Hemo dialysis.

Matt, thanks for sharing your experiences! I'm still in a holding pattern having regained some renal function. BUT I know dialysis is still on the horizon so it helps a lot to here personal experiences for those who have gone before me, so yo speak.

Im down for hemo having had the fistula put in. What do you mean by litres taken off?

I heard the needles are huge and painful. Is that right?

I always wondered about healing from the needles only to get another lot two days later. Does it bleed much after the needle comes out?

Sorry bout so many uncertainties.

At the moment you are probably passing urine, so they will only really “clean” your blood and take a minimal amount of fluid off you. If your condition deteriorates, you may produce les and less urine. This means that when you drink you are not peeing it out so basically you will gain weight. I’ll be honest, quite frequently when on dialysis, the kidneys get used to the machine doing everything so urine output decreases. I ended up producing zero urine, so the machine does 2 things......cleans the bad stuff out your blood and secondly removes the excess fluid that isn’t passed  because of the lack of urine. Basically, 1kg of weight = 1 litre of fluid. Say my dry weight (the proper body weight I should be without excess fluid) is 65kg and I drink 3 litres, my weight would go up to 68 because I’m not peeing. That means at the dialysis session they would remove 3 litres to get me back to my dry weight. This is why you may eventually find yourself with a fluid restriction, otherwise if you drink too much between sessions and don’t pass it, you would just get heavier and heavier due to fluid retention.

The needles are bigger than injection needles and I won’t lie, it can smart a bit but once they are in it doesn’t hurt. What you might want to do is use a numbing cream. There is a good cream called EMLA CREAM 5%. You spread it thickly across the area 1hr prior to dialysis, and wrap the arm /area under cling film. This ensures the numbing agent sinks into the skin. This cream helps a lot.

When they take the needles out, they will generally cover the entry point with gauze / cotton ball / surgical dressing, push down with a finger and pull the needle out to stop blood from spraying out. Seeing as the needles are quite thick, it takes some time to stop bleeding. You will generally wait on the bed / in the chair holding the 2 pads down for about 20 minutes to let the bleeding stop / wound close up. Then the nurse will come back and put tape on the dressing to free up your holding arm so you can get up and move around / go home!! Personally, I used something called “fistula stop” which are 2 tourniquets with a plastic button in the middle. You (the nurse) place the button over the wound and then tighten the tourniquet so you don’t have to hold the wound for 20 mins with your other arm. It’s just convenient.....it still has to stay on for the 20 mins while the wound dries up.

Lastly, recovery of the wound between sessions. What the nurses do is a technique called “the rope ladder technique”. This is where they don’t use the same spot every time. There are 2 needles, say an inch apart. They will use these 2 spots on day 1. The next session, they will look where the wounds are, then move a couple of millimetres up from each wound, then the next session a further 2mm up etc. etc. etc. Once they reach the top of the “useable area” then they’ll start at the bottom all over again by which time the bottom would have healed really well and be ready for needling again.

Where about are you based BTW? Are you in the US or U.K.? The names of the cream and tourniquets may be different if you’re in the US. I used the U.K. names as that’s where I am (well, was as I’ve had a kidney transplant 2 weeks ago so I’m off dialysis now!).

Sorry to be brutally honest but it’s best to go in prepared rather than the shock I had on day 1. Nobody even explained the waiting to stop bleeding to me and I just stood up and bled all over the place!!

Just try to make sure you get EMLA cream. You won’t know where they will needle until after the first session, so make sure you have it for session 2 onwards and ask them to indicate where they may needle on session 2.

Anything else just shout. Good luck my friend.

John

I'm so happy to hear you got a transplant. I hope all goes well for you. It must be far better than dialysis. What is the gfr with the new kidney?

My gfr was 60 on monday.

You made me feel so happy with this reading. Wow