Tag: fresenius (Page 3 of 47)

This past Monday and Tuesday, the Fresenius Complaint people contacted me regarding my letter to their CEO, Helen Giza. Their interest was strictly limited to ascertaining the nature and extent of my complaint(s). This arm of Fresenius has nothing to do with the resolution of any shortfalls but only acts as a fact-gathering, independent agency within Fresenius.

During Monday’s call, the  complaint-gathering person made a statement that is really bothersome to me as a patient. She stated that Fresenius bears no responsibility for the cassette fiasco in that it was perpetuated by a vendor and they had nothing to do with it. I cannot explain all the ways this does meet any smell test. The CEO of Fresenius is a bean counter – background in accounting and finance – it is a given that the C-Suite is under the gun to keep costs down. Given price pressures on vendors, their response, much like we see at the grocery store and reduced amount of product in a package at the old price, is to cut corners to maintain their margins. How this took place without recognition by Fresenius continues to be a mystery.

In that Fresenius is still in the “fact-gathering phase” of resolution, I don’t see any merit to rumors on such places as PatientHub that Fresenius will be going back to the former cassettes in the short term. Perhaps this is based on wishful thinking.

In today’s blog, I am straying from peritoneal dialysis to present readers with a source of predictive data about future events, such as the US presidential election. First, I will present what Perplexity has to say about Polymarket.com, then show you some screenshots about the coming presidential election. This is not a political statement but is meant to provide readers with the latest tools to spread knowledge.

Polymarket.com has emerged as a prominent player in the world of prediction markets, offering users a unique platform to trade on the outcomes of real-world events. Founded in 2020 by Shayne Coplan, Polymarket has quickly gained traction as a decentralized information market that leverages blockchain technology and the wisdom of crowds to forecast future events57.

How Polymarket Works

Polymarket allows users to buy and sell shares based on the likelihood of specific outcomes occurring. The platform covers a wide range of topics, including politics, sports, pop culture, and science5. For example, in the current 2024 U.S. Presidential Election market, users can trade on the likelihood of various outcomes, with prices reflecting the perceived probabilities1. The platform operates on the Polygon blockchain, ensuring transparency and security in transactions4. Users can deposit USDC cryptocurrency to participate in the markets, with share prices ranging from $0 to $1, representing the probability of an event occurring.

Accuracy and Performance

Polymarket has gained a reputation for accuracy in predicting outcomes, often outperforming traditional polls and surveys. This accuracy is attributed to the “wisdom of crowds” principle, where collective intelligence tends to produce more accurate forecasts than individual experts7. Notable figures have praised Polymarket’s predictive power:

1. Elon Musk, the billionaire entrepreneur, recently stated that Polymarket is “more accurate than polls, as actual money is on the line”8.
2. Thomas Miller, a data science professor at Northwestern University, asserted that “Political betting websites excel in reflecting the collective intelligence of the public”3.

The platform’s accuracy has been particularly notable during significant events like the 2020 U.S. Presidential Election, attracting considerable attention and trading volume5.

Growth and Funding

Despite facing regulatory challenges, including a $1.4 million fine from the Commodity Futures Trading Commission in 2022, Polymarket has continued to grow and attract investment25. In 2024, the company raised $45 million in a Series B funding round led by Peter Thiel’s Founders Fund, with participation from Ethereum co-founder Vitalik Buterin5.

Current Status and Future Outlook

As of October 2024, Polymarket has become a significant player in election forecasting. The platform has seen over $1.9 billion wagered on the 2024 U.S. Presidential race alone4. To enhance its credibility and expertise, Polymarket has brought on board notable figures such as Nate Silver, founder of FiveThirtyEight, as an advisor4. While Polymarket continues to operate its election prediction markets offshore due to regulatory constraints, it has shown resilience and adaptability in the face of challenges. The platform’s growing popularity and perceived accuracy suggest that it may play an increasingly important role in shaping public understanding of event probabilities and outcomes in the future. As prediction markets like Polymarket continue to evolve, they offer a compelling alternative to traditional polling methods, providing real-time insights into public sentiment and event probabilities across a wide range of topics9.

I wrote today’s blog as much for me as readers of the blog. While I have never had Peritonitis, I know research has shown it to be the number one most serious problem PD patients face. Below is a summary of my research taken from Google’s NotebookLM and accompanied by a Podcast of the findings. Below that is the original seed I obtained from the DoctorSage Bot in Poe that I fed into NotebookLM.

