Is anyone else having a problem trying to convince their dialysis clinic -- with State and County shelter-in-place orders -- that coming into the clinic, with hemodialysis patients present (some of which have been diagnosed with covid-19) is something you would like to put off for at least a month of April?
The authorities, including the CDC and NIH, have said the next 2 weeks in America are going to be very Important as far as this pandemic is concerned. Everything I hear says unless it is an emergency, don't even leave your house for groceries or the pharmacy in the next two weeks. I'm getting a lot of pressure from my clinic to come in for a blood draw. At first they had almost no protocols in place for addressing germ control and slowly they put into effect some of the conditions and features I suggested!
I would really appreciate getting some feedback on this. I was TOLD by the renal dietitian that I MUST come in this month for a blood draw and examination at the clinic and then have a Telehealth appointment with the nephrologist a week later.
My labs and health condition in the four and a half years I've been on PD have been the highest numbers in my clinic. My albumin is good, my potassium, sodium, calcium and all of those numbers are in the normal ranges or even better. I feel okay except for the stress and anxiety (pre-existing issues with anxiety) of this virus. I have not gone out in a month. I have sequestered myself in the house and not expose myself to any other people, and I don't feel that putting myself at risk by going to the clinic is necessary. However, I cannot find any Authority in Medicare or the various renal associations that would give me any guidance about this. They keep telling me I need to talk to my clinic. Maybe the CDC will help?
The renal nurse cannot practice proper social distancing as outlined by the CDC when she's taking my blood. She even offered to take the blood in my car (,which is small and probably less than a foot between the driver side and the passenger side.) How is that being safe?
I will really appreciate anyone's feedback. I feel pressured and I do not believe they are concerned about my health as much as their bottom line.
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TaffyTwoshoes27
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I know it is scary times and it is hard to know what to do. My question to you is on what authority did a renal dietician tell you what to do. "was TOLD by the renal dietitian that I MUST come in this month for a blood draw and examination at the clinic and then have a Telehealth appointment with the nephrologist a week later." I would over step her and speak with your nephrologist directly. I always wonder where the desire to create billing for service and good patient care cross.....
I agree with Bassetmommer. Do you see the dietician while at the clinic? If so, couldn’t the dietician do a telemedicine appointment with you as well as the clinic personnel. I’d certainly ask my nephrologist about all of this.
If I needed bloodwork done I’d also ask if it could be done at a different lab where there aren’t COVID 19 positive patients receiving dialysis specifically. I’m thinking the monthly labs could be fine at Quest or a similar lab. Then a telemedicine followup appointment.
I had to get my regular monthly transplant labs run last month as well as labs for my nephrologist. I’m going to be able to do them at the same time from this point forward. I also called the lab to see if I could set an appointment. I asked them how they are handling the social distancing; how and how often they are sterilizing their chairs, door handles, etc. I then scheduled that lab for a time when they have the fewest patients and had just wiped the chairs and door knobs sterilized.
I went through quite the routine to protect myself. Long story short? I have to get the labs done. The transplant center and my nephrologist’s office both require them. Now that the CDC is recommending masks I’ve ordered disposable masks. I’ll have those before I need to go back to the lab this month.
Well, good luck and let us know how this turns out.
I had a telephone conference call with Renal dietitian. The renal dietitian for our Clinic was fired and a RD from another FMC clinic has taken over. She seems to be a ball buster. She said that according to Medicare rules she must go over the labs with me once a month plus a yearly status report which was done this week (but neither of which was ever done). That is when she told me I had to have my labs this month.
Although I have voiced my concern about my age, 64, and my COPD diagnosis, they don't seem to be very sympathetic to anything. I have not been able to reach my nephrologist at this point. We have a good relationship, but my feeling is that he is going to tell me I have to " play the game" and have my labs taken at the renal Clinic. He does not draw blood in his office. He has a receptionist and a nurse practitioner that works out of the clinic, but that is it. He will be doing the Telehealth appt with me after the labs results come back.
