Tag: Navy (Page 21 of 44)

Peritoneal Dialysis & Anxiety: A Research Perspective

March 1, 2024 / Henry Feeser / 0 Comments

Several days ago I commented that our son, who recently underwent quadruple bypass (he is doing great BTW), displayed a high degree of anxiety over small stimuli during the procedure. I speculated that PD patients were also prone to such behavior. This blog aims to provide the reader with what researchers have found.

Within the AI engine I often use, Poe, there is a specific bot named DoctorSage. I used this bot with the following Prompt and results to ascertain what research has uncovered regarding PD and Anxiety:

Prompt: A patient who is on peritoneal dialysis may experience anxiety. What has research shown in this area?

Research has shown that patients on peritoneal dialysis may experience anxiety due to various factors. Here are some key findings from studies conducted in this area:

Prevalence of anxiety: Several studies have reported a high prevalence of anxiety among patients on peritoneal dialysis. The exact rates vary across different studies, but it is generally higher compared to the general population. This suggests that peritoneal dialysis patients are at a higher risk of experiencing anxiety.
Factors contributing to anxiety: Several factors have been identified as potential contributors to anxiety in peritoneal dialysis patients. These include:

Fear of complications or treatment-related problems
Uncertainty about the future and long-term outcomes of peritoneal dialysis
Fear of dependency on dialysis and its impact on daily life
The financial burden associated with treatment
Social isolation and limited support network
Concerns about body image changes and self-esteem issues

Impact on quality of life: Anxiety can significantly affect the quality of life of peritoneal dialysis patients. It may lead to increased psychological distress, reduced treatment adherence, and poorer overall well-being. Addressing anxiety in these patients is, therefore, crucial for improving their quality of life.
Relationship with depression: Anxiety and depression often coexist in peritoneal dialysis patients. Studies have found a high comorbidity between these two conditions. It is important to recognize and manage both anxiety and depression simultaneously to provide comprehensive care to these patients.
Interventions and management: Various interventions have been explored to address anxiety in peritoneal dialysis patients. These include:

Psychological interventions such as cognitive-behavioral therapy (CBT) and relaxation techniques
Education and counseling to address concerns and provide support
Peer support programs and support groups to reduce social isolation
Pharmacological interventions, such as selective serotonin reuptake inhibitors (SSRIs), in severe cases

In summary, research indicates that anxiety is prevalent among peritoneal dialysis patients and can significantly impact their quality of life. Understanding the contributing factors and implementing appropriate interventions are essential for addressing anxiety in this patient population.

Ode to Jerry Seager

February 29, 2024 / Henry Feeser / 3 Comments

My brother-in-law, Jerry Seager, is in the throes of dealing with AML Leukemia. He was born and raised on an 80-acre farm in Central Indiana. I ran across the following yesterday on Facebook and recognized it captured perfectly his way of and philosophy in life. This blog is dedicated to Jerry Seager and the Seagers of the world who encapsulate innate wisdom into their way of life.

Advice from An Old Farmer

Your fences need to be horse-high, pig-tight and bull-strong.

Keep skunks and bankers at a distance.

Life is simpler when you plow around the stump.

A bumble bee is considerably faster than a John Deere tractor.

Words that soak into your ears are whispered… not yelled.

Meanness don’t jes’ happen overnight.

Forgive your enemies; it messes up their heads.

Do not corner something that you know is meaner than you.

It don’t take a very big person to carry a grudge.

You cannot unsay a cruel word.

Every path has a few puddles.

When you wallow with pigs, expect to get dirty.

The best sermons are lived, not preached.

Most of the stuff people worry about ain’t never gonna happen anyway.

Don’t judge folks by their relatives.

Remember that silence is sometimes the best answer.

Live a good, honorable life… Then when you get older and think back, you’ll enjoy it a second time.

Don ‘t interfere with somethin’ that ain’t bothering you none.

Timing has a lot to do with the outcome of a Rain dance.

If you find yourself in a hole, the first thing to do is stop diggin’.

Sometimes you get, and sometimes you get got.

