[RajaTaurus]

Fistula is not something they fit in the arm. They connect two veins inside near Wrist, to make the blood flow better during dialysis.
As H_Zoom says, it takes 3-4 weeks for the fistula to start 'working'. So, even if the decision is deferred, I think it is better to get one fistula done in his arm, to be ready when dialysis is required.
In addition to what H-Zoom suggests, he must avoid high protein and high potassium food and completely avoid sugar and salt.

[KITE RUNNER]

GTO,

I am sure this thread will be helpful to many in future.

Certain things to remember -

1) Try to get the best possible care from a patint friendly hospital, where the patient is not just a commodity. Once you start dialysis, it will be continued on a regular schedule, so better to be in a peaceful & friendly atmosphere

2) Ensure that the staff & hospital are following proper infection prevention programmes as infections can be life threatening in renal failure programmes.
The patient also should maintain proper personal hygeine. Foot care is very important especially for diabetic patients.

3) Educate your dad about chronic renal failure, the treatment options & personal tips. When in the hospital, he should be aware of the dialysis process & actively take part in it by discussing with healthcare team & ensure that they are following proper infection control protocols. Simple thing, just see that the staff are washing hands properly before working on you.
Vaccinations are available against some infections that are common among dialysis patients, discuss with this with the treating doctor.

4) Always maintain a healthy diet - best thing to do is to get the help of a qualified & experienced dietician, follow his/her advices properly

5) Always continue doing moderate exercises, till your body is allowing you - not to the point of getting breathless.

6) Live your life as if nothing has happened - dialysis is just removing waste materials from your body, a cleaning process. Positive thinking is most important for better outcome in any illness.

8) Always keep updated about newer developments in the field & never hesitate to discuss & clarify doubts with your doctor.

Hope your dad can maintain healthy lifestyle for many more years.

[Blue Thunder]

Originally Posted by GTO

...Goods news is, Dad's report from yesterday made the Doctors optimistic. They have decided to wait another 60 days before deciding on dialysis. Though the probability is still high, the Doctors are hoping to cure it with medicine, diet and limited fluid intake. He's responded well to the medicines over the last 4 days. ...

Good news, indeed . My best wishes for his speedy recovery.

[RajaTaurus]

Added to the above tips, make sure they use New needles and tubes every time they do the dialysis.This one set could cost around 1200 - 1500 rupees depending on the hospital and many dialysis centers have clandestine ways of reusing these without the patient noticing it. Take care on that. Ask for the used tubes and needles and destroy them if possible, as you would have paid for it anyway. Some centers have sterilized shelves for storing these, with proper name tags and they re-use the tubes only 2 or 3 times before throwing it away. But, this has to be ensured.

[Mik]

Originally Posted by RajaTaurus

Fistula is not something they fit in the arm. They connect two veins inside near Wrist, to make the blood flow better during dialysis.
As H_Zoom says, it takes 3-4 weeks for the fistula to start 'working'. So, even if the decision is deferred, I think it is better to get one fistula done in his arm, to be ready when dialysis is required.

I am getting confused now. Last year, i underwent multiple dialysis sessions due to temporary kidney shutdown caused by Jaundice(My bilirubin was 48 !!)
They used to put in the fistula either near the groin or on my neck and it was done just before the dialysis. They took it off after every two sessions and alternated between the groin and the neck every 4 days.
So how can it take 3-4 weeks for the fistula to start working ?

[RajaTaurus]

^^ You are right. That is also done. But, what I am talking about is a permanent connection of two blood vessels near the wrist, so that you don't need this near your neck. This is done as a permanent thing in case of chronic kidney failure case.
Please see the following link for more details and illustration.
Arteriovenous fistula - Wikipedia, the free encyclopedia
This is the one that needs about 4 weeks to start 'working'.

[KITE RUNNER]

Originally Posted by Mik

I am getting confused now. Last year, i underwent multiple dialysis sessions due to temporary kidney shutdown caused by Jaundice(My bilirubin was 48 !!)
They used to put in the fistula either near the groin or on my neck and it was done just before the dialysis. They took it off after every two sessions and alternated between the groin and the neck every 4 days.
So how can it take 3-4 weeks for the fistula to start working ?

Dear friend,

What has been used for you is a Central Venous Catheter, which can be connected to Dialysis machine.

Catheter technique is used for patients who require dialysis for acute renal shut down & they usually improve after few sessions of dialysis. Chronic renal failure patients require dialysis lifelong & for them arterovenous fistula is preferred, which is surgically created on the forearm, which takes 10-14 days to become fully functional.

Dialysis can be started for them with catheter till fistula is created & gets functional.

[GTO]

In case this is of help to anyone who is undergoing dialysis, Barley juice has been highly recommended to us, as a supplement to the medication.

1. Add handful of barley seeds and one small beetroot (medium size, cut
into small pieces) into a pressure cooker containing 5 cups of water.

2. Boil for 30 minutes (10-12 whistles).

3. Cool, strain the liquid and serve.

[BuRnT RuBbEr]

Originally Posted by GTO

Can Ayurved provide a realistic cure in such cases?

Let me set the expectations right here. ayurved/yoga help more as preventive/supportive/resistance building medicine. Quite often, they assist only in controlling side effects of standard medicine.But that itself is significant, from the perspective of maintaining a certain quality of life during treatment.Suggest you to hunt for a genuine ayurvedic treatment and inculcate that in the patient' normal routine, iff the patient responds positively or neutral to the same ( ayurved sometimes doesn't show any indicators).

please do not infer ayurvedics to be an alternative to active intervention such as dialysis.

