[raghuvir]

My father had been diagnosed with Chronic Kidney Disease about a year ago. His creatinine had increased to 3. We did a routine check last week and his creatinine had gone up to 3.8 and also had swelling and infection on his legs. We admitted him immediately to counter the infection and next day his creatinine went up to 4.2. He was treated with IV antibiotics and next day creatinine was 5.6. Doc advised to start hemodialysis, but we wanted to wait for a day and see if creat levels would go down. The very next day it came down to 5.3, however, the day after it shot upto 5.9. We started dialysis day before yesterday.
Today the Doc sent a guy for giving us options for type of dialysis-Hemodialysis or Peritoneal. It was a well orchestrated sales pitch. The sales guy showed us on paper how peritoneal was cheaper and better than hemo.
I had researched on dialysis and had come to the conclusion that Hemo was the best method and this was confirmed by the Director of the ICU who happens to be our family friend.
Also, if you do not have mediclaim, the surgeon will rip you off for inserting the fistula. In Pune, the best surgeon suggested for the procedure is Dr. Vishwanath Jigjjini.

[GTO]

Originally Posted by raghuvir

We started dialysis day before yesterday.

Please read up my earlier posts on this thread. All of you need to support him. Don't let anyone worry, it's not the end of the world . Dialysis is actually a life-saver.

Your Dad might have a li'l discomfort at the start only. His body will set into the rhythm after a couple of sessions.

Today the Doc sent a guy for giving us options for type of dialysis-Hemodialysis or Peritoneal.

Peritoneal dialysis is good as well, but it requires more effort & discipline. We found hemodialysis to be more convenient.

Question: How old is your father? If he is otherwise fit, you might want to consider the kidney transplant option too. This wasn't something my Dad could consider as he was too old & weak by the time his kidneys gave up.

[raghuvir]

Thanks GTO. Dad is 71 years old and a kidney transplant doesnt seem possible. We have been advised dialysis twice a week, however, I'm skeptical about the diagnosis. The Doc usually advises dialysis twice or thrice a week, but it should be different for every individual, depending on how the creatinine and electrolyte levels vary each day.

[GTO]

Originally Posted by raghuvir

Thanks GTO. Dad is 71 years old and a kidney transplant doesnt seem possible. We have been advised dialysis twice a week, however, I'm skeptical about the diagnosis.

True, it does vary from patient to patient. Plus, dialysis isn't a perfect science. The schedule & treatment will be fine-tuned depending on how your Dad responds to the dialysis.

Why are you sceptical about the diagnosis? Let me know if you have specific questions. Will try to answer.

[girish4731]

I was looking up info on dialysis last night and google showed me this thread in the results

As I read through the thread, I was really able to get a basic sense of what it entails and how one needs to prepared for it. Thanks to each member, who has posted their views/experiences on this thread. Appreciate it. I am feeling a bit relaxed, after reading it so far.

A bit of background - My dad (He's 71 and his creatinine has been on the higher side for couple of years now. He has managed with strict diet and fluid restrictions all the while!). needs to undergo dialysis and there is (and has been) a lot of apprehension around this. Given his current health situation - has fluid accumulation and a chest infection to go with - he's unable to get much of the fluid out of his system. His intake is restricted to around 1L per day.

Doc advised today that dialysis is needed and there's no time to go through the AV Fistula procedure. So, the docs will use the other approach of inserting tube near his neck [not completely sure what exactly it will look like].

Hoping it'll go well. Will know by evening or late night.

Thanks again to everyone for sharing their experiences and inputs. Appreciate it.

Cheers.

[GTO]

Originally Posted by girish4731

As I read through the thread, I was really able to get a basic sense of what it entails and how one needs to prepared for it. Thanks to each member, who has posted their views/experiences on this thread. Appreciate it. I am feeling a bit relaxed, after reading it so far.

. Fire away with any questions that might come up.

Think of dialysis as a life-saver (which it actually is). Nothing scary about it. Dialysis only gets out the dirt from the body.

The first couple of sessions are the most sensitive. After that, it'll become a way of life.

Please check his sugar & BP levels continuously after dialysis. A li'l weakness will come in, but he'll slowly get used to it.

