Hi everyone. A few months ago I talked about how my exit site was getting infected and how my doctor referred me for a fistula surgery for HD. Oh well, I had the surgery last week Thursday and I’m home healing a little at a time. I’m still doing PD and I have to wait for 2 months or there about to heal before starting HD.
I don’t really know how to feel about this. I was totally against HD because of my extreme fear of needles and how I might find it hard to stab my vein with a needle each time I have to dialyse. A lot of people say HD is better as it doesn’t get infected like PD and I will have days off dialysis during the week as it’s not every day like PD. However, before the surgery, the surgeon had a chat with me about HD and said he prefers PD as it’s everyday which means I’m having my blood cleansed daily as opposed to few times a week. Knowing how the kidney works 24hrs, PD is doing a closer job than HD. He also said HD puts a lot of strain on the body. This really discouraged me about HD. If it was not essential for me to change to HD, I would have changed my mind there and then.
So guys who have been on HD, how do you feel? Does the HD put a strain on your heart? Also if you have made a switch either from HD or to HD, do you notice any difference either worse or better than PD? I’ll really like to know to put my mind at ease or just prepare for the worse.
Another thing, how long did you have to wait for your scar to heal before you started HD? I heard some people couldn’t wait enough and it caused scarring like keloid on the arm. I feel like I should wait longer than 2 months since my PD is still working.
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Imaanforever
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It’s completely normal to feel uneasy about the switch. Many people find HD takes some adjusting, but it often gets easier over time. Some do notice changes in their energy or overall feeling. Waiting a bit longer might be wise if you’re still comfortable with PD. Healing times vary, so listening to your body and staying in touch with your healthcare team is key. You’ve got this and reaching out for support can help a lot!
Why on earth would the surgeon preparing you for HD give you such a negative evaluation of the procedute? If its the best type of procedure now for you given your history of infection with PD, then it's the procedure you need. As someone else said, making such a big switch can be stressful, but if it will provide a healthier option then it's what you need. Hopefully, you will make an easy adjustment to it once it takes place.
I think the surgeon gave you a lot of misinformation. HHD, is hard for sure, but it is the most gentle of all the dialysis. There is work for sure to learn all the set up. And cannulating can be difficult at first for some, but it actually is less painful when you do it yourself and it is a lot more accurate. There are creams to use to numb the area if needed. HHD lets you schedule your dialysis around your life and not the other way. It is less harsh on the body and heart. You will feel better much faster. And depending on your needs, you may need less time on the machine than with PD. The scar and fistula may never not be apparent. I used to hide it. Now I wear it as a badge and people ask about it. It gives me a chance to do education on kidney disease. If you can, ask someone at the center you go to about it, a patient who is actually on HHD.
hello I did pd for a year and half in June I got fungal infection from the catheter . So they had to take out the pd catheter . So they had to put in a temporary chest catheter for hemo you can’t go back to pd after having a fungal infection only like 3 to 6 percent get it and it can be deadly so I don’t want to do pd again knowing that a possibility. I heard so many horror stories about hemo don’t belive everything you hear everyone is different . I actually feel better on hemo I just been doing it about four week but my color is better I have more energy on pd I almost stop urinating and now I’m urinating again and I was always constipated on pd and I had terrible drain pain every night . I only slept two hours a night .
Now I don’t have a fistula yet so don’t know how bad the needles hurt but I watch other and I only seen one person cry out when they were putting needles in him .I figure sometimes with drain pain in pd I was on the floor it hurt so bad I think I can handle the needles . The nurses and tech are over in a heart beat if my blood pressure drop and they let me tell them if I can handle the fluid they take off I found that 2500 was to much for me I can do 2000 2100 and they will set the Machince at that . And I like this doing three hours is my prescription and having four days off.I went to vascular appt today they will be scheduling surgery for fistula soon .
Ugh tell me about the drain pain. It’s like something is sucking my intestines out. It’s horrible. On some days I feel no drain pain but most days I’m on the floor begging God to save me.
I hope your fistula surgery goes well. Thanks and I wish you all the best.
