Henry Feeser's Peritoneal Dialysis (PD) journey

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Results Meeting with Dialysis Team Friday 3-10-2023

March 10, 2023 / / 0 Comments
From Craiyon using prompt draw a comic picture of a dialysis team

As advertised I met with my Dialysis Team (monthly meeting) with myself, my nurse, my dietician, my neurologist, and the social worker in attendance. I met with my Dialysis Nurse ahead of the meeting and we went over several of my lab readings and in general, how’s it going kind of things. Now to the Discussion list i published in the last blog post:

  1. Get on the Kidney transplant list ASAP: The social worker provided me with folders with pertinent information from three kidney transplant centers in the general area. We briefly discussed using the VA also. Tha ball in now in my court to pour through the folders, decide with whom to apply, and start the process.
  2. Discuss Cognitive Decline and Dialysis. In general, this was not discussed. We did discuss dietary aspects to the extent I was provided with a protein bar to try out, and if I tolerated it OK, will be provided with a supply by Fresenius. Also, I am to receive a subscription to vitamins that are kind to kidneys. Nothing on testing, nothing on what to be on the watch for, re cognitive decline, briefly discussed Laxative Use but the Team’s position was it is still needed for the Liberty Cycler to operate properly. On B12 intake, it was the position of the team that it was the responsibility of my GP to handle all aspects of B12 which I’m OK with.
  3. Lab Results Discussion. On item c., the wKr/V goal is 1.7 or higher which I meet so I’m OK there. Regarding Calcium, there is a corrected value on the full lab report of 8.8 which puts my readings within goal limits. I was told, paraphrasing, that usually, corrected calcium is calculated whenever albumin levels are not in the normal range, thus allowing an estimate as if the albumin values were normal. Lastly, we discussed why I listed Creatinine – just for reference. Since I am on dialysis, creatinine results are not just what my kidneys are doing but impacted by dialysis also my nephrologist inputted.
  4. My Dialysis Nurse recorded all of my vitals, I was asked if I needed any supplies, and the dietician promised an additional listing of supplemental protein products which I have received.

The bottom line is I’m hanging in there and good to go for another month “Underway as before.”

Peritoneal Dialysis Monthly Labs by Fresenius

February 7, 2023 / / 0 Comments
Lab Day @ Fresenius Medical

Yesterday @ 0830 CST I visited my local Fresenius Medical facility in Granbury, TX for labs. This blog relates what took place during my visit.

Valentine’s Day is just a short week away. To thank five of the members of my Fresenius dialysis teams, both Hemo and PD, my wife and I bought Valentine cards, candy, and Hoffbrau Restaurant gift certificates for them. I handed the gifts out on the way into the clinic. They were very well received which is always a good feeling.

Straightaway I wan logged in and provided biometric data – Weight, blood pressure, pulse, glucose, and temperature data, and the USB drive from the Cycler that I had removed prior to leaving home. I then signed several forms to catch up on paperwork for Fresenius, there is always paperwork to catch up on, provided my two insurance cards – Medicare and my military ID for Tricare for Life, and signed some more forms.

I was then shifted to a treatment room where I removed my coat and sweatshirt, was seated and attended to by my dialysis nurse and another nurse. The second nurse drew blood samples and gave me two shots, one my last hepatitis B shot, and the second a Pneumovax shot. My dialysis nurse meanwhile asked me a battery of questions to ascertain my general health and well-being, listened to my heart and lungs, thoroughly inspected my feet, and visually and digitally inspected my stomach catheter area. I was provided a sheet with March’s appointments, and my monthly education package, this time Module 7, Medicines; Tools for Good Health.

I was then sent on my way but had to return as I forgot to pick up a replacement USB drive for the Cycler.

I also noted the Glucose reading on my Libre 3 as being 100 at the time the blood sample was drawn, and the corresponding BMI (remember poor man’s A1C reading) was 6.1%. When my labs come back, probably tomorrow, we’ll compare readings. I had my biometric watch on but forgot to take a reading from it.

When my labs come in, we’ll discuss in some detail what the findings are. For now, I feel great, good, awesome.

Peritoneal Dialysis Labs: An In-Depth Overview

February 6, 2023 / / 0 Comments

On Monday 2/6/2023 I am scheduled to have my monthly lab work done at Fresenius Medical Center in Granbury, TX. I thought it would be appropriate to blog about what these tests are all about in a general nature, followed by more specifics of my personal results. So here goes:

Peritoneal dialysis (PD) is a form of renal replacement therapy that is used to treat patients with end-stage renal disease. It involves the use of the patient’s own peritoneal membrane, which is the inner lining of the abdominal cavity, as a filter to remove waste products from the blood. This process is performed through a series of exchanges that are done several times a day, typically at home. For me, I do four exchanges or two hours duration each.

One of the critical components of PD is the use of dialysis solution, which is a sterile solution that is instilled into the peritoneal cavity through a catheter. This solution works by drawing waste products from the blood into the peritoneal cavity, where they are then removed during the next exchange. To ensure the safety and efficacy of the dialysis process, it is essential to regularly monitor the dialysis solution and the patient’s response to it. This is where peritoneal dialysis labs come in.

What are Peritoneal Dialysis Labs?

Peritoneal dialysis labs are specialized facilities that are designed to monitor and evaluate the quality of the dialysis solution and the patient’s response to it. These labs typically use state-of-the-art equipment and technology to perform a series of tests that help to assess the concentration of waste products, electrolytes, glucose, and other important parameters in the dialysis solution and patient’s blood. For me, Fresenius uses spectra laboratories out of Southaven, MS to conduct the labs. At least that’s the letterhead on my lab reports.

The main objective of peritoneal dialysis labs is to ensure that the dialysis solution used in PD is both safe and effective. To achieve this, they perform several key tests, including:

  1. Dialysis Solution Glucose Concentration Test: This test measures the concentration of glucose in the dialysis solution, which is critical to the success of PD. If the glucose concentration is too high or too low, it can affect the efficiency of the dialysis process and cause adverse effects such as hypoglycemia or hyperglycemia.
  2. Peritoneal Equilibration Test (PET): The PET test measures the rate of transfer of glucose and other solutes between the blood and dialysis solution. This test helps to determine the effectiveness of the dialysis solution and the patient’s peritoneal membrane.
  3. Dialysis Solution Electrolyte Concentration Test: This test measures the concentration of electrolytes in the dialysis solution, including sodium, potassium, and calcium. It is important to maintain a proper balance of these electrolytes to ensure the safety and efficacy of PD.
  4. Bacterial Culture Test: This test is performed to assess the presence of bacteria in the dialysis solution. Bacterial contamination of the dialysis solution can cause severe infections, and regular monitoring is critical to prevent this from happening.

The results of these tests are used to adjust the dialysis solution and the patient’s treatment plan, ensuring that the PD process is both safe and effective.

Benefits of Regular Monitoring by Peritoneal Dialysis Labs

  1. Improved patient outcomes: Regular monitoring of the dialysis solution and the patient’s response to it helps to ensure that the PD process is effective and that the patient is receiving the best possible care. This, in turn, leads to improved patient outcomes, including better control of waste product levels, improved electrolyte balance, and a reduced risk of infections.
  2. Increased patient comfort: Regular monitoring helps to identify and address any issues or adverse effects that may be affecting the patient’s comfort and well-being. This helps to improve the overall quality of life for patients undergoing PD.
  3. Improved safety: Regular monitoring by peritoneal dialysis labs helps to ensure that the dialysis solution is used.

In a following blog we’ll discuss my actual labs, what they mean to me, and how I respond to them if at all.

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