Doc advised today that dialysis is needed and there's no time to go through the AV Fistula procedure. So, the docs will use the other approach of inserting tube near his neck

Docs are always in a hurry :(. But for the longer term, get a fistula. Very minor operation. Start with the hand. If he's a righty, then the left hand.

Good luck to your Dad!

[D4d-maniac]

Originally Posted by girish4731

Doc advised today that dialysis is needed and there's no time to go through the AV Fistula procedure. So, the docs will use the other approach of inserting tube near his neck [not completely sure what exactly it will look like].

The tube near the neck which your doctor mentioned is called an IJV line. The tip of that line lies very close to the heart and it provides access for dialysis. However, it is a temporary access. It may get blocked or infected , when it has to be removed. Judging from your dad's condition as described by you, he does need urgent dialysis.
Now for more permanent dialysis access, we have Permacath or av Fistula. None the options are without complications. But I would suggest if a Fistula can be made, it should be the first option. It takes 6-8 weeks for a Fistula to mature after surgery. Hence the need for an IJV line to tide over that period.

[girish4731]

Thanks GTO and D4D - for writing in.

After the first session of dialysis, Dad was definitely feeling better. Much of the fluids have come out of his system. A bit weary - yes, but he's okay. BP/ Sugar - both are maintaining well. Creatinine has come down, post the procedure.

GTO -- The reason for not doing the Fistula approach is because he is already in the hospital with a viral infection and that's causing lot of discomfort overall. This was causing a market shoot up in creatinine and that's why, the doc suggested to proceed with the dialysis. [During Sep review, as an out-patient, he'd suggested to my dad that he should get the AV Fistula done, so that it's easier for him, should the need for dialysis arise].

Post the dialysis, when we met the nephro, we did ask him whether this will have to done on an ongoing basis. He explained in a very calming and relaxing manner that, we should not think too much ahead on such things. So, it's best to take one step at a time and see how the body reacts to the current dialysis. The Nephro is a very senior doc and often says it like it is - I somehow like that about his approach.

As of now, Dad's okay. A bit tired with the cough/phlegm from the viral infection. Looking forward to a happier Sunday, from his point of view.

Thanks again for this thread and the responses. Much appreciate all the inputs.

[girish4731]

The Fistula was done yesterday, after much improvement in my dad's overall health. The doc said, it'll be ready for dialysis in 4-5 weeks (if needed at all).

Last 2 days, in the morning Fasting Sugar dropped it a bit, but otherwise Dad has been keeping well. Has recovered from the viral infection that led to all this, in this first place (this time). He'll be back home later this evening. Have a review next week with the nephro.

Again, I must say (at the risk of sounding repetitive), I found this thread helpful in alleviating some of the apprehensions of dialysis and how it can be handled. Thanks a bunch for the different wishes, views and perspectives from all members who shared here in this thread - all have helped in some way or the other.

Wish you all good health.

Cheers!

Originally Posted by GTO

. Fire away with any questions that might come up.
===============
Good luck to your Dad!

[GTO]

Originally Posted by girish4731

The Fistula was done yesterday, after much improvement in my dad's overall health. The doc said, it'll be ready for dialysis in 4-5 weeks (if needed at all).

Good to hear of the progress. How are his creatinine levels?

Again, I must say (at the risk of sounding repetitive), I found this thread helpful in alleviating some of the apprehensions of dialysis and how it can be handled. Thanks a bunch for the different wishes, views and perspectives from all members who shared here in this thread - all have helped in some way or the other.

That's the beauty of Team-BHP.

[girish4731]

It was 8.xx before the first dialysis was mandated by the doctor. Post dialysis, it was down to 4.8x. A test, before he was discharged, showed his creatinine levels at 8.xx again. Next review with the nephro is on Tue.

Let's see how things go!

Originally Posted by GTO

Good to hear of the progress. How are his creatinine levels?



That's the beauty of Team-BHP.

[GTO]

Originally Posted by girish4731

It was 8.xx before the first dialysis was mandated by the doctor. Post dialysis, it was down to 4.8x. A test, before he was discharged, showed his creatinine levels at 8.xx again.

Ah okay, dialysis is inevitable then.

