I did jinx myself. Last night my Liberty Cycler on the first drain blared its klaxon horn and I had to get out of bed for 5 minutes or so until the indicated drain volume was over 1700 mL. At this point, I got back into bed and it remained mute for the remainder of the night. Just as five nights in a row without alarms does not a whole story make, so does a single alarm on a given night not indicate a trend. I still maintain that Fresenius knows full well the problems with their Cycler (notice that I refer to the cycler/problem as “theirs”) and not the dialysis patient’s problem to correct with MiraLAX or other nonconventional workarounds.
The weather in North Texas tends to be sinusoidal in the Spring, with broad swings between cool/cold and warm weather. The last couple of days we had fronts coming through from the West, and now the temperature is in the forties. In a couple of days, it will be back in the 70s/80s. The trick is to time your planned outside activities accordingly. One thing I can plan but not around the weather is walking our Golden Retriever Dickens. Come rain, shine, heat, cold, he gets his due exercise, and by association, I get mine. I read yesterday in the WSJ not less than 20 minutes of brisk walking at my seniority is necessary and sufficient exercise. Thanks to Dickens, which is why I agree to raise yet another Golden, I am getting my exercise in.
My last follow-up concerns the Egyptian Goose/Geese that built a nest on a valley of our roof. Below are four pictures. The first shows the pair out in front of our home when they were casing the joint. The remaining three are in-session closeups of the nesting female. All of the shots were made with my new – to me Samsung S23-Ultra phone which has a 200-megapixel lens and great zoom capability. What does this have to do with Dialysis you ask? Part of smelling the coffee and Mindfulness, for don’t you see?
Look at this as an unstructured chat about whatever comes to mind that’s taking place in my universe as we speak.
Yesterday Fresenius made a delivery of Dialysate for the next thirty days. They started with the delivery of several boxes of manual Dialysate, which is not usable in the Liberty Cycle Dialysis Machine I am currently using. I had to refuse delivery, get on the line with Fresenius Custom Service, and reorder several boxes of Dialysate. What happened doesn’t matter. Perhaps I screwed up the order when I placed it using the PatientHub app, or Fresenius. Regardless, a corrected order is now scheduled for 3/27/23. My Dialysis Nurse through the backdoor got involved and called to make certain I have enough Dialysate to last until delivery which I think I do.
The bottom line here is that Fresenius is taking care of me. I have seen gripes that Fresenius is not responsive which I find NOT to be the case.
For the past five nights, I have not received ANY Drain Alarms!!!!! So what is different? After constant probing by my Dialysis Team, I finally started taking MiraLAX daily. I took the cover off the plastic line leading from the Cycler to my catheter, and I rerouted the line on my stomach that leads from the catheter outbound to the Cycler – three changes that appear to be working. I’ll keep you posted. Hope I haven’t jinxed my current success by reporting the same.
I’ve been thinking about Mindfulness, and how we can apply this concept to our daily lives. As a starting point, during my morning walk with our Golden Retriever Dickens, I have with malice of forethought paused several times, just to “smell a rose,” listen to morning sounds of birds chirping, mowers mowing, PickleBall balls going whack, and in general, being more observant and at peace with our surroundings. It is working. I seem to be less tense and more in tune with nature.
Speaking of Nature, we have an Egyptian Goose that has laid eggs on the roof dormer over our master bedroom. The pair paraded around our and our neighbor’s yards for several weeks. They went missing for several days, and a neighbor who faces our bedroom side of the house said he has been watching them come and go on the leaf and stick nest they mashed up on our roof. Looks like we will be blessed with little geese running around our yard in the near future. Worse things could certainly happen.
Lastly, before my kidney failure, my fighting weight was around 162 pounds, and stayed there for years and years. As my kidneys started failing and my eGFR became lower and lower, I started losing weight. Just before I started Dialysis, I was down to 137 pounds. Once I started on Dialysis, initially I did not gain any appreciable weight. In the last month or so, I have been able to start gaining weight again and am up to about 150 pounds. There is a God.
Dialysis is a medical procedure that is critical for the survival of patients with end-stage renal disease (ESRD). This blog explores the economic and financial implications of dialysis and its impact on society. The cost of dialysis treatment is high, and the burden of the cost falls on both patients and society. In this blog, we analyze the various costs associated with dialysis treatment, including direct and indirect costs. Additionally, we examine the economic impact of ESRD on individuals and the broader society. We also discuss the financial implications of the increasing prevalence of ESRD, including the impact on healthcare systems and insurance providers. The findings of this blog suggest that the cost of dialysis is significant and that the increasing prevalence of ESRD has significant economic and financial implications for individuals and society.
Introduction:
Dialysis is a medical procedure that is essential for patients with end-stage renal disease (ESRD). ESRD is a condition in which the kidneys lose their ability to function adequately, and dialysis is necessary to remove waste products and excess fluid from the body. Dialysis treatment is costly, and the cost burden falls on both patients and society. According to the National Kidney Foundation, the cost of dialysis treatment in the United States is approximately $90,000 per year per patient (National Kidney Foundation, 2021).
Direct and Indirect Costs of Dialysis:
The cost of dialysis treatment includes direct and indirect costs. Direct costs include expenses related to dialysis treatment, such as the cost of equipment, supplies, and medication. Indirect costs refer to the expenses associated with ESRD, such as lost wages and productivity, transportation costs, and caregiver costs. A study conducted by the University of Michigan found that the average annual cost of dialysis treatment in the United States was $86,600, of which 44% were indirect costs (Erickson et al., 2019).