The biggest troublemaker you’ll probably ever have to deal with, watches you from the mirror every mornin’.

Always drink upstream from the herd.

Good judgment comes from experience, and a lotta that comes from bad judgment.

Lettin’ the cat outta the bag is a whole lot easier than puttin’ it back in.

If you get to thinkin’ you’re a person of some influence, try orderin’ somebody else’s dog around..

Live simply. Love generously. Care deeply. Speak kindly. Leave the rest to God.

Don’t pick a fight with an old man. If he is too old to fight, he’ll just kill you.

Most times, it just gets down to common sense.

Catching Up Dialysis Or Not

February 28, 2024 / Henry Feeser / 0 Comments

Our son’s first night at home went well. He was able to sleep and is in the process of figuring out what meds to take and when. The pharmacy in Mineral Wells did not fill all his scripts so this resulted in a snafu when he arrived home but it got worked out.

I heard from one of my Porsche buddies in Indiana that he is also in ICU for a heart-related matter. He went in to have modest procedures accomplished to remedy AFIB but in fixing this, a hole was poked in the heart which had to be repaired so he will be in the hospital much longer. Linda and my best to you and yours Henry R.

We are having crazy weather here in North Texas. Yesterday, 3/26/2024 the temperature in Mineral Wells Texas was 100 F. For the next couple of days the highs are predicted to be in the low 50s, bouncing back to the 70s once again. Poor trees and plants don’t know what to think. Currently, we have over 30 daffodils in bloom and the grass is greening up. Keep this up and I’ll be mowing again shortly.

Our new Great-granddaughter, along with her parents are planning on flying out from Seattle on 9-11 March. As my wife Linda and I haven’t had the pleasure as of yet, we’re really looking forward to their visit. So far we have laid on a baby bed, playpen, and high chair in advance of their visit.

Sometimes when you are on dialysis you just have to do what you have to do – regardless.

Son Is Home

February 27, 2024 / Henry Feeser / 0 Comments

It is a short and sweet blog. Our son was released from the ICU at Fort Worth Medical City mid-afternoon yesterday. My wife and I picked him up and took him home to Palo Pinto County via Mineral Wells to pick up prescribed drugs and a blood pressure cuff—more tomorrow.

Monday Update

February 26, 2024 / Henry Feeser / 0 Comments

Our son is still in ICU recovering from his recent quadruple heart bypass. Most of the associated tubes have been removed and he is urinating on his own now; catheters have been removed. He still has to do the big BM soon but hopefully, nature will take its course. If things go as suggested by hospital staff, he should be moved to a regular care hospital room tomorrow from ICU, and possibly be released Tuesday or Wednesday.

Our son has exhibited a side I did not know he had/has. He seems anxious over the least little perturbation like his BP going up a couple of points or one of the many machines he is hooked up to beeping. Recall that he has an ICU nurse devoted full time to his care and feeding so it’s not like he is winging it all alone. I guess stress can do things to our minds and bodies that bring out another side of our personality.

Since dialysis has been known to be somewhat stressful, it would be interesting to know how dialysis patients manifest their response to stress?

Update Son’s Bypass

February 23, 2024 / Henry Feeser / 0 Comments

Yesterday morning on schedule our son had a quadruple heart bypass at Fort Worth Medical City. He went in on schedule and came out a couple of hours sooner than expected. We visited him Thursday afternoon. He was awake, sitting up, talking, and lucid. Pain yes. But, hanging in there. He is in a single-room ICU with a devoted ICU nurse tending to his every need. Today he is to start walking and doing breathing exercises. He is progressing well and I am convinced he will be up and at them before we know it.

As a result of our son’s plight, dialysis, while still going on as prescribed, has taken a back seat as it should. Hopefully, by some time next week, we’ll be of a mindset to more deeply relate the ins and outs of my dialysis. At the present time, I’m in automatic.

Last PET and Our Son

February 22, 2024 / Henry Feeser / 0 Comments

Yesterday I wrote about how the PET and other tests tie together to present an overall picture of the efficacy of a given Dialysis Prescription. Recall also that this past Monday I underwent yet another PET. The results are in, and would you believe, my Transport flipped 180 degrees again, to Low from High. This will require/support yet another prescription from my Nephrologist. Please stand by for more on this as it develops. How this can happen is beyond my understanding at this point.

