Dialysis 2 Eclectic Boogaloo

Filed under: @ 12:23 pm

Having decided on peritoneal dialysis, but not, as yet, ready to begin dialysis, Andrew had to start learning about the process regardless.
Andrew’s primary nephrologist referred him to (another shout out) the Northwest Kidney Center for dialysis training and management. I am not sure whether Northwest Kidney is actually associated with a particular health care organization or if they are an independent entity taking any patient to whom they are referred by any nephrologist. I do know that Northwest Kidney runs a large number of dialysis centers around the area, but they’re not the only organization that does. Doesn’t matter. Northwest Kidney is a class organization, they employ bright, kind, dedicated people and are also on the list of people to whom we are eternally grateful. Andrew’s primary dialysis person was a lovely lady named Mae.
It was Mae’s job to stuff all the hundred thousand fiddly details of how to manage PD into Andrew’s head. Andrew went to a number of solo training sessions and Mae came for at least one home visit.
The home visit was to evaluate the patient’s physical environment to decide whether or not PD was a reasonable option. Mae had to evaluate whether we had, or could create, everything from safe storage for all the PD supplies, to an appropriate indoor area for Andrew to store his in-use supplies (amount of storage and cleanliness being two of the most important criteria), to an appropriate area for Andrew to actually perform the dialysis.
A PD patient has to have an area where he can be surgically clean (there’s a difference between “surgically clean” and “sterile”, but I’m not going to go into that right now) with easy access to hand washing and disposal facilities (a sink and a toilet), electricity, and all of the supplies that are necessary for a transfer of dialysis fluid. It’s a surprisingly large amount of space. Also, since the area needs to be able to be closed off from random visitors who might be in and out during the transfer process, the area has to have a door.
Our house was built in 1968. It has 1968 ideas of how much space a bedroom needs and how many electrical outlets are necessary. And even though the 1968 idea of how much garage space is necessary is perfectly fine for two cars and other garage *stuff*, adding a month’s worth of peritoneal dialysis supplies to that garage strains the space a little bit.
We reorganized the garage and put in a new shelving unit. The shelving unit is only rated to support something like 800 pounds and since a month’s worth of PD supplies weighs more than that I’m surprised, and infinitely grateful, that the engineering of the shelving unit meant that 800 pounds was a conservative recommendation.
We reorganized the bedroom and in a massive burst of blowing through Target gift cards that I’d been given, we purchased a LOT of storage totes and a LOT of vacuum storage bags. While I took a huge load of stuff to Goodwill and vacuum packed more stuff so we had more shelf and drawer space, Andrew put in another new shelving unit and tweaked the electrical supply so he had a convenient, constant, surge protected electrical supply within close reach of his side of the bed. As an added little nod to the gods of cleanliness Andrew also installed an umpty-something micron HEPA air filtering fan so that when he did his PD stuff he could stand in front of it and have it blowing incredibly clean air over him. The benefits of working for a company that needs to work with sterile environments and filtered air sometimes make themselves known in really odd ways.
Mae was thoroughly pleased to note that while our cats do sleep in our bedroom during the day they don’t sleep with us at night. We learned a long time ago that cats actually *don’t* sleep most of the night whereas, as people, we tend to like to. Also when cats *do* sleep with people they don’t sleep with people, they sleep with person. Most specifically, they sleep with the person in the bed who is least likely to disturb them while they sleep. Since Andrew sleeps in more than three dimensions this means that if we attempt to sleep with cats it means that *I* sleep with cats and since I like to breathe air when I sleep instead of breathing cat butt all night our cats have pretty much always had separate sleeping rooms than the people.

Andrew’s primary nephrologist told him that it was probably better to start dialysis while he still had some native renal function left. So, having had his previously placed peritoneal dialysis catheter excavated, Andrew started learning about how to dialyze himself.
If you opt for peritoneal dialysis you will first be trained on manual transfers. Which is to say, you hook yourself up to a bag of dialysis fluid, let it drain into your peritoneum, then unhook yourself and wander around with 2 liters of dialysate for a couple of hours. Then you drain yourself out and refill with fresh. Make no mistake. This. Is. Time. Consuming. 30-45 minutes every 2-4 hours depending. Andrew would not have been able to do this if he hadn’t been working from home. And the trash! Godalmighty the trash!
It wasn’t long, though, before Andrew had demonstrated sufficient improvement and expertise with the manual process that they switched him to a dialysis cycler. The cycler, a critter about the same size as an average laser printer only a LOT more annoying, automatically pumps and drains 6-12 liters of dialysate through your peritoneal cavity over a preprogrammed series of hours. Since you’re tethered to the cycler by a 30 foot fluid line most people opt to do cycler-based peritoneal dialysis overnight.
So Andrew started tying himself to an annoying machine that bitched about what position he was lying in and occasionally tried, in essence, to suction his caudal abdominal viscera out through a straw every night. And we learned to subconsciously respond to a variety of really peculiar noises throughout the night.

One Response to “Dialysis 2 Eclectic Boogaloo”

  1. Sara Says:

    Is this PD stuff what Andrew was doing before? Oy.

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