Kidney Dialysis Question(s)

[Susan BAV]

An elderly aunt, with no prior kidney issues, was sent to the Critical Care Unit earlier this week. She was originally admitted to the hospital late last week, from her nursing home, with pneumonia and dehydration. Yesterday they said that her kidneys needed help and that if she wasn't better this morning, after even more hydration, then they'd begin her on kidney dialysis--which they said would hopefully be temporary. This morning they said that, while she is some better, they will begin her on a mild kidney dialysis this afternoon.

I found her kidney doctor to seem extremely informed in his field and familiar with her chart. He also said yesterday that mild dialysis won't hurt her. All of his detailed explanations made sense (and were actually very interesting). Since she's reportedly better today and yet still going to get dialysis, I suspected hospital authorities over this nice doctor realized her medical reimbursement situation will allow for the dialysis. I have no say in the matter anyway, but just hope it's true that it won't hurt her.

I'm going to do a quick web search to find out a little more of the "nuts and bolts" of kidney dialysis so I don't think I need help with that; but I figured some of you here might have first hand knowledge and/or first hand experience with kidney dialysis. I don't know what I'm asking for exactly but we all know that once you've had "hands on" experience with something, you understand it much better than you do from just reading about it. So if you have any advice/experience to offer, please do. Thank you, in advance.

I do hope the dialysis will be temporary for her. While she's practically ancient, she still has such a joy in and zest for life. But psychologically, I think this will depress her.

On a side-thought, just earlier this week I read a new medical report/theory in regard to antibiotics which suggested that letting nature "take its course" in the elderly with infections might be better than giving them antibiotics--because of the mutated infections those patients can come into the hospital with from their nursing homes; the theory blamed the elderly for some antibiotic resistant bacteria. My first reaction to that was one of horror, especially when I considered what the next steps in medical care like that could be.

Anyway, I'm probably going to be away from my computer the remainder of the day, and not having an I-phone, I'll have to read any kidney dialysis experiences later. Thank you again, very much, in anticipation of any replies.

 

[Bina]

Most of the younger, stronger dialysis patients never experience any problems or discomfort.
The older and/or more fragile patients need extra care while being dialysed.
We found that some nurses would "rush" the dialysis and my Mom would crash as a result (dangerously low BP, headaches, passing out). When she was dialysed at a slower rate and without extracting quite so much fluid from the blood, then she responded much better.
Best wishes with this, don't be shy to ask questions and look at her blood/urine test results.

 

[Ross]

Sorry to hear she needs it, but it shouldn't hurt her any. There is a newspaper reporter here in town that has been on dialysis for years as an outpatient. I never knew it until someone saw him at the dialysis center, then he did an article on it.

Jim Hillibish. You could probably email him as a source of info. He's a very nice guy.

http://www.cantonrep.com/index.php?Category=26&columnists=yes

 

[Susan BAV]

Thanks Bina and thanks Ross. I slipped in to see her tonight after meeting up with the West Coast Reunion Group and the dialysis tech was just beginning a two hour session of dialysis. The tech said she'd also be having 2 1/2 hours of it tomorrow night and then, depending on what her doctor says, she may or may not have more on Sunday.

I have no experience with this but tried to say all of the right things to her...
but she really looked frightened tonight and she's too weak to speak.

Thank you again, for your kind and helpful posts.

 

[Ross]

Really about all you can do at this point. Do you ever feel like you spend the majority of time waiting? Man I sure do.

 

[Ross]

Sue check this out:

http://www.wickedlocal.com/ghs-newsservice/lifestyle/health/columns/x1100219445

 

[Nancy]

Joe was on dialysis for many months. It started out to be temporary, but ended up being permanent.

But, many people have kidney recovery after dialysis gives their kidneys a little rest.

I hope things will have improved enough for her to be w/o dialysis in the future.

It does work out for many.

 

[Bina]

Sue check this out:

http://www.wickedlocal.com/ghs-newsservice/lifestyle/health/columns/x1100219445

For some of the chronic hemo dialysis-for-life patients there are options, finally!
Susan, what I am sharing probably won't apply to your aunt since she is on mild dialysis, but it may help others.

When my father got fed up watching the nurses rush through my Mom's dialysis and have her passing out, he transferred to a different hospital and learned about "self dialysis" on the hospital machines. He could be in control of the rate of dialysis and shut down when necessary. After a year of that he was confident enough to ask for a system at home. That was complicated to set up since it was a large hospital sized machine....a spare bedroom was converted. New flooring, new furniture, storage system for supplies, closet gutted for a water treatment centre, water analysis, application to the town for the extra water use, account set up with a courrier, and more.
It was so worth it!!! Mom was thrilled.

 

[JudithD23]

Sue, I hope your Aunt does well both physically with the dialysis and emotionally/mentally with the fear of her situation. I'm sure you're a comfort to her, just seeing you and hearing you say reassuring words. She's lucky to have a resourceful niece. I'll be thinking of you both.