Since my transplant center has put all transplants on hold, I doubt seriously that they are waiting with bated breath for a sample from my dialysis center. In fact, my transplant coordinator at the hospital has gone back to her previous job in the ICU battling coronavirus there.
I have thought of asking the neph to do an order for Quest or LabCorp, but the thing is that Georgia has been so slow to test people that we just don't know who has it and who doesn't. very depressing situation. I have tried to go over the heads of those Clinic people and have not been successful as of yet.
I am very afraid. I have no one to help me if I end up quarantined at home and I feel very scared of going into the hospital with a known lung disease.
We’re very far behind on testing too. When I went for my two labs (one mid March and the other the last week of March) I called both labs first to talk with them as I mentioned in my earlier reply. Staring this month I’ve gotten my labs set up so they can both be done at the same time and the same lab. That is certainly prudent in these times. But I’ll still be going.
Here’s what I will do in mid April:
1. A friend will drive me so I don’t have to use uber or lyft. (I’ve had a low vision impairment for my life which has worsened when my kidneys went into renal failure so I’m not driving any more now.)
2. My friend will sanitize her car before she comes to get me. She’ll also wear a mask.
3. I’ll take Clorox wipes in a ziplock bag so I can wipe down chairs before using them.
4. I’ll wear a mask and latex gloves.
5. After returning home I’ll dispose of the mask and gloves in the garage before coming into the house.
6. I’ll take my shoes off and leave them on the top step of my garage steps.
7. I’ll take my clothes off in the mud room and put them in the wash.
8. I’ll wash my hands.
9. I’ll start the laundry using detergent and Clorox bleach to disinfect my clothes.
10. I’ll wipe down the door knobs, light switches, garage door opener, trash can lid, shoe soles, counter tops, faucets, washing machine,, and my cane with Clorox wipes.
11. I’ll wash my hands one more time.
12. Then I’ll let my dog out of her crate and tell her that I think we’re safe🐶🐶
It’s an ordeal but something I need to do to be sure my kidneys are hanging in there. In my case I am still not on dialysis. This means that they’ll have to do the PD catheter placement before I can start. That will now have to be done at some satellite clinic by a different surgeon; a surgeon who only does PD catheter placements from what I was told in my last telemedicine appointment. So they’re now monitoring my function with monthly rather than bi-monthly labs. I believe my transplant center is still doing transplants at this point.
I’m fortunate in that my state has fewer cases per capita than many others at this point. Although, we’ve had several recent outbreaks that have raised our COVID 19 cases notably. Our Governor had extended the gatherings no larger than 10 people to religious gatherings and funerals this past Tuesday. But the legislature just pushed back and ruled that her extension of that order to religious gatherings and funerals was unconstitutional so she had to reverse her extension yesterday, Wednesday. Most of our churches are meeting virtually. But we have some that are not. I’m hoping that we don’t have more significant community spread associated with Easter Sunday services...
Anyway, at this point our projections are that we have just barely enough ICU and hospital beds for COVID 19 patients. We’re supposed to be in fairly good shape on ventilators and PPE., likely in part because we’re peaking later than other parts of the nation. We may have some personnel shortages but are hoping to flatten the curve sufficiently to be alright on that front as well. But we’re just barely balancing all of this IF we honor the guidelines. So I’m truly hoping, for the sake of everyone in this state and the nation, that we can manage this without having to draw resources badly needed in other states.
Anyway, quite the ordeal but I’m going to head in for labs as scheduled in spite of COVID 19. I’ll just take as many precautions as possible and then hope for the best.
Wow...my dialysis center requires everyone to be masked before entering, then before you get both feet in the doorway they take your temperature. All nurses are in full mask, gloves and disposable lab coats which are changed per patient, patient chairs are bleached down after each patient.. I only go to the clinic once a month as I still work full time, then I do telehealth for my doctor appointment. I take minimal risk, but I need the lab work to make certain my dialysis is at the optimum level. I also have great labs and I intend to keep them that way. My view on this, be as careful as possible, but be reasonable, don’t make yourself sick with fear
My clinic has created a "last shift" where it is ONLY for Covid 19 folks. That way we have no possible way to come into contact with them. They have also cut most folk's machine time so we leave a litte earlier and the lobby is empty because the next shift folks aren't there yet - brilliant.
