Sick of it
Joined: 11 Feb 2003
Posts: 46
Posted: Tue Feb 18, 2003 9:50 am Post subject: A guide for understanding ESRD BLOOD LAB VALUES
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Click here: A Guide for Understanding ESRD Blood Lab Values <
>www.azstarnet.com/~bsmith/tools/labvalus.htm<
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>THIS IS A GREAT WEB SITE TO HELP YOU UNDERSTAND WHAT IS GOING ON IN YOUR BODY.<
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>TAKE HEALTH AND TAKE CHARGE<
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>HERE IS TO LIVING WELL ON HEMO
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Lin
Joined: 28 Oct 2002
Posts: 337
Posted: Wed Feb 19, 2003 3:30 am Post subject: Thanks!
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Have used this site for quite a while now and find it to be invaluable! When I get printouts of my labs at the unit they give values in the norm., but not what they would be for renal pts.. I would like to see this change! Lin.
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DJ
Joined: 31 Jan 2003
Posts: 19
Posted: Thu Feb 20, 2003 6:45 am Post subject: Lab Reports
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Lin, <
>The reports that I give out each month have normal values for dialysis patients. I can't see comparing an ESRD pt. to someone who doesn't have kidney failure-it's like comparing apples to oranges.
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Lin
Joined: 28 Oct 2002
Posts: 337
Posted: Fri Feb 21, 2003 5:54 am Post subject: So True!
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The unit I go to uses a lab that gives "normal" results too, but most of the pts. don't even ask to see their labs. I'm sure the ones who do are confused but don't want to ask. We only get a printout if we beg for one, otherwise all we get is the dietary related lab values; the dietician comes around with those, and if you do good you get stickers lol<
>When I started getting printouts I noticed a few errors, one of which was that my iron was way too high. When I questioned it at first was told dialysis pts. need it to be higher, but then a call to my neph. proved otherwise and the Ferrlicit has been witheld; it was way too high considering I only get 1000 units of epo a week! Staff gives standard answers much of the time, and doesn't consider that each pt. is an individual. Until that happens I'm keeping my eyes on my labs. Lin.
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Nora
Joined: 21 Feb 2003
Posts: 1
Posted: Fri Feb 21, 2003 7:46 am Post subject: Labs
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Labs are somethng I don't have enough knowledge on yet but am working on it. Your post made me think that if they wanted to make $$ off of patients they could easily give too much of various meds. I've read your posts where you say you go to your doctor when your care by the staff is wrong and he gets things straightened out. But how do you know that he doens't know things are not done right and is just playing you?
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Lin
Joined: 28 Oct 2002
Posts: 337
Posted: Fri Feb 21, 2003 12:00 pm Post subject: Not sure!
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I doubt it; I don't see what there would be in it for him! The unit is owned by a large company not located in the state I live in. The doctor is not part of that co. and is not involved (except for having some pts. there) in the operation of the unit.<
>The only way one can be sure they're not being given too many meds. or too much of a particular med.. is to keep an eye on their labs. Also, the insurance co. and Medicare have guidlines. Nothing is perfect however, but pt. education is key in discovering flaws. Lin.
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DJ
Joined: 31 Jan 2003
Posts: 19
Posted: Sat Feb 22, 2003 8:53 am Post subject: lab values
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Lin, You're right on target about being educated, and looking at your labs values (all of them!). I have to admit, I only go over the nutrition related labs, plus Hemoglobin & %URR. I will print out the full lab report upon request. SOme units will have the nurses give out the full lab report, and I do prefer this, so that more than one person is going over labs, but this is not at the majority of the units I'm at.<
>I guess I have to admit, I am a stickeroholic, although everyone gets one!
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Cautious
Joined: 22 Feb 2003
Posts: 2
Posted: Sat Feb 22, 2003 11:24 am Post subject: Labwork
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Yes, keep a watchful eye on your labs and compare when you may have to go to hospital for any reason and they perform a test that you just had done a couple of days ago. These large dialysis corporation own their own labs and are billed under a different name. One of them was just recently investigated by government.