Summary

This Podcast explains the serious health complication of peritonitis, which is an inflammation of the peritoneum lining the abdominal cavity. It focuses on the specific dangers of peritonitis for patients undergoing peritoneal dialysis, as it can significantly impact the effectiveness of their treatment. The Podcast then delves into the causes, symptoms, diagnosis, treatment, and prevention of peritonitis in peritoneal dialysis patients, highlighting the importance of proper hygiene, technique, and regular medical check-ups to minimize the risk of developing this complication.

Peritonitis is an inflammation of the peritoneum, the abdominal cavity’s membrane. For patients undergoing peritoneal dialysis (PD) , peritonitis is a significant concern, as it can lead to severe complications and impact the effectiveness of the dialysis treatment. This blog post aims to provide a comprehensive overview of peritonitis, including its definition, causes, symptoms, diagnosis, treatment, and preventive measures specifically for PD patients.

What is Peritonitis?
Peritonitis is an inflammatory response of the peritoneum, which can occur due to infection or other irritants. In the context of peritoneal dialysis, peritonitis often arises from bacterial infection introduced into the peritoneal cavity through the catheter used for dialysis.

Causes of Peritonitis in PD Patients
Bacterial Infection: The most common cause of peritonitis in PD patients is the introduction of bacteria during the exchange process. Common pathogens include:
Staphylococcus aureus
Streptococcus species
Escherichia coli
Pseudomonas aeruginosa
Non-infectious Causes: While less common, peritonitis can also result from:
Chemical irritation from dialysis solutions.
Presence of foreign bodies or materials in the peritoneal cavity.
Pancreatitis or other inflammatory conditions affecting the abdomen.
Symptoms of Peritonitis
Patients should be vigilant for the following signs and symptoms, which may indicate the onset of peritonitis:

Abdominal pain: Often diffuse and can be severe.
Fever: Elevated body temperature (typically above 38°C or 100.4°F).
Nausea and vomiting: May accompany abdominal discomfort.
Changes in dialysis effluent: Such as cloudiness or the presence of an unusual odor.
Decreased appetite: Often a result of discomfort.
Diarrhea: Sometimes present, although not universally.
How to Ascertain if You Have Peritonitis
Diagnosis of peritonitis typically involves:

Clinical Assessment: A thorough history and physical examination by a healthcare professional.
Dialysate Analysis: Examination of the peritoneal dialysis effluent for:
Cell count: An elevated white blood cell (WBC) count, especially with a predominance of neutrophils (>100 cells/mm³), suggests infection.
Gram stain and culture: To identify the causative organism.
Biochemical analysis: To check for glucose and lactate levels.
Blood Tests: To assess for systemic infection, including:
Complete blood count (CBC)
Blood cultures
Treatment of Peritonitis
The treatment of peritonitis is critical and typically involves:

Antibiotic Therapy: Empirical (initial) antibiotics are started promptly, and adjustments are made based on culture results. Common regimens include:
Intravenous antibiotics for severe cases.
Intraperitoneal antibiotics for mild to moderate cases.
Supportive Care: This may include:
Pain management.
Volume resuscitation if needed.
Nutritional support.
Catheter Management: In some cases, the PD catheter may need to be removed or replaced, especially if the infection is recurrent or severe.
Surgery: Rarely, surgical intervention may be necessary if there are complications such as abscess formation or bowel perforation.
Prevention of Peritonitis
Preventing peritonitis is crucial for PD patients. Key strategies include:

Proper Technique: Adhering to strict aseptic techniques during dialysate exchanges.
Training and Education: Patients should receive comprehensive training on PD techniques and recognize the signs of infection.
Regular Follow-ups: Frequent check-ups with healthcare providers to monitor for potential complications.
Good Hygiene: Maintaining clean hands, catheter site, and surroundings.
Conclusion
Peritonitis remains a significant risk for patients on peritoneal dialysis, but with proper knowledge and preventive measures, the risks can be minimized. Understanding the signs and symptoms and prompt treatment are essential in managing this potential complication. Regular communication with healthcare providers and adherence to recommended practices will enhance the safety and effectiveness of peritoneal dialysis.

Key Takeaways:
Peritonitis is a serious complication of PD, primarily caused by bacterial infections.
Symptoms include abdominal pain, fever, and changes in dialysate appearance.
Diagnosis involves clinical assessment and analysis of dialysate.
Treatment typically includes antibiotics and supportive care.
Prevention focuses on aseptic technique and patient education.
By remaining vigilant and proactive, PD patients can significantly reduce their peritonitis risk and ensure better dialysis treatment outcomes.