Hi, I am a new kidney transplant patient. I go in once a week for labs very important. I go in as soon as lab openes, usually only me and two lab techs are there. When you enter building there is a checkin, hand sanitizer and I bring my own mask. I don't sit on any chairs while I wait and I have the tech move the arm down on chair. When I leave I use my hand sanitizer I carry. When I was on pd dialysis the nurses always wore masks, even before this virus. Some times you just have to do things and then make sure you do your best to stay safe. Good luck with everything.
Please bear in mind that dialysis clinics are probably the safest, most germ free places you can go. They have to clean and sanitize each station several times a day before and between patients.
Fair comment but I personally am not going to attend my blood test as I am stable and doing well. Additionally of course although the facilities may be clean they have no control over the people in the building.
There have been several changes to entering dialysis facilities since the COVID-19 pandemic. Every patient who enters the waiting room must have their temperature checked and answer health questions like if they have a cough, fever or shortness of breath. No one but patients can be in the waiting room (except for drivers dropping off patients who are allowed in with masks and must leave after calling staff to tell them the patient has arrived.) Every patient must wear a mask the whole time they are in the waiting room and facility. All staff likewise wear their masks the whole time. Patients seat themselves at safe distances apart from others in the waiting room and inside the chairs are set well apart. There is an isolation room at our clinic where a patient can have a blood test in seclusion. Check with your dialysis center for all their procedures and rules before making a decision.
I am a PD patient. It is not my Renal Nurse’s examination room that I am concerned about. I have been told that there are Fresenius Clinics where Hemodialysis patients have tested Positive for COVID-19. Many of the Hemo patients I see that come thru the clinic get there by EMS drivers on stretchers. Are you telling me that the ancillary people, i.e., the EMS attendants, postal workers, family members that bring in their elderly parents, caregivers, UPS delivery drivers, medical supply truck drivers and others that come thru the same door I would walk thru to get to the Nurse’s exam room are negative for the virus? Can the personnel at the clinic be diligent enough to wipe every single surface that is touched by outside sources with sanitizer?
This virus isn’t “playing games.” I have 3 of the most high-risk conditions that cause me to be very susceptible to contracting the virus. I’m not taking any chances. If Fresenius does not want to accommodate it’s PD patients, that is up to them. If they want to “fire” me as a patient, so be it.
BTW: Pre-Coronavirus, I wouldn’t even use the bathroom in the patient waiting area. I have seen feces on the seat. Are the personnel not any more conscious of keeping a sanitary environment without a pandemic than they are without one? I would use the QuikTrip bathroom down the street before I would use the Fresenius clinic bathroom!
Until TESTING is ramped up in my State and County, I intend to stay home. Can you believe that the USA, the best country in the World, has tested only 1% of its 350 million inhabitants? Germany and South Korea both did much better at testing its residents much faster than the US has.
Yes. I am not going. I have been on peritoneal dialysis for 6 months and have only had two blood tests and only seen the nephrologist once and she hadn't even bothered to look at my results so no way am I bothering to drag up to the clinic and risk getting this virus.
I don't blame you. BTW: after talking to the Regional Mgr for Fresenius, I had my blood drawn at a Fresenius Clinic in the same area of town that only handles Home Dialysis patients, and then a Telehealth conference with my "old FMC clinic" was done on April 30. Effective 5/1/20, I was permanently transferred to the FMC facility handling only Home Hemo patients. I unfortunately lost the Nephrologist that I like because he does not have privileges at the new clinic.
I had a blood draw at the new clinic again this past Friday, May 8th. The staff was very friendly to me and when I told them I was nervous b/c of the issues with the old clinic, they said not to be upset about the past and that I was starting fresh with them.