When you meet with the nephro, please also ask if kidney replacement is a viable option. A successful kidney transplant is a more longer-term solution than dialysis, but it also depends on the patient's health.

[girish4731]

It's nearly 2 years since I last posted to this thread - It's a longish post, so, please bear with me !

Around Sep-2017, with ongoing dialysis, my dad was doing alright except he was always weak with very low immunity levels. His Hb levels were low (7-8), creatinine was around 6.5-7. With the diet restrictions that he was in, his Hb wasn't improving despite the regular Hb injections and periodic follow-up with the doctors and not missing any of the dialysis sessions. Even the slightest change in climate would result in him getting a fever and going for a dose of antibiotics and it didn't seem to matter which city he was in. Clearly, Bangalore wasn't suiting because it was getting too cold for him (so much so that he wouln't even go out to walk the corridors of the building!!)

So, we decided that it's better for him to be in warmer climate and therefore, took him to Chennai. Along with this, we also decided to look at another nephrologist to get another opinion and try to improve his overall health.

Surprises were in store for us - The doctor at Kauvery Hospital Chennai was surprised at the diet restrictions my dad was under and he almost immediately assured that there are lot of improvements that can be seen in the overall health, provided the changes suggested by him were followed to the T. Those words came as a big relief for my dad, more than, for anyone of us.

The doc also advised strongly that the medication needs to be reviewed completely as well. Many of the existing meds were removed from the list and the laundry list of meds dropped by 40% ! . [i don't recall all of the meds now, so not posting details here].

With regular follow-up and prompt dialysis sessions, we all noticed that his health began to get better. For someone who wasn't willing to walk indoors of the house, my dad started by getting to the Terrace and walking 15minutes every day - this after 1 month of consultation with this doc and following his suggestions. Within 3-4 months, he was going to Dialysis sessions by himself !! Hb levels started to improve and so did his physical strength! Considering how vast majority of 2017 went for him, this was a very good improvement.


Slowly but steadily, the 15min walks turned to 30min walks. His morning routines got better and he was doing most of the things himself and had started going out to buy stuff ! [this also meant, he was wanting to a say in what was happening around the house too ]. He was bolstered that his Doctor gave him a green light to attend family weddings, go on short overnight trips to nearby places too. He indeed was a happier and busier person that he used to be for majority of 2017!


All going at the same tempo so far in 2019 - as well. Beginning this year, the injections for Hb have stopped as well. His Hb is around 14 now - which is considerably good. His creatinine is around 5-5.5.

He asks the doctor at times, if there's no way out of dialysis (because he still thinks for all the medical advancement, there should be a solution to this!!) but otherwise, he is doing pretty well.

Diet changes mentioned by the Doctor post Sep-2017 -

1. Eat all types of vegetables (earlier there was restriction on what he could eat and could not!)

2. Salt restriction was relaxed as well. This was monitored by the Doctor and his team and changed periodically

3. Doc advised strongly that atleast 5-10min of walking is MUST to start with. Time needs to be increased each week. [Earlier, walking was out of the question due to physical weakness].

All of these, combined with regular dialysis sessions, helped improved his physical and mental framework over a period of 2-3 months.

On a related note, there are some days that he feels weak or tired, and that according to Doctor, can happen to someone who's undergoing dialysis.

Barring dialysis and follow-up consultations with the doctor, my dad hasn't been an in-patient since Sep-2017 (touch wood!! and hope he remains that way). All of us at home, will happily, take that any day.

The decision to take a second opinion and revisit his overall health in Sep-2017 has helped immensely. Finding a good doctor then and even so importantly, getting the right kind of advise, acted as a great catalyst in bringing many things back on track in my dad's health !!

[GTO]

Girish,

So happy to hear that your Dad is doing better . A good doctor makes a world of difference and yours seems to have given just the right advice.

We were never too hard with the dietary requirements either. You got to live a little! Heck, I used to give my Dad cigarettes whenever he felt like having one. Having a good time is very important to a patient's (mental) well being.



A dinner, just 3 weeks before he left for heaven. You can see how happy he is:

Originally Posted by girish4731

He asks the doctor at times, if there's no way out of dialysis

Kidney transplant an option for your Dad?