A website named www.homedialysis.org has some good info for everyone involved with or concerned about dialysis. One of the bits of information offered is a resource named PATH-D. PATH-D was developed to help patients and caregivers codify who is responsible for what regarding the care and feeding, so to speak, of all the effort that goes into adding up to successful dialysis. The site states “…PATH-D acts as a behavioral contract between the patient and the partner that explicitly defines the tasks at hand and determines what tasks each person is willing to take on.” If you read down the list, you can get a feeling of all that is involved in successful PD if nothing else. A PDF of PATH-D is available below:

As a group, those of us on PD tend to be older. With age comes a need, no, a requirement, to schedule appointments with a wide variety of doctors more frequently. I am entering such a phase.

This week I have an appointment to have an Ecogram done as a preliminary to checking out my heart. I also am scheduled to have the stitches removed from the surgery to remove the basil cell cancer on my left temple. The following week I have an appointment with my audiologist. My left hearing aid stopped working followed the same day by I hope, minor surgery to remove yet another cancer cell under my left chin. This is followed by an appointment to do a chemical stress test to ascertain more about my heart condition and then at month’s end a video conference with my cardiologist to discuss what all of the tests previously conducted portend for me. That is, where do we go from here?

This leads to introspection, and my mantra in writing this blog is Never Ring the Bell, adopted by US Navy SEALs. For them and me, this symbolizes perseverance and resilience. To do otherwise is to take the easy way out for those who wish to quit. Not ringing the bell is crucial for overcoming life’s obstacles and achieving success, while quitting leads to lifelong regret, and in the case of those of us on PD, potentially death.

This dude will never ring the bell. Bring it on! And yes, I made and make our bed every day suggesting there will be a tomorrow.

As a blogger with personal experience with Peritoneal Dialysis (PD), I can confidently say that the word “GRIT” perfectly embodies the spirit and resilience of patients undergoing this treatment. PD is a life-saving procedure that requires dedication, strength, and unwavering determination to face the challenges of managing a chronic illness.

G – for Growth: Patients on Peritoneal Dialysis experience tremendous personal growth throughout their journey. From learning how to perform the dialysis procedure to adapting to lifestyle changes, they constantly push themselves to grow and evolve in the face of adversity. It takes courage to embrace the changes that come with a chronic illness, and PD patients demonstrate remarkable resilience in their ability to adapt and thrive.

R – for Resilience: The resilience of PD patients is truly inspiring. Despite facing physical and emotional challenges on a daily basis, they exhibit an incredible strength that allows them to persevere through difficult times. Whether it’s dealing with treatment side effects, managing dietary restrictions, or coping with the unpredictability of their condition, PD patients show unwavering resilience in the face of adversity.

I – for Independence: One of the most empowering aspects of Peritoneal Dialysis is the level of independence it offers patients. Unlike traditional hemodialysis, which requires regular visits to a dialysis center, PD can be done at home on a flexible schedule. This independence allows patients to take control of their treatment and maintain a sense of autonomy over their lives. It also requires a great deal of self-reliance and responsibility, as patients must diligently follow their treatment plan to ensure their health and well-being.

T – for Tenacity: The tenacity of PD patients is truly remarkable. Despite the challenges they face, they approach each day with a sense of determination and perseverance that is awe-inspiring. Whether it’s dealing with setbacks in their health, navigating the complexities of the healthcare system, or advocating for their own needs, PD patients demonstrate an unwavering resolve to overcome obstacles and continue moving forward.

In conclusion, the concept of “GRIT” perfectly encapsulates the strength, resilience, independence, and tenacity exhibited by patients undergoing Peritoneal Dialysis. These individuals face each day with courage and determination, embodying the true meaning of perseverance in the face of adversity. Their unwavering spirit serves as a source of inspiration for us all, reminding us of the power of resilience amid life’s challenges.

Things are heating up concerning Fresenius shortening the drain and patient lines on the Liberty Cycler cassettes. The following post was made yesterday on PatientHub:

Gwenietay asked a question.

Edited 17h agoActions for this Feed Item

Need my 20 ft tubing

“dear Helen Giza

you and fresenius are killing me literally!!!

i still pee and have bowel movements since I can no longer get the 20 ft tubing. i am forced to sleep on the cold bathroom floor so I can pee and have diarrhea . Hopefully i can reach and sleep sitting up

once my supplies run out I will have to stop dialysis and die. Thank you very much for signing my death sentence Helen Giza

dont waste my time by referring me to my clinic as they have no clue

there is nothing to trouble shoot so Kaelyn not needed to reply

the decision to shorten the tubing on cycler cassettes is in very very poor judgement. Sad and sickened

Helen Giza lives matter!!!!!!!!!!”

