Anatomy of a Dialysis Clinic: The Patient

I thought I would describe to you all what the routine of a dialysis patient is while in the clinic (from the POV of me, La Kim.)

Let’s say your name is um, Deborah Peel, and you are a regular here at BDC.  You come in 20 minutes before your scheduled on-time which is say 615 a.m.  So it’s about 5:55 am. on your regularly scheduled dialysis day and you step through the clinics doors and you can hear music beating through the thin wall that is between you and the clinic floor. 

You are now in our waiting room, please have a seat.  A few moments pass and that lovely tech opens the door which is locked due to HIPPA. 

 

 

 

You enter to this  and the lovely tech tells you you’re in chair number 2.  Which just happens to be by the door and you’re favorite chair, your TV actually works on that station unlike the one on station number 6, which rarely works.  You know this because the staff occasionaly moves you around, especially when a few patients are gone or in the hospital, but you definately don’t like station number 6. 

You find your chair and start laying out all your stuff, which includes but not limited too:

-earphones, ipod or discman (depending on your age), three books or magazines, two blankets the tech’s gave you from a drug rep, a neck pillow and a snack and perhaps a bottle of water or two.

The lovely tech approaches and asks how you are while documenting that you are walking, talking and looking rather puffy.  Chest pain? Shortness of breath?  Have you been in the hospital?  How are you feeling?  You answer accordingly and then the tech asks, “have you got your weight yet?”

You reply in the negative and swagger over towards the scale.

 

You stand on it while a line forms behind you of newly arrived patients..you weight 89.9 kilos, you sigh heavily and mutter something about it being a good weekend.  Your estimated dry weight is 85.0 kilos, yes,indeed a big gain.

The tech looks at you expectantly and you mutter 89.9 killos.  Lovely tech smiles and says “big gain today, Deborah, you think you can pull five kilos?”

You reply yes and sit. 

This is what five kilos looks like:

 

 Yes, you’re holding that all in your body.  And to maintain your health we have to try to get as much of it off as possible, if we don’t, several things may happen.  Shortness of breath?  Chest Pain? Hospital. 

You and only you are in complete control of how much you drink.  Remember that, it’s all you, baby, all you.

 

You get your blood pressure taken standing up and sitting down.  Tech notes it a little high and that you probably have the fluid on.  You nod and put on your headphones right after your temp is taken.  Lovely tech shows you your dialyzer because they do reuse here, you see your name and then they show you a strip that is white, it means the sterilent the tech’s put in it to clean out the blood as been cleaned out.  You are all set to go.

Your arm is prepped with either betadine or Chlorehexidine.  The tech applies the antiseptic in a circular motion going from inside to the outside.  It cools your skin and you can feel a slight breeze as the air conditioner kicks in, you wish you packed another blanket but oh, JAG is on!

About a week ago you stopped using lidocain for the needle sticks because lovely tech told you it was much better for your fistula if you didn’t use it, plus it really doesn’t hurt that bad.  Well maybe a little, but JAG is on and you’ll get over it.

The tech gently but firmly inserts 15 gauge needles into your access arm, you feel it and take a deep breath, the tech reminds you to breathe.  The second needle goes in and you barely feel it.  Lovely tech hooks you up to the machine and dials in all the appropriate numbers.  You run three hours, taking off five kilos, which will put you at just above your dry weight, perhaps half a kilo.

Lovely tech wraps you in one of your blankets making you warm and cozy for your three hour snooze….

Which ironically has the name of Lovely tech but no one is really sure why…heee.

You fall asleep roughly ten minutes before JAG ends right as most of the patients are on.

 You don’t know it but every half hour lovely tech strolls by and charts blood pressure, venous and arterial pressures and how much fluid they have taken off so far.  She also notes your resperations are normal and you’re resting peacefully.

You wake up to an annoying beeping sound, Lovely tech is back over and you feel your BP cuff inflate, you look up at her and she says “your pressure dropped a bit, just rechecking it.” 

You feel fine and you tell the tech to keep going with the treatment.  You have ten minutes left so the tech agrees but gives you the warning that if anything changes to call her over immediately.

Beep….beep…beep.

Your done!

The tech disconnects you and takes out the needles and places one clamp on the venous side of the fistula while you hold (with a gloved) hand the arterial.  You used to clamp both arterial and venous until you were told it really isn’t healthy for the fistula. 

It takes you ten minutes to get out of the chair and by now it is almost 930.  Your sitting blood pressure is good, not too low and not too high.  Standing is a little low, you feel slightly dizzy but it goes away the longer you stand.  You walk back over the scale and weigh in.

85.8, not too bad, but over your dry weight.  You tell the tech and she says goodbye as she wraps up your stuff and puts it in your bag.  You say goodbye and practically run down the little old lady who is coming in to go home.  Breakfast and a nap are in order.

Good bye Ms. Peel, be careful with your fluid and have a nice day.

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~ by Kim on May 21, 2008.

2 Responses to “Anatomy of a Dialysis Clinic: The Patient”

  1. Wow! I feel so bad for all the patients who have to go through this. I hope my kidneys never fail!

  2. You wrote this very well. How often do the patients visit?

    I’m with Scott on this. I hate needles, blood, veins and such. I would be a nightmare of a patient. I doubt that I could sleep. How can they sleep through that? I’d be watching the clock saying, “When can you take this thing out of my arm”. lol. The whole thing makes me squeamish. Plus, I have been known to pass out when a vile of blood is taken. One time I made it to the elevator and blacked out, cold. The hospital insisted I be seen in E.R. UG! I was fine.

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