My hubby has been on both forms - HD and PD. PD is clearly the most gentle of all of them since it involves not accessing the blood vessels but relies on a solution involving osmosis to remove toxins. Hence, blood pressure/cardiac function remain very stable on PD; the tendency towards calcification is generally also reduced. And he slept through the treatments and managed to never catch an infection. When my husband was on HD, he went to the center 3 days a week. That's where he experienced blood pressure challenges and cramping while sitting in a chair for very long periods of time (4 hours). It tired him out a lot. However, if one is going on HD, consider doing HHD - that's when you do it at home several times, even daily, reducing some of those issues. HD is the choice for anyone who is prone to infections. Our dialysis center was quick to react, especially if it happened twice in a row. Crazy fast. I fervently believe those going on dialysis need to know all the positives and negatives of all forms of dialysis - full disclosure matters! Waiting until the last minute to do that (or not doing it all) is terrible a disservice to those impacted, including the caregivers.
That might well be the case for you since you are retaining fluid on PD. Keeping water in the body is hard on the heart and increases blood pressure. HD is very efficient in eliminating water. My husband's blood pressure came down quickly on HD, but later on it became very unpredictable. I hope things stay stable for you.
Yeah basically you really have to keep that site clean. My spouse has PD and has not had any infections. But he is really ruthless and how clean he keeps it I actually have to leave the room when he's setting himself up to hook up. I'll be honest if you have pets and things like that that can contribute to the problem. Because you're on immunosuppressants possibly your immune system is reduced so you can get infections quite easily you have to be extremely rigid you have to use all kinds of antibacterial soaps things like that.
You're so right about that. Our PD nurse turned into interrogator and judge - often sending people with infections to the other side of the center. Even failure to order supplies on time, could send one to HD. But she allowed a young man, who travelled and admitted he overlooked something, a second chance. She often praised an older lady who had been on PD for sixteen years and did everything right. Everyone was watched like a hawk.
My husband got a p.d. catheter tunnel infection and had to have the catheter removed 3 months ago. He had to do HD via jugular access at the dialysis center 3x week. Jugular access is not without risk, as it can lead to endocarditis, but he had no choice. He just recently had a new catheter placed and after 3 weeks of exit site healing, he's now back on p.d. at home every night. He hated HD as it left him exhausted and short of breath which was depressing and alarming, and his bp went crazy and was hard to regulate. After only a couple of days back on p.d. his energy is restored and his bp is under control again. He's so happy to have his life back again.
Well I've not heard of them doing it through the jugular before that's kind of scary. It could cause an infection it could also cause a clot and we know it could happen in that situation. Gladly PD is back online
I'm on HD for 18 months now and have learnt a lot about both types of dialysis through documented case studies. Through my own bad experiences at HD centers, I have learnt a few important lessons. Know your script and ensure the dialysis machine is setup correctly accordingly. Check that filtration rate is correct, check that the heparin release is correct, check that the right size kidney is being used, check that the pump speed is correct, check the hourly clearance rate to see if you going to meet your clearance target (1.2 to 1.4), check the venous and arterial pressures are not excessive and check the dialysis time is correct. All of these parameters if not setup correctly can lead to a bad experience. Try not to use your AVF fistula until the 6 rule is met. Fistula should be at least 6 weeks old, 6 millimeters minimum in diameter, not more than 6mm deep with a blood flow greater than 600ml/min. Also ensure that nurses use the correct size needle. Don't let them use bigger needles than necessary and ensure they always use a new area of the fistula when needling. You need to look after your fistula which could last up to 15 or more years. Be cautious and advise new nurses about how to work with your fistula - some nurses can cause unnecessary incidents if your fistula is new to them. Advise them of where and how to use the needles on your fistula to avoid them causing damage and unnecessary bruising and blood loss. Use Emla cream on your fistula to numb the area being needled. In the beginning start low and slow with HD. That means aim for sufficient clearance (1.2) at a pump speed not exceeding 250. Im currently being trained to do my own HD at home. Good luck.
Hi Imaanforever, any type of dialysis requires a lot of care, it is a huge task to avoid infections. I have been helping my husband for four years and something that keeps his exit site without infections is to clean it with Exsept (skin cleaning chlorine solution), after that, I use a little bit of Gentamicine Sulfate cream on a 2x2 gauze (covering the exit site and then placing a window dressing or a medipore pad (these two dressing options have a soft adhesive to avoid any skin lesions. That has worked really good in our case, my husband is also diabetic , so any infection would take double the time to heal. Talk to your PD nurse, I’m sure they can help you with these supplies. I hope you feel better soon!
yeah with pd can get infection on exit site but I kept my exit site super clean the of nurses said I had one of the cleanest exit site they ever seen but I got fungal peritonitis it was from the inside the catheter itself . So just saying sometimes if the exit site is super clean infection can still happen
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