On this past Wednesday I called in my monthly supply order to talk to a Fresenius supply rep directly. Before doing so I went to the supply order part of the PatientHub and checked on what supplies were being listed. The Liberty cassette was listed as the former, 10 to a box with long drain and patient lines. When talking to the supply rep in making my order, I quizzed her about this and was told they only ship the new cassettes, 14 to a box with 15-foot lines. When I checked my order yesterday, it was listed as the new cassettes. Obviously, this is confusing.

Rumors are spreading on the PatientHub that in October Fresenius will divert back to the former cassettes. When challenged as to the basis of the rumor, one participant posted the following:

Actually, who knows? This reminds me of the passage in the Bible, Matthew 24:6 where Jesus speaks about conflicts as part of the signs of the end times with the phrase “wars and rumors of wars.” We have a change and rumors of change.”

In celebration of the passing of Kris Kristofferson, my wife and I recently watched a YouTube program about his many accomplishments. One of his early hits was a song made popular by Janis Joplin titled “Me and Bobby McGee.” Her version of this song is linked at the end. In it was a line “Freedom is just another word for nothing left to lose.” I know that this song was written while the influence of the war in Vietnam was prevalent thought, and also that Kristofferson was previously a helo pilot and had completed Ranger training so he was probably directly influenced by his military service in the Army.

This got me to think beyond the obvious; how does this line apply to those of us with peritoneal dialysis? Thus the following:

“Freedom’s Paradox: Finding Liberation in the Constraints of Peritoneal Dialysis”

Introduction
In the tapestry of human experience, certain phrases have the power to resonate deeply, transcending their original context to offer profound insights into the human condition. One such line comes from Kris Kristofferson’s iconic song “Me and Bobby McGee,” popularized by Janis Joplin: “Freedom’s just another word for nothing left to lose.” At first glance, this lyric might seem pessimistic, even fatalistic. However, when applied to the experience of someone living with a chronic illness, such as a person on peritoneal dialysis, it takes on a new and surprisingly uplifting meaning.

This article explores the philosophical implications of this powerful line, examining how it relates to the journey of those undergoing peritoneal dialysis. We’ll delve into the paradoxical nature of freedom when faced with significant health challenges and how constraints can sometimes lead to unexpected forms of liberation.

Understanding Freedom in the Context of Illness
Traditionally, we tend to associate freedom with the absence of constraints – the ability to do what we want, when we want, without hindrance. It’s often linked to physical mobility, financial independence, and the luxury of choice. But what happens when life throws us a curveball in the form of a chronic illness that seems to strip away these conventional freedoms?

For someone on peritoneal dialysis, the very notion of freedom might seem laughable at first. After all, how can one feel free when tethered to a medical regimen that dictates much of daily life? Yet, it’s precisely in this seeming contradiction that we find a deeper, more nuanced understanding of what freedom truly means.

Peritoneal Dialysis: A Life-Changing Experience
What is peritoneal dialysis?
Before we dive deeper into our philosophical exploration, let’s briefly explain peritoneal dialysis. It’s a treatment for kidney failure that uses the lining of your abdomen (peritoneum) and a cleaning solution called dialysate to filter your blood. Unlike traditional hemodialysis, which typically requires frequent visits to a dialysis center, peritoneal dialysis can often be done at home, offering a different kind of freedom within its constraints.

The daily reality of dialysis patients
Living with peritoneal dialysis means adapting to a new routine. There are regular treatments to manage, dietary restrictions to follow, and constant awareness of one’s health status. On the surface, this might seem like a severe limitation of freedom. But could it be that this very limitation opens the door to a different kind of liberation?

Nothing Left to Lose: The Paradox of Illness
The stripping away of normalcy
Chronic illness, including the need for peritoneal dialysis, often strips away what we consider “normal” life. The ability to eat whatever you want, to travel spontaneously, or to go about your day without medical considerations – these seemingly simple freedoms are no longer taken for granted. In a sense, you’ve lost the luxury of ignorance about your body’s fragility.

Finding freedom in limitations
Yet, paradoxically, it’s in this stripping away that many find a new kind of freedom. When you’ve “lost” the ability to live life as you once did, you’re also freed from many societal expectations and self-imposed pressures. The phrase “nothing left to lose” takes on a positive spin – when you’ve already faced one of life’s biggest challenges, many smaller fears and inhibitions lose their power over you.