As a result of an investigation by the Wetherford CathLab, it was ascertained that our son needs a quadruple bypass ASAP. He was transferred to the Fort Worth Medical Center yesterday evening, where he is in the surgery queue for an 0730 procedure today. He is still fighting Hypertension.

And if this isn’t enough, my brother-in-law with AML Leukemia is soon to be released from the hospital into hospice care at his home in Mulberry, Indiana.

For all you dialysis patients who think you are carrying the weight of the world on your shoulders, get a grip. You are undergoing a life-giving procedure. Things could certainly be much worse as suggested above.

BTW, here in North Texas, we have been experiencing 80+ degree days. All over Pecan Plantation where we live the Daffodils are starting to bloom. See the lead picture from our front yard.

PET Plus

February 20, 2024 / Henry Feeser / 0 Comments

Yesterday my dialysis nurse Cindy conducted a PET again. In a couple of days, we should have a readout on my Transport “Function” and go from there on whether or not my prescription should be altered. To uninitiated reading about a PET concerning dialysis involves manually loading 2000 mL of 2.5% fluid the night before the test, at home, and several loads and drains at the dialysis center the following day along with lab draws. The whole PET takes several hours. I started at 0900 and got back home about 1500.

We dialysis patients often get caught up in our little worlds. Friday night our son, a robust 61-year-old hard-working man, was admitted to the hospital with chest pains. He has been experiencing high blood pressure for some time and also experiences white coat anxiety. He was scheduled to go to the CathLab early Monday but was postponed to Tuesday because of continued hypertension. Stay tuned.

If diabetes or CKF then fingernails impacted?

February 19, 2024 / Henry Feeser / 0 Comments

Over the past few years, my fingernails have become thinner and more prone to cracking. Small scraping tasks I could perform previously were no longer possible without bending or cracking my fingernail(s). Since we know diabetes and CKF impact our bodies in ways that are not always apparent, I explored the ties between fingernail health diabetes and CKF. Recall that quite often diabetes is a precursor of CKF; they often go hand-in-hand. Likewise, CKF more often than not leads to dialysis.

For this research I used Perplexity.ai. Recall that perplexity.ai is an intelligent “Google” that provides textual responses not just links as Google does. I first inquired about the link between nail failure and diabetes, then CKF. Perplexity’s responses followed by my closing remarks are below:

The connection between being a type 2 diabetic and experiencing thinner and cracking fingernails is attributed to the impact of diabetes on the nail matrix and vascular function. Diabetes can lead to weakened nails due to vascular disease, which disrupts the nail matrix’s function, causing the nails to become brittle and thin. This vascular disease, resulting from high glucose levels in the blood, affects the supply of oxygen and nutrient-rich blood to the nail matrix, leading to nail abnormalities. Additionally, diabetes can increase the risk of fungal nail infections, further affecting the health and quality of the nails

1. Research also suggests that long-term type 2 diabetes affects the intrinsic material properties and structural integrity of tissues, including the fingernails, due to prolonged hyperglycemia causing chronic damage to tissue quality2. Furthermore, people with diabetes have a higher risk of fungal nail infections, as diabetes can make nails brittle and prone to splitting due to changes in the protein composition of the nail plate3. Therefore, individuals with type 2 diabetes should be mindful of changes in their fingernails and seek medical advice if they notice any abnormalities, as these could be indicative of underlying diabetic-induced tissue damage.

The search results indicate that there is a tie between chronic kidney disease (CKD) and fingernail changes, such as becoming thinner and cracking. CKD can cause various nail disorders and abnormalities, including half-and-half nails (Lindsay’s nails), absent lunula, splinter hemorrhages, and changes in color and texture. These nail changes can be non-specific signs of renal impairment and may precede other symptoms of CKD. The presence of half-and-half nails, where the top part of the nails is white and the bottom part is a reddish-brown color, can be a valuable clue to underlying kidney disease, especially when serum creatinine levels are not readily available

1 2 3 4. Therefore, individuals experiencing changes in their fingernails, such as becoming thinner and cracking, should consider consulting a healthcare professional to evaluate the possibility of underlying kidney disease.

