surgeon when he joins a vein to an artery, usually in the arm, and it slowly grows into a vein large enough to accommodate the insertion of the needles that transfer the blood from the body to the machine and from the machine to the body. Hemo-dialysis is performed three times per week and takes about four hours each time it is administered.
The other method of dialysis is called ‘Peritoneal’ dialysis. It can be done in hospital, but it is an easier and more ‘user friendly’ system that allows a patient to perform it on a daily basis in their own home. There are certain health requirements that make it possible for a person to use peritoneal dialysis. One must have a moderately intact stomach lining, with minimal scarring which allows the free flow of fluids. This type of dialysis needs to be repeated on a daily basis because it does not remove the blood from the body, as in hemo-dialysis, but instead, it cleans the blood through the stomach lining, which acts as a filter for the treatment.
There are two methods of peritoneal dialysis. One is ‘manual’ – more or less. That is, there is no need of machinery or advanced technology to perform the treatment. First, one must have a soft, plastic tube surgically inserted (permanently) in the stomach.
Then, one must connect the external portion of the tube to a bag of liquid known as ‘dialisate’ or ‘dialysis fluid.’ This fluid is manufactured by a reputable, licensed medical establishment and consists of water and dextrose. The principle is very simple, really. It is the same principle that causes the liquid to be drawn from strawberries when one covers them in sugar. The dextrose acts as a sugar and draws the excess water from the blood, along with much of the toxins that the body ingests on a daily basis. One connects the belly tube to the dialysis bag. Then, the stomach is drained of fluid into an empty bag, after which, the full bag (pre-heated for comfort, of course!) is drained into the stomach. There it sits for about four hours and then the process is repeated. This type of dialysis is performed four times per day, seven days per week.
The last type of dialysis is also peritoneal dialysis, but it is done with a machine that acts as a kind of ‘pump,’ and looks something like a large VCR or a computer printer. On the top is a ‘bed’ on which a five litre bag of dialisate is placed, where it is heated to a comfortable temperature by a mechanism designed for that, in the machine.
Three other bags are also connected to the machine. Another five litre bag, and two three litre bags. Once the patient is connected to the machine, the process continues for a ten hour period. During those ten hours the stomach (peritoneal cavity) is filled and emptied six times, in total. The drained, toxin-filled fluid is pumped by the machine into a drain or a ‘jerry’ can and is emptied in the toilet after the procedure. This method is performed at night while the patient sleeps, which is a convenience for it leaves one’s day free for whatever activity one may be occupied with. Keep in mind that at the end of the treatment there is one and a half litres of fluid that remains in the stomach and absorbs some toxins throughout the day.
Dialysis is not a ‘cure’ for kidney failure. It is a treatment that is designed to keep one alive and hopefully, will be discontinued should the patient be the recipient of a kidney transplant. Dialysis is a poor substitute for kidney function. It only offers about ten percent of normal kidney function.
I hope, sincerely, that you are never in a position that demands that you experience it for yourself.
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