The Liberation of Acceptance
Embracing the new normal
One of the most profound freedoms that can emerge from the experience of peritoneal dialysis is the liberation that comes with acceptance. When you stop fighting against your reality and start working with it, a weight lifts. You’re free from the constant struggle against what cannot be changed, allowing you to focus your energy on what can be improved or enjoyed within your new parameters.

Discovering inner strength
This acceptance often leads to the discovery of inner resources you might never have known you possessed. The strength required to face daily medical procedures, to advocate for yourself in the healthcare system, and to maintain hope in the face of challenges – these are powerful forms of freedom that many people never have the opportunity to develop.

Redefining Personal Values and Priorities
Shifting perspective on what matters
When faced with a life-altering condition like kidney failure requiring peritoneal dialysis, many people find their values and priorities shifting dramatically. Things that once seemed crucial – career advancement, material possessions, social status – might pale in comparison to the simple joy of a pain-free day or a meaningful conversation with a loved one.

The freedom to choose one’s attitude
Viktor Frankl, the psychiatrist and Holocaust survivor, famously said, “Everything can be taken from a man but one thing: the last of human freedoms – to choose one’s attitude in any given set of circumstances.” This profound truth resonates deeply with many on peritoneal dialysis. While you may not have chosen your medical condition, you have the freedom to choose how you respond to it.

The Unexpected Gifts of Illness
Deeper connections and empathy
Many people on peritoneal dialysis report experiencing deeper, more authentic connections with others. When you’re no longer able to hide behind the facade of perfect health, relationships often become more genuine. There’s also a newfound empathy for others facing challenges, creating a sense of connection to the broader human experience.

Appreciation for the present moment
When the future is uncertain, and the past is a reminder of lost abilities, many find a new freedom in focusing on the present moment. The simple pleasures – a beautiful sunset, a child’s laughter, the taste of a favorite (kidney-friendly) food – take on new significance. This heightened appreciation is a form of freedom that many people in perfect health never experience.

Challenges and Opportunities in Medical Freedom
Navigating healthcare decisions
Peritoneal dialysis presents both challenges and opportunities when it comes to medical freedom. On one hand, you’re constrained by the necessity of treatment. On the other, you often have more control over your treatment schedule and location compared to traditional hemodialysis. This control, while within limits, can be profoundly empowering.

Advocating for oneself and others
Many people on peritoneal dialysis discover a new voice as they learn to advocate for themselves within the healthcare system. This advocacy often extends to others in similar situations, creating a sense of purpose and community. The freedom to speak up, to make informed choices, and to help others is a powerful form of liberation.

Beyond Physical Constraints: Mental and Emotional Freedom
Cultivating mindfulness and resilience
The challenges of peritoneal dialysis often lead individuals to explore practices like mindfulness meditation or resilience training. These practices can offer a form of mental and emotional freedom that transcends physical limitations. The ability to find calm amidst discomfort or to bounce back from setbacks is a profound form of freedom.

Breaking free from societal expectations
When you’re no longer able to meet many of society’s typical benchmarks for success or normalcy, you’re also freed from the pressure to conform to them. Many on peritoneal dialysis find liberation in defining success on their own terms, free from the weight of others’ expectations.

Conclusion
As we’ve explored, the line “Freedom’s just another word for nothing left to lose” takes on a rich and nuanced meaning when applied to the experience of someone on peritoneal dialysis. Far from being a pessimistic statement, it can be seen as a gateway to a deeper understanding of what true freedom means.

The freedom found in the face of severe health challenges isn’t about the absence of constraints. Instead, it’s about finding new ways to express oneself, to connect with others, and to find meaning within the parameters life has set. It’s about the liberation that comes from accepting what cannot be changed and focusing on what can.

For those on peritoneal dialysis, freedom might mean the ability to choose one’s attitude, to find joy in small moments, to advocate for oneself and others, or to break free from societal expectations. It’s a freedom forged in adversity, often more profound and meaningful than the carefree liberty of perfect health.

In the end, the paradox of finding freedom through limitation reminds us of the incredible resilience and adaptability of the human spirit. It challenges us all, regardless of our health status, to reconsider what freedom truly means and to find ways to cultivate it in our own lives.

https://www.youtube.com/watch?v=5Cg-j0X09Ag link to Janis Joplin “Me and Bobbly McGee