Judith

 

[Susan BAV]

Thank you very much, Ross and Nancy and Bina and Judith--I really appreciated the posts. And the home dialysis information was very interesting; thanks for providing that link, Ross.

The main nurse said that our aunt has "turned the corner." What a relief! They did a third round of dialysis today and I haven't yet heard what the "forecast" will be for her at this point, in regard to further dialysis, or getting out of the Critical Care Unit.

Thank you again. Your posts were all very encouraging and helpful .

 

[Ross]

I was just listening to a Doctor on TV and he said that dialysis slowly but steadily takes it's toll on a body. So it's a temporary solution, but does cause damage of it's own over time.

 

[Nancy]

"but does cause damage of it's own over time"

This is true, and it did cause damage in Joe. He was in very frail health when dialysis was started. For him it was brutal. and his health did not improve.

 

[Susan BAV]

That's interesting, about it causing damage over time also. It sure is an exhausting thing. But getting those toxins out through dialysis must have helped her to some degree because when we saw her yesterday, while she was agitated, she was able to put some words together. She didn't seem to know us, though. Her heart rate flew up as soon as she saw us, from 85 to 115 and stayed around 115 the entire time we stayed there, and the nurse came in a bawled us out. I still haven't heard the latest opinion about her long-term prognosis. The range of diagnosis over the past week has been amazing. There's a mass; there's not a mass afterall. It's this; no, it's not that afterall. She's properly hydrated; she's dehydrated. That simple hydration issue has really been complicated, how much to hydrate her without exacerbating the pneumonia and lung issues.

Last night she kept asking us where she was. She kept saying she wanted out of there. And she kept saying she was scared. It's heartbreaking.

Thank you again for your posts, which I have found personally heartwarming.

 

[Nancy]

There is a well known condition (to medical personnel) with people who are in ICU for a while. It is called ICU psychosis. It is a temporary condition where the person becomes very disoriented and confused due to their illness, the isolation of the ICU rooms, the blending of day and night, the loss of "self" and many other things.

She may be exhibiting some of this. It does go away when life becomes more normal.

I also found that Joe became disoriented and totally exhausted for a while after dialysis.

 

[Bina]

Susan, are her kidneys working at all on their own?
Is she having any urine output? If yes, this should be measured.
There is indeed a fine line between hydrating her and over-hydrating (which would only cause more stress to her system during dialysis).
My best wishes are continuing....

 

[Susan BAV]

Warmest thanks!

Warmest thanks!

Nancy, thank you! The ICU psychosis issue was very interesting, seemed applicable, and I shared that with our great aunt's "baby sister" today (who is 80). Our great aunt's hospital room is along the north side of the building and has one small window, several feet away from her bed, behind her head. Dreary!

They let her rest all day yesterday but gave her more dialysis this morning and she was pretty exhausted while I was there today, but gradually more and more "with it" as time wore on. Her heart rate stayed around 115 today but happily there were no grumpy nurses around. The Critical Care nurse said that maybe she'll be put on a regular floor tomorrow because she no longer needs Critical Care. I hope that goes well. Once today, she gave my hand a really warm sqeeze and that was new so I was tickled.

Bina, thanks! I thought it was odd that she's had some output all along and I've seen them measuring it. Before dialysis began, though, the kidney doctor explained that it wasn't a "good quality." I don't know if they knew that from her kidney blood test results or if they actually check the urine. Maybe both?

 

[Nancy]

Re: ICU psychosis

Somewhere I read that it helps if people can bring in familiar pictures from home, of favorite relatives or friends, a picture book or photo album book, special things that mean something to that person. It helps to humanize the experience and bring the person around. Maybe even bring in a book that the person loves and read to them. Joe always liked the newspaper, since he read that cover to cover every morning, and strangely enough when I brought in bookwork (the monthly bills, etc) he really perked up, since that was what he liked the most. I brought it in even when he couldn't do much of it himself, and let him walk me through it as best he could.

He also liked to try to do very simple crossword puzzles. I read the questions to him, and he answered them, and I filled them in (I gave him a lot of hints )

Little spring holidays are coming up, maybe some small decs for St. Patrick's Day or Easter.

And a calendar is a wonderful idea. They lose all track of time and what day it is. It is a good thing to mark off each day for them.

 

[Susan BAV]

Wonderful ideas; thanks!

[Edit four days later - Rather than bumping this to the top of the thread pile, I'll just add this very sad edit. I just got a call that hospice will be called in because her kidneys are no longer working (among other medical issues). She is/was one of the brightest characters I've ever known. Such an enduring woman. And a good friend. She has called me her niece for over twenty years but she is/was actually my husband's great aunt. She always chuckled about being "great."

Further edit later - Sadly, she died. She had also developed congestive heart failure. She was an extraordinary person and is already greatly missed.]