Thank you all for your honesty about Hemodialysis and PD. My husband , age 79, should have the fistula created in the next week or two, in the mean time , if his kidney function continues to drop , he will start with a port in his chest. His GFR13 as of last week, the GFR had held around 20 for years so this rather sudden drop has us a bit shocked and unprepared.
He has many health issues, diabetic for 40 years, heart issues and sepsis survivor. You can throw in 3 strokes and 1 heart attack.
He is worried about PD because if or when something goes wrong, it would just be the two of us at home. His feeling is, in the center, which is across the street from our local hospital, he is very close to an emergency room in addition to the staff at the center.
We have a great team of doctors but I feel like they all push for PD, he is a stubborn guy and seems to have make his mind up about HD. I understand it will be harder on him given his co-morbidities and we have had good conversations what that could mean.
Again,
Thank you for your kindness everyone,
Updates to follow.
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Retirement2023
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Just take it one thing at a time, get the fistula that alone is a relatively minor surgery. He can always give PD a try afterwards. The PD catheter surgery is a little more involved and painful.
Although they say the HD is harder on the body, lifestyle choice is important. I too was told to start with PD and I said no. I do not want the constant fighting against the known weight gain and for my lifestyle, it will impact me more. I am going with HD at home. That was a decision I made years ago before I was even close. I want to control my time on HD. But incenter would be less scary than doing it with just me and my hubby. But I am confident in the training and my ability to do it. If I wasn't it would be in center. I am having fistula surgery soon but I am hoping to stay off dialysis for a while. I am at 13, but feel fine.
Not so sure about the "known" weight gain. I've been on PD since Feb and I'm still fighting to gain weight. But again choice is yours. While I have no problem with needles for taking blood there's no way I want to be sticking those needles in my self. More power to you
PD dialystate is made up of glucose. and for some people , they gain a lot of weight on it depending on what stength it is. For me, I would gain weight. I gain weight looking at cupcakes......
It generally isn't a problem. There are different levels of glucose concentrations in the solutions - from low to high. Most people use the dialysates with the lower concentrations. (The higher one, is our experience, is rarely used.) And there's one that isn't sugar based at all. My hubby actually got off all diabetes meds while on PD, the glucose wasn't a deal breaker. For the others, a very simple adjustment to their diabetes meds is all it takes to "normalize" things. I've seen very few that become "overweight" while on PD. If people gain weight while on dialysis of any type, it's often water weight from inadequate dialysis. Inactivity, food issues, other health conditions, etc. also contribute It's a wonderful thing that a number of dialysis treatments are available and I respect what each person goes through to reach their own choice. There really isn't a "bad" form of treatment - they're all designed to save life.
In August last year, my husband’s kidneys failed. He had to go on immediate dialysis. First the port was one place. Then another. He was in the hospital for over a month as he has diabetes , heart problems, etc.
while in the hospital the doctors convinced him PD was the way to go. And they put the catheter in. Well, come to find out, it’s not as simple as they made it seem. So he has opted to do in center HD. It has been a better fit for us. He’s 75 and I’m 74. Neither one of us was comfortable enough with the necessary duties of PD. Plus we didn’t have enough room for the machine and supplies.
So then he had to have the PD port removed. And it took forever to get the fistula inserted. It was a nightmare. But we’re happy with the schedule now. And he’s able to drive himself back and forth to dialysis. Plus he has it first thing in the morning, so has the rest of the day free.
Sometimes it does take too much out of him. But in that case, he just rests. We’re learning to be flexible.
It’s a big lifestyle change. And came on suddenly. So I understand where you’re coming from. He nearly died. And we’re fortunate he survived.
That's why I decided to do dialysis at the center, too. It was at our former local hospital 20 minutes away from home and the emergency room was right around the corner from the building I was in. It was the best decision I ever made. I did need the E.R. once and when I fell and broke my hip I was still able to be in a nursing home rehab center owned by the hospital and nearby so I was able to be transported there for my dialysis treatments.
Your husband is also making a very good decision to get a fistula created - it is the safest option for getting dialysis. It is rated the best for preventing bloodstream infections, but it will be some time before the fistula is usable. Tell him to make sure to exercise that arm by squeezing a soft rubber ball every day. Use icepacks at first because there will be bruising and swelling of the arm, but it should resolve within a week or so. The surgeon's office will be a big help if he has any questions or concerns. Oh, and he will be under sedation for the fistula creation, so it should go well for him. The same for the port creation. I once had a temporary port done one day , dialysis that night and a fistula gram (where they go in to unblock a fistula) done the next day. I'm a veteran! Take care!
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