Isabel
Joined: 11 May 2003
Posts: 25
Posted: Sun May 18, 2003 12:34 pm Post subject: Internal political reasons??? please advise!!!
--------------------------------------------------------------------------------
jfwag<
><
>I spoke with my mother neph last week to asked him a question on why he did not put the stent first. He told me that my mother was vry sick and getting too much fluid in her lungs, taking too much medicine so, he decided to do the dialysis first. I also asked him what was her kidney's function when he recommended dialysis. He advise me to check with the hospital medical records. (I will) <
><
>As of last week my mother will have dialysis twice a week. The Neph told me that her KT/V is 1.92, he told me that this was high, and he will recommend 2 times per week. I think that the reason she never felt well after dialisys was becuase she was getting too much, or she was anemic. She will come home always tired, dizy, depressed. I questioned him about iron and to give me the name of a medicine for anemia, he told me that the center put Epogen and Iron in the last week of dialysis. ( I noticed a difference that day.... but I am not sure about it, we are not supposed to visit her except for 5 minutes). <
><
>I am keeping my eye on my mother's test results, I do not understand them very well but I will compare them with the one at the hospital. <
><
>I am very persistant and will try to get my mother off dialysis if is possible, I have heard that PT that have their kidney function at least 24% as my mother did can delay the dialysis up to 4 years and also heard about some Dr's that prescribe medicine to PT to shut their kidneys down. I need to know more about those prescription and I am also concern with the internal political reasons you mentioned. What do you mean????
****************************************************************************
Be advised
Joined: 18 May 2003
Posts: 2
Posted: Sun May 18, 2003 4:08 pm Post subject: Isabel
--------------------------------------------------------------------------------
Be advised that anyone responding to your posts are only giving you suggestions, not medical advice. I would suggest that you obtain the book "Review of Hemodialysis for Nurses and Dialysis Personnel" as it would be a good crash course in dialysis and a resource for you later on as you begin to understand more.<
><
>Also go over to the Education portion of this site and look up the web site given there for lab values specifically for Renal patients. This will help you.
****************************************************************************
FYI
Joined: 15 Feb 2003
Posts: 72
Posted: Mon May 19, 2003 5:32 am Post subject: Try the PDR
--------------------------------------------------------------------------------
You can resource the medications with a Physicians Desk Reference (PDR) or your pharmacist.
****************************************************************************
Isabel
Joined: 11 May 2003
Posts: 25
Posted: Tue May 20, 2003 12:18 pm Post subject: Confused
--------------------------------------------------------------------------------
I am aware that these are only suggestions not medical advice But it is good to know that you can talk to someone. I am very confused and worried about my mother getting worse instead of better. I was happy to hear that she will be only getting dialysis 2x's week. but seems to me that they are doing more hours. She is supposed to do only 3hrs per day, today she did 4 hrs. I went to pick her up and she could hardly walk, she has to strain just to walk, she was confused, had a headache, also she told that her heart hurt. My Dear adviser, I do not know what to do....., and I refuse to see my mother in these conditions. I am trying to help her and do not want ANYBODY to take advantage of our us and jeopardize her health. I thought that this so called "dialysis will help her. <
><
>When I request her lab work, the nurse told me that they do it once a month, that I will have to wait until June. She gave me her "Treatment Long" instead in this report all I can understand is that she was unable to stand for BP. In the treatment orders I see<
>Dry Weight 58.5<
>Blood (ml/min) 300 <
>Dialysate (ml/min) 800<
>Time (min) 210<
>Heparin Type PORK<
>Heparin Load (u) 1000<
>Heparin Rate (u) 0<
>Bath k 3.0 Ca 2.5<
>Dex 200 Buff BIC<
>SVS Base 13.5<
><
>they gave her 4000 units of Epogen.<
>her last test result show <
><
>potassium 4.2<
>co2 24<
>bun 69<
>creatinine 2.7<
>calcium ..abnormal 8.9<
>calcium, corrected (alb) (3.5) 9.4<
>calcium,ionized (calc) 4.5<
>phosphorus 4.4.<
>calcium/phosphorus product 39<
>total protein 6.7<
>albumin abnormal 3.4<
>alkaline phosphatase 171<
>sgpt 14<
>sgot 15<
>ldh 276<
>glucose abnormal 244<
>pre-bun - day 1 68<
>pre creatinine- day 1 abnormal 2.7<
>post bun - day 1 15<
>post creatinine- day 1 abnormal 0.9<
>urea reduction ratio 0.78<
>creatinine reduction ratio 0.67<
>kt/v abnormal 1.92<
><
>Can somebody help me to interpret these test results in lamens terms, do you have any suggestions on how I can make my mother feel better after dialysis. <
><
>Thank you very much. Isabel<
><
><
>
****************************************************************************
patient
Joined: 29 Oct 2002
Posts: 137
Posted: Tue May 20, 2003 1:47 pm Post subject: your mom
--------------------------------------------------------------------------------
Hi Isabel,<
>Forgive me as I don't have time to read your Mom's case from the beginning. How old is your Mom. How many dialysis txs has she had so far? Does she have any other conditions? <
><
>I was very emotionally and physically wrung out my first weeks of dialysis as virutally nothing was explained to me and I had to search everywhere for info. on what was happenening to me. I would be very tired after tx, but not so bad that I could not stand up. <
><
>The first txs were horrible as they were trying to find my dw and again explained little to me about what was going on. I was painfully cramped and scared out of my wits. <
><
>I've heard many nurses etc say that thats what they have to do find the patient's dry weight. But I think its horrific and feel they should of educated me on what was going on and I don't believe its necessary to cramp a patient to establish their dry weight. To cramp a patient with no forewarning or explanation of how to protect himself is barbaric, but with many units its standard practice. <
><
>I witnessed many elderly patients in great pain and confusion unable to stand up after tx. I hope this is not what your Mom is experiencing and that she has good care. I am glad you are watching out for her and questioning everything. That's exactly what you have to do. <