We deduce from the above that both diabetes and CKF may lead to fingernail abnormalities. Along with diabetes, I also have been diagnosed with peripheral artery disease and peripheral neuropathy both of which may impact nails. The bottom line is it’s just something I’m going to have to learn to live with. If you’re also in my boat, you probably will have to also.

Palliative Care and Hospice: Enhancing Quality of Life for Patients on Peritoneal Dialysis

February 16, 2024 / Henry Feeser / 0 Comments

Introduction:
Palliative care and hospice are essential components of comprehensive healthcare that aim to improve the quality of life for patients with serious illnesses. While peritoneal dialysis is an effective treatment option for end-stage renal disease (ESRD), some patients may eventually require palliative care or transition to hospice as their condition progresses. In this blog entry, we will explore what palliative care and hospice entail and provide definitive examples of how they can benefit a patient on peritoneal dialysis.

Understanding Palliative Care:
Palliative care is a specialized medical approach that focuses on relieving symptoms and improving the overall well-being of patients facing serious illnesses. It is not limited to end-of-life care but can be initiated at any stage of a chronic illness. The primary goal of palliative care is to enhance the patient’s quality of life by managing pain, addressing emotional and psychological needs, and providing support for the patient’s family.

For a patient on peritoneal dialysis, palliative care can play a crucial role in managing symptoms and complications associated with the treatment. For instance, a patient may experience chronic pain, fatigue, or anxiety due to the dialysis process. Palliative care specialists can work collaboratively with the patient’s healthcare team to develop a comprehensive care plan that addresses these issues. They may prescribe medications to alleviate pain, provide counseling to manage emotional distress, and offer guidance on lifestyle modifications to enhance the patient’s overall well-being.

Exploring Hospice Care:
Hospice care is a form of specialized care provided to individuals who have a limited life expectancy, usually estimated to be six months or less. It is primarily focused on providing comfort and support to patients and their families during the end stages of a terminal illness. Hospice care can be delivered in various settings, including the patient’s home, a specialized hospice facility, or a hospital.

In the context of peritoneal dialysis, a patient may reach a stage where the treatment is no longer effective or desired. In such cases, the patient may choose to transition to hospice care to receive comprehensive support during their end-of-life journey. Hospice professionals can assist in managing symptoms such as pain, nausea, and breathing difficulties, while also providing emotional and spiritual support to both the patient and their loved ones. Additionally, they can help with organizing and coordinating necessary caregiving services, ensuring the patient’s comfort and dignity.

Definitive Examples of Palliative Care and Hospice for a Peritoneal Dialysis Patient:
Let’s consider the case of a patient on peritoneal dialysis who has advanced kidney disease and experiences significant fatigue, anxiety, and depression. Palliative care specialists can intervene by prescribing medications to alleviate the patient’s fatigue, offering counseling sessions to address anxiety and depression, and collaborating with the patient’s healthcare team to optimize the dialysis regimen. This holistic approach can enhance the patient’s quality of life, allowing them to engage in activities they enjoy and maintain emotional well-being.

In another scenario, imagine a patient on peritoneal dialysis who has progressed to the end stages of kidney disease and decides to discontinue treatment due to personal preferences or worsening health conditions. Hospice care professionals can step in to provide support during the patient’s remaining time. They can focus on pain management, ensure symptom control, and offer emotional support to the patient and their family members. This compassionate care allows the patient to spend their final days in comfort and dignity, surrounded by loved ones.

Conclusion:
Palliative care and hospice play vital roles in enhancing the quality of life for patients on peritoneal dialysis, both during active treatment and at the end stages of their illness. From managing symptoms to providing emotional support, these specialized care approaches ensure that patients receive holistic, patient-centered support. By integrating palliative care and hospice into the treatment plan, patients and their families can navigate the challenges of renal disease with dignity, compassion, and improved well-being.