[idea]

GTO. This is really a terrible news.

Unfortunately i have gone through this phase for my father. Every event was a eye opener.

However after two years of trial and error, things came of track. (i figured
out ways to sort of automate things.)

I am happy to know that he is responding to medications and decision about dialysis is delayed by doctors.

There are two options (I am not giving long details as of now)

1. peritoneal dialysis

Peritoneal dialysis requires a small operation where in a catheter is fitted in peritoneal cavity. You need to send in liquid (available in bags costing 250-300 each) in cavity - keep it there for 2-3 hours and take it out. It all works on gravity. The cycle needs to be repeated for aprx 5 to 6 times depending upon urea level.

No need to visit hospital for this. However you need a dedicated person for this process as chances of infaction are really high.

2. Heamo Dialysis

Depending on urea/cretanine level, its done every week or 10/15 day (if water and food intake especially salt is controlled). Needs to be performed in hospital on dialysis machine which generally takes 5-7 hours depending on patients health.

It requires small operation where in a fitulla (big artery) is made at convenient location mostly hands. You really need to look after fitulla location like avoid any strenuous activity etc. You can actually feel blood flowing when you touch it. It will actually used to take out blood from body through dialysis pipes to dialysis machine which filters blood.

Consumables are dialysis filter , tubes which need to be replaced every 4-5 dialysis cycle. Combined cost is around 1000/-. You will also need to use injection Eprex 1000/2000 costing aprx 2000/- in order to take care erythropoitin deficiency which actually leads to less HB.


However at this point i will advice you to be positive. Its not end of world. Spend more time with him and its advisable to not to treat him as patient (Dont put too much restriction on diet and too much stress on medicines) and keep his morale up.

You will be flooded with advice like ayurved, some home recipe, some special doctor, people with divine power etc. Please be alert.

Most of MR you will meet show great empathy and concern however at end of day you are their customer (its all commission game and good nexus. - no offence here - it is just my personal experience.).

Kidney transplant is option however it all depends on health of patient, kidney availability. Post transplant there will be lot of medication (Hi Power Anti Biotics) which actually weaken our self defence so that body do not attack "New Kidney"

At end of day, if god forbid if dialysis is adviced , chose a wise option.

Feel free to contact me at any time for any help.

May god be with you and with all my best wishes. All will be fine.

[GTO]

Thanks Idea!

Originally Posted by idea

GTO. This is really a terrible news.

Dad doesn't see it that way. If there wasn't any dialysis technology, we wouldn't have any option at all, would we?

I am happy to know that he is responding to medications and decision about dialysis is delayed by doctors.

Good news is, his creatinine level has dropped from 7 to low 5s. Doctors have changed their recent 60% dialysis probability to 50. Still, they have clearly instructed us to be mentally prepared for the same.

It requires small operation where in a fitulla (big artery) is made at convenient location mostly hands.

This is the one. They have decided on Papa's right hand to place the fistulas.

However at this point i will advice you to be positive. Its not end of world. Spend more time with him and its advisable to not to treat him as patient (Dont put too much restriction on diet and too much stress on medicines) and keep his morale up.

Dad (and us) is completely ready for his dialysis (if & when). He's mentally prepared.

You will be flooded with advice like ayurved, some home recipe, some special doctor, people with divine power etc. Please be alert.

Tell me about it, man. You won't believe the kind of stuff that's been recommended to us.

Feel free to contact me at any time for any help.

Thank you for this, and your advice. It's truly appreciated.

[procircuit_234]

that is called as AV fistula.yu can try homoeopathy.i have seen creat droping from 7 to 2.5.

[abeerbagul]

I guess the most optimum recommended treatment is daily nocturnal dialysis at home. But this requires a huge expense at start for purchasing dialysis machine (6.5 lakhs), R.O. plant (1 lakh) and a generator backup.
You will also have to pay the technician salary who comes home.

But this is best for following reasons:
1. Zero chance of Hepatitis B and Hepatitis C infection. My wife works at KEM hospital, and the biggest source of Hepatitis infection is the Renal Unit where dialysis takes place. At this age, treatment of Hepatitis is also difficult.
2. Best quality of life for patient. Just like our kidneys work 24 hours, daily dialysis is required to avoid the highs and lows due to the regular dialysis modality of 4 hours, 3 days a week.

[furioussphinx]

I have been to a conference today and yesterday and I met the MD of a chain of dialysis centers. I think you should get in touch with him. He is a very nice person and very knowledgeable too. His name is Mr. Vikram Vuppala and he started "Nephroplus" dialysis centers.

Contact him on 9640280777
vikram@nephroplus.com

Hope this helps

[esoteric_su]

No matter what the doctors or journals say , my experience of having faced this in my family and also seeing lot of patients in Apollo , Bangalore :
1) Once you start dialysis , you have to continue for the rest of your life
2) For senior citizens above 65 , chances for survival after 2 yrs of continuous dialysis ( min 2 times per week ) is extremely rare . In most cases patients suddenly expire , mostly in their sleep.
3) BE careful about hepatitis B & C infection from the machines. The haemoglobin levels will fall due to dialysis and very costly injections like Eprex 4000 will be required down the line for chronic renal failure .

Delay the dialysis as much as possible and try naturopathy . But still make sure potassium levels are under 5 and fluid, salt intake is controlled. Higher potassium leads to sudden stroke / heart attack. This is a very costly , bad and one of the worst diseases .
I hope your dad recovers and does not need it . All my best wishes for him .