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Sick of it
Joined: 11 Feb 2003
Posts: 46
Posted: Sun Feb 23, 2003 6:04 pm Post subject: Medications
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Always get and Keep your monthly labs it is your right to have copies of these. I would further suggest you keep them in a three ring binder along with your dialysis journal. I continue to do this and have found it extremely helpful with other doctors and emergency rooms to give fast and much more accurate diagnoses. <
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>A lot of clinics do not want to provide these to patients and the dietitian
ings you some "comic book juvenile" looking page with pictures of bones, Milk and vegetables with meat, with only some of your values on it. This drove me crazy. Don't just except this get the true report. I had to beg for these at one clinic and when the doctor came around finally. I said in a very sweet voice that I felt like I need to go to an out side clinic to get my blood test just so I could have copies of the test. It was amazing how every month the comic book came attached with the true blood test!<
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>Additionally, when you have an infection and they take a blood test for it ask to see the sensitivity report for it. I had an exit site in INFECTION on a Tessio catheter. The head Nurse I called her Ms Fortaze (xsp) she always put every body on this (FORTAZE) IV antibiotic (MONEY),it did not cure the infection she wanted to put me on another round. Dr. DUMB A-- went along with it so I requested the sensitivity report which was withheld for a few hours and finally given. On this report it showed that a cheap oral antibiotic Ampacillin was the number one drug that the bug (bacteria) was most sensitive to. I felt better in a few hours. It cured the infection. No where on the list was (FORTAZE). I found out later that it was a fourth generation drug of the last one on the sensitive list :::the weakest. This is another way of checking to see the effectiveness of the drugs they are picking for you. Also go to the web site of the drugs you are on. Find it either by name of drug or Manufactures name. At the Manufactures web site you can find dosing amounts side effects and drug conflicts. If it is a prescription ask your Pharmacist if there is another similar drug on the market with less side effects, less expensive, easier to digest et.<
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>STAY INFORMED AND STAY HEALTHY.
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Lin
Joined: 28 Oct 2002
Posts: 337
Posted: Mon Feb 24, 2003 2:36 am Post subject: Yes, you're right!
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I had a bad tx. one night,shaking violently, with a fever. First staff insisted I was "coming down with something" and then they insisted
I had bacterial blood infection, so called neph. and gave me iv antibiotic. It turned out what I had (two other pts. did too) was a pyrogenic reaction for which the antibiotic did nothing but net the company extra money. Lin.
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Observer
Joined: 24 Feb 2003
Posts: 7
Posted: Mon Feb 24, 2003 7:15 am Post subject: Pyrogenic Reaction?
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A woman across from me had what looked like a pyrogenic reaction. She was shaking like a leaf. I wish you could see the staff in my unit. When a patient gets sick they come and take their temp and then they just stand there and gawk at the person. They don't have a clue in the world whats wrong with them and just stand there and gawk away. Gives a patient a real secure feeling..
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Sick of it
Joined: 11 Feb 2003
Posts: 46
Posted: Mon Feb 24, 2003 9:38 am Post subject: Patients in trouble
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If a patient next to you is shaking like a leaf you should ask in a sweat voice all innocent (like you are an air head). HAS THE DOCTOR BEEN CALLED?<
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>THIS IS A STRONG REACTION TO SOMETHING - A PYROGEN REACTION, BACTERIAL INFECTION ALSO COULD BE A REACTION TO THE TYPE OF DIALYZER BEING USE.<
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>DOCTOR SHOULD BE NOTIFIED IMMEDIATELY.
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FRN
Joined: 24 Feb 2003
Posts: 25
Posted: Mon Feb 24, 2003 10:45 am Post subject: Shake & Bake
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Anytime a patient does a "Shake & Bake" on the run, not only should the Dr. be called, but blood cultures drawn and sent. Tylenol can be given for the symptoms and most Drs. will order a gram of Vanco to be given as a wide spectrim antibiotic to cover until the blood culture results are in, usually 24-48 hours after being drawn. Then a specific antibiotic for that bacteria can be ordered.<
>Anytime this happens, the dializer should be thrown out and the patient given a new one.<
>We are seeing far fewer reactions to dializers than before as most of the newer ones coming out are more biocompatible. The most common reason for a "Shake & Bake" is an infection, usually access related.
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Lin
Joined: 28 Oct 2002
Posts: 337
Posted: Mon Feb 24, 2003 11:17 am Post subject: Shake and bake
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Love that! My cultures came back negative, as did the two other pts. on either side of me. Staff was pretty tight lipped, but my neph. told me they cultured everything in the unit and there was a "water/water tx. problem" that led to us having a pyrogenic reaction. The unit isn't open on Sundays so they
ought in the professionals and replaced equipment. At the same time my neph. ordered that I no longer be on reuse, but now the whole unit is on non reuse.Lin.