><
>Is she in a hospital acute unit or in-center? Are you allowed to watch what is going on and ask questions of the staff or doctor? <
>
****************************************************************************
Be advised
Joined: 18 May 2003
Posts: 2
Posted: Tue May 20, 2003 1:51 pm Post subject: Isabel
--------------------------------------------------------------------------------
Once again, go to the education section and look up the ESRD lab site given there. The education site also has some of the labs values and a simple explaination. This will help you understand some of the lab values. Actually the lab values for your mother are not too bad. In fact they are what I would expect to see for someone starting on dialysis.<
><
>It is very normal for your mother to feel bad after dialysis, esp. since she is just starting on it. It may be that you will need to talk to her Dr about doing it 3 times a week for 3 hours as that may be a bit easier on her body. Think of it this way, Your kidneys work for you 24 hours a day, 7 days a week. Your mother is getting the equivilant of having her kidneys work only 8 hours a week if she runs 4 hours, twice a week. Does this make sense to you? <
> Everything your mother eats and drinks has no where to go but
to stay in her body. She can not pee or it is very little. So the first place that fluid is going to go is her heart. Her heart is going to have to work harder to push that fluid around. It will then back up into her lungs, then you will see it as edema in her tissues. <
> Your mother puts on all this fluid over a 2-3 day period. Her body adjusts to this, but when she goes to dialysis, the machine is programed to take off all that fluid in just 4 short hours. It puts your body into a kind of shock. And it is esp. hard on older patients.<
>In order for your mother to not feel so wiped out, she will need to limit her fluid intake to only 2-3 liters between dialysis runs. You will also need to be educated by the dieticain to help make the right food choices to help limit her intake of sodium and potassium. Take it all one day at a time and you will be fine. <
>Also be very aware that your mother may never get off dialysis. It is very rare and it is usually based on what was the original cause in the first place. So do not be disapointed.<
> The best thing your mother can do after dialysis is to go home and rest. Also talk to her Dr and ask if there is anything else that can help her tolerate it better. Occasionally headaches can be helped by a dose of IV Mannitol, but it needs a Dr. order. <
>Could you do home hemo? What about Peritoneal dialysis, would your mother be a canidate for either?
****************************************************************************
Type in
Joined: 20 May 2003
Posts: 1
Posted: Tue May 20, 2003 2:02 pm Post subject: ESRD lab values
--------------------------------------------------------------------------------
Go to Yahoo and type in ESRD lab values and scroll down to the bottom of the page. I think it is the last one on there, lab values, it gives a quick overview of the labs. <
>The goal is to try to keep the lab values as close to normal as possible. It will not be perfect, but as close as possible.
****************************************************************************
aprnjam
Joined: 28 Apr 2003
Posts: 85
Posted: Mon May 26, 2003 2:52 am Post subject: Re: ESRD lab values
--------------------------------------------------------------------------------
Can also be found on the Education Portion of DEO's website. Founding FRN has done a great job of providing a lot of information there and that information may be able to help you.<
><
>First of all, I want to commend you for caring so much for your mother and being so concerned about her care. I found that so infrequently in my practice. So many people abandon their elders in long-term care facilities and forget that they are there. The elder sits and waits for their loved ones to come visit and they never do. It always
oke my heart to hear them make excuses for them that they worked a lot of hours, that they were too busy to come visit them, the grandkids took up too much of their time, and the list goes on and on. It reminded me so much of the excuses my own mother made for my oldest
other who only lived two hours away from us (she lived with me until she passed from giant cell lymphoma). She could never understand why I was angry with him. So, what it boils down to is that your mother raised one great daughter who truly loves and cares about her mother! Hats off to you and a big HUG to you!!!<
><
>In my first post to you, I suggested that you have a care conference with all of your mother's physicians, and Founding RN also agreed with that suggestion. Have you gotten that arranged yet? I have re-read all you postings and have not been able to find out if you have been able to schedule the care conference with your mother's doctors. This is a very important piece of your mother's care. YOU are your mother's advocate and while we are here to help you and provide support to you, you have to make the appointments with them and demand a care conference. In this care conference, many of your questions can be answered. The Social Worker can arrange for this meeting. At the very least, you need the nephrologist and the cardiologist present. Care conferences are not unusual things, these are done routinely in different areas. Founding RN, correct me I'm wrong, but this can also be arranged in the dialysis setting as well. Keep asking the Social Worker when the meeting has been scheduled (about once a week). Since they are so touchy, always be polite, and just let her know that you have questions because you don't understand everything about dialysis yet. Get the book that was recommended and that will also help. Check out our Education Section of the DEO Website, that will also provide you with a lot of information. In some cases you have to educate yourself.<
><
>Please remember that we don't know your mother's whole case, her past medical history, her medications, her allergies, etc, which makes it very difficult to answer many of your questions, which is why the care conference is so important to you mother's care and you understanding the dialysis process. You may even want to consider a second opinion. It's never, ever too late for a second opinion. See my story in Patient Stories. It saved me from dialysis!<
><
>Joyce
****************************************************************************
