Friday, November 21, 2014

Week 3 dialysis - transition from Hemo to PD

Whew...this week went fast.

On Monday, I woke up early to get Izzy on the bus, and then logged onto my work computer to start sorting through my emails (I'm sure no one envies THAT particular task :), and the afternoon was spent at the dialysis center doing my hemo.  I was actually excited for that one, as I didn't have to pull as much fluid off as I thought I would, which meant that the treatment would be a bit easier.  I noticed that it was getting easier to recover from the treatment in the evening.  I would still come home and lie down most of the night, but I wasn't as bone-tired as I had been the first week.

On Tuesday, Joacim stayed home to help with the delivery of the PD supplies.  It seems that we are 2nd on the route, which means the delivery will come early.  My PD nurse says we usually get the same driver, and some people build such a relationship as to allow access to their homes for their deliveries.  I'm not so sure that I'll ever be that comfortable, but I do think that I'd at least like to leave him a little something occasionally.  He tried to bring the first set of boxes through the inside of the house down to the basement, but it's a tight fit, so the remaining delivery he went outside, down the hill and into the basement from the back of the house.  If this continues, he'll HATE it come January when there's 2 feet of snow out there, and I'll be a guilty mess.  Guess we'll jump off that bridge when we have to!  Here's the picture of a monthly supply delivery, in case you didn't see it in the last post:



On Wednesday, I worked a little more.  I sent an email to my coworkers letting them know how I was doing as I don't know if they all know about this blog.  Can I just throw out a "Thank You!" here too?  My coworkers have totally picked up everything that was left hanging, and I can't thank you enough! I had what is hopefully MY LAST hemodialysis treatment.  My friend, Nita, drove me and stayed the whole time.  It's amazing how fast 3.5 hours go when you're talking to a friend the whole time :)

On Thursday, Joacim and I began training on home PD (peritoneal dialysis).  I was a bit nervous, because honestly, how weird is it that I'm filling my belly with a crapload of water through a tiny tube that comes out of my belly?  I mean, wrap your head around it.  It's AMAZING that someone came up with this as a treatment for kidney failure.  And the science behind it....well, it's definitely cool.  Joacim and I ask a ton of questions each day (we also did it today), and there are always more.   We've had 8 hours of training so far, and we've learned how to do a manual exchange (without the cycler machine) so that I can do dialysis even if the power goes out, or if I'm on a long road trip and don't have anywhere to power my machine.  We've learned about sterile technique, fluid balance, how to set up the cycler, exit wound care, and a little on nutrition (I need to eat a LOT of protein while on PD, because protein molecules cross the peritoneum quickly and easily, so I'll lose more protein on PD).

This is what fluid overload looks like.  You're all familiar with these pictures, as I've posted a ton of them in other posts. 
This is something I still deal with, but it's what I'm working on lessening

I think I may become a bit of a freak out my weight, and how much water I'm pulling off with each night.  You see, dialysis not only cleans your blood, but it also helps pull off excess fluid...how much fluid is the mystery that I'll be trying to find the answer to.  I'll use several things to help manipulate it to achieve my optimal dry weight (this is my weight assuming no fluid retention), including:  dialysis solution concentration, dwell time, extra manual exchanges in addition to nightly cycles, diuretics, and diet.  It'll take awhile to figure out the formula, but that challenge is something I'm looking forward to.  I mean, this is something I can totally do!!!

Today, after dialysis, we went to The Container Store (otherwise known as Nirvana :) to get organizers for my cart.  This cart is needed to keep all of my PD stuff together, and I'll use it to set my machine and associated supplies on it.

Things I need to store include:  blood pressure machine, thermometer, gauze pads, sterile caps for my catheter and the PD cartridge tubing, PD cartridges, drain bags, cleaning solutions, antiseptic gel, and face masks.  I'm sure there's more that I'm forgetting, but that's a decent list.  I haven't gotten everything organized yet...I think that's the task for tomorrow, but at least I have all of the stuff.

So, that's been my week in a nutshell.  Overall, I still think I'm feeling better than I was.  I'm VERY anxious to get this chest catheter out, and I actually think that can happen the 1st week of December.  I meet with my nephrologist in the clinic on Monday (where we're doing more training), and I'll talk to her about it.  The site is a bit irritated right now, and it's itchy and annoying.  Plus, getting this out brings me one step closer to being able to start up yoga again.  I was THRILLED to learn that I can do hot yoga with this PD catheter....I was worried that they'd say no, but that's not the case.  Granted, it's going to take months to build up my strength again to be able to go to a class at Lifetime, but it's a motivator :)

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