Changes afoot to dialysis


So, I’ve been on haemodialysis (HD) for just over two months now. Just settled into the rhythm of it. Sunday afternoons (after church), Tuesday mornings (first thing), and Friday lunchtimes are the days I have been going up to Tallaght University Hospital for my HD. Each day there are friendly faces from the nursing staff and from other patients who are there. Each day brings a different set of people with whom there is some socializing.

Seems ages ago now, but in reality it is only just over a month ago that I had a day procedure to insert a Tenckoff catheter into my peritoneal cavity so that I could move to Peritoneal Dialysis (PD). On Monday 25th February, two nurses came out to start me off on that at home. Don’t worry, I had had plenty of training sessions in the hospital before they let me go it alone at home.

PD involves putting in fluid into my peritoneal cavity. Four times a day there is an exchange. Basically, this means taking out the old liquid and putting in new. At present, I am up to 500 ml of liquid inside me. The target, ultimately, is 2000 ml.

Two weeks ago, when I tried to up the volume to 1 litre as instructed by the nurses in Tallaght, I ended up with a pain in my right hand side. I then had to drain out in advance of coming in for HD. (There is no point in having fluid inside you when on HD as the dialysis machine will remove the liquid anyway.)

Last week, I completed a week of dialysis until I found that I was constipated (via an X-ray whilst in for dialysis). I was given Picolax® to solve this — and solve it, it did, well until Monday when there I was back to a lack of movement.

John on HD with two cuddly toys.
Liam my #dialysissupportbear comes everytime to Tallaght. On this occasion he was joined by Apollo the husky. From Instagram

Yesterday, when up in Tallaght, I met with my consultant and one of the PD nurses. We have now formed a plan. I’ve been given more laxatives (but less industrial strength than the Picolax®) for the next few days and then when movement has been achieved, I am to restart PD. The plan is to complete review in three weeks’ time. Should I have got to 2 litres volume and also completed the three weeks, then the nurses can do a PET test (not quite sure what that is, but I am sure I’ll find out more as we get there). This will then allow them to see what settings would be needed for the machine dialysis. Of course, there is another potential outcome: if PD is still not working, then I have been told that it will be abandoned and the next move will be to get a fistula created in my arm to allow for ongoing HD.

“Best option”

All the nurses and doctors tell me that PD really is the best option for me. It should allow Andrew and me to travel. But to get to that stage, I need to get on to the machine which does the exchanges for me although overnight. Therefore, the next three weeks are make or break for us. Wish me luck!

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