I felt that I did the best to take care of myself. I have not met the nephrologist yet, but at this Clinic, the Nephrology Office is just one floor down in the same building and with Covid-19, they are doing only Telehealth appointments with the nephrologists after the blood results are completed.
It is interesting to state that one of the documents I had to sign and that were given to me at the new FMC was a list of important phone numbers that I could call to ensure my patient rights. I had never been given this document at the old facility and in August 2019 I was experiencing some very bad health issues that were not being addressed at my old clinic. That really is what started the downfall of my relationship with my renal nurse, the renal dietitian, the social worker and with my own nephrologist back then. I ended up in the hospital ER in early September 2019 because of the problems I kept wanting my dialysis clinic to help me through. In August, my nephrologist told me in a telehealth environment that I "only had a virus" that was causing constant vomiting and chronic constipation. The doctor's nurse practitioner told me that viruses do not last 6 weeks (this was obviously prior to Covid19). When I was taken to the ER, I was dehydrated, had low electrolytes, and went into an A-fib situation.
I am now happy that I made the transition to the new facility. I am sure I will miss my nephrologist, who is a very knowledgeable and kind man. But if he was no more proactive in helping me with my illness back in 2019, maybe it's best that I have moved on. I had been seeing him since 2013 when I was first diagnosed with CKD.
Thank you. If my original nephrologist had been proactive then I could have delayed starting dialysis. I have little confidence in the medical system at the best of times. I have recently changed clinics too because of incompetence at my original hospital. I have agreed to have a blood test at my local doctors rather than expose myself to risk travelling many miles to the kidney clinic. Best of luck to you.
Good for you for taking care of yourself and finding alternatives.
I asked my PCP if they would take my blood way back in March, but they were already closed and using telehealth. I asked for an Order for a blood draw at Lab Corp or Quest (where my blood draws were done prior to being put on PD). FMC said "No". I asked if a FMC RN could visit my home (I live alone), and they refused [even though the do home visits and blood draws for immobile dialysis patients.]
I, too, believe that I was put on dialysis sooner than was necessary. Although, as I said, I had confidence in my nephrologist, I think he expedited the catheter insertion so that he could get me into the Fresenius clinic (I had only been seeing the nephrologist prior to that) and FMC now bills Medicare $1.2 million a year just for my care. Of course Medicare does not pay that amount, but they do bill that amount. I still wholeheartedly believe that it's all about the money to them.
I worked for years in the legal industry as a paralegal in the area of medical malpractice. I have seen it all with doctors and hospitals. The doctors and hospitals pay huge malpractice insurance premiums b/c they make huge mistakes.
I am a hemodialysis patient at a dialysis center 3X a week. All dialysis centers are having to follow CDC guidelines during this pandemic. My dialysis nurse and techs have masks, gloves and gowns and face shields on when they put me on and take me off the machine. They have to use hand sanitizer frequently before and after gloving and the various procedures. We patients must have two needles placed in our fistulas or grafts, one for arterial and the other for venous. Our accesses are washed and sanitized before any needle goes in. We patients must wear masks the whole time we are there. I am sure your nurse will take every precaution when she draws your blood. Please check with your clinic to make sure they are following these rules and procedures and you can be confident they will take good care of you. I have had a telehealth appointment with my PCP that went very smoothly. Your nurse or NP should give you an exam so she can check your heart, lungs, temperature and respirations and chest sounds. Also, they feel your ankles to see if you are retaining fluid. There is no reason your nephrologist shouldn't be able to do a tele health appointment once he reviews your bloodwork and sees the results of your exam. Please try to relax and know you will be taken care of. Stay safe and healthy!
You have to stop panicking. First of all all these CDC rules are ridiculous. Did we do this with the swine flu? No. And despite what you hear on the so called news it was jist as bad as this. This entire thing is POLITICAL. You must go into your clinic. If something is wrong with your numbers it will be far worse for you in the long run if you do not fix it. I go to hemo 3 times a week. NOONE there is sick. Just chill
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