Economic Impact of ESRD:
ESRD has a significant economic impact on individuals and society. Individuals with ESRD face financial difficulties due to the cost of dialysis treatment, lost wages, and reduced quality of life. The economic burden of ESRD extends beyond individuals to the broader society. A study conducted by the American Kidney Fund found that Medicare spending on ESRD patients increased from $12.7 billion in 2000 to $35.9 billion in 2016 (American Kidney Fund, 2021). The same study found that the annual cost of ESRD to the US healthcare system was $114 billion in 2016.
Financial Implications of Increasing Prevalence of ESRD:
The prevalence of ESRD is increasing, and this trend has significant financial implications for healthcare systems and insurance providers. The Centers for Disease Control and Prevention (CDC) estimates that the number of people with ESRD in the United States will reach 1.5 million by 2030 (Centers for Disease Control and Prevention, 2021). As the prevalence of ESRD increases, the cost of dialysis treatment and the burden on healthcare systems and insurance providers will also increase. A study conducted by the University of Michigan found that Medicare spending on ESRD patients increased by 2.2% per year between 2006 and 2013 (Erickson et al., 2019).
Conclusion:
Dialysis is a critical medical procedure for patients with end-stage renal disease, but the cost of dialysis treatment is high, and the burden of the cost falls on both patients and society. The economic impact of ESRD on individuals and society is significant, and the increasing prevalence of ESRD has significant financial implications for healthcare systems and insurance providers. As the number of individuals with ESRD continues to rise, there is a pressing need to address the economic and financial implications of dialysis.
One approach to addressing the economic and financial implications of dialysis is to focus on prevention and early intervention. This could involve promoting healthy lifestyles, increasing awareness of the risk factors for ESRD, and improving access to screening and diagnostic tests. Additionally, efforts to develop new treatments and technologies that can improve the efficiency and effectiveness of dialysis could help to reduce the cost burden of this treatment.
In conclusion, the economic and financial implications of dialysis are significant and extend beyond individual patients to the broader society. Addressing these challenges will require a multi-faceted approach that involves prevention, early intervention, and innovative solutions. By working together to address these challenges, we can ensure that individuals with ESRD receive the care they need while minimizing the economic burden on patients and society.
Erickson, K. F., Winkelmayer, W. C., & Chertow, G. M. (2019). Cost of end-stage renal disease in the United States. Kidney international, 96(3), 580-585.
Practicing mindfulness and gratitude can contribute to happiness while on dialysis. Mindfulness involves being present and aware of one’s thoughts and feelings without judgment. Dialysis treatments can be stressful, and it is easy to become overwhelmed by negative thoughts and emotions. However, practicing mindfulness can help to reduce stress and anxiety levels. Additionally, focusing on things to be grateful for can help to shift one’s perspective and create a more positive outlook. It can be as simple as being grateful for the healthcare team, supportive loved ones, or even the ability to receive life-sustaining treatments.
Mindfulness is the act of being fully present, aware of where you are and what you’re doing, and not being overwhelmed by what’s going on around you. It’s a simple yet powerful practice that can help you to manage your stress, increase your focus, and improve your overall well-being. All of us on Dialysis need mindfulness to the nth degree.
Benefits of Mindfulness
Reduces Stress: Mindfulness has been shown to reduce stress levels by allowing individuals to focus on the present moment instead of worrying about the future or dwelling on the past. This can lead to a decrease in cortisol levels, which is a hormone that is released in response to stress.
Improves Focus: Practicing mindfulness regularly can improve your ability to focus and pay attention. By staying present in the moment, you can improve your productivity and reduce distractions.
Boosts Overall Well-being: Mindfulness has been linked to several physical and mental health benefits, including improved sleep, reduced anxiety, and lower levels of depression. It can also help individuals to develop a greater sense of self-awareness and compassion toward others.
How to Practice Mindfulness
There are many ways to practice mindfulness, and what works best for one person may not work for another. Here are a few common techniques to try:
Meditation: Meditation is a popular mindfulness technique that involves sitting quietly and focusing on your breathing or a specific object. It can be practiced for just a few minutes each day and can have a significant impact on your overall well-being.
Body Scan: A body scan involves lying down and focusing on each part of your body, starting with your toes and working your way up to your head. This can help you to become more aware of your physical sensations and can be a useful tool for relaxation.
Mindful Eating: Mindful eating involves paying close attention to the experience of eating, including the taste, smell, and texture of the food. By doing so, you can develop a greater appreciation for your food and become more aware of your body’s hunger and fullness cues.
Conclusion
Mindfulness is a simple yet powerful practice that can help you to manage stress, improve focus, and boost overall well-being. By incorporating mindfulness techniques into your daily dialysis routine, you can develop a greater sense of self-awareness and compassion towards others, and lead a more fulfilling life. So why not give it a try today? And be happy! See Ted-Talk below for more on Mindfulness please.
Since being on PD, I have observed people’s responses to being informed of my being subjected to this medical life-supporting procedure. Many appear not to know how to act. They don’t make eye contact. Say their sorry (whatever that means, sorry for me or glad it’s not them?). They both change the subject or perfunctorily address it and then move rapidly on. They appear to be uncomfortable as if they were coming into contact with a leper. It has reached a point where I am considering not even relating my situation to people at all. Keep in mind that dialysis has been a cloud over my head for upwards of thirty years because of an ever-declining eGFR, diabetes, etc.
That got me thinking this phenomenon is not unique to me. There have to be studies of this mainly social-interaction observation and thus this blog. I talked to my assistant Notion, and the following results provide insight to research in the area of the Stigma associated with Dialysis and its impact on Patients’ lives. There are actually two major types of Stigma, Social and Self. I’ve embedded a YouTube video from Kahn Academy at the blog’s end if you should desire to know more about the concept of Stigma in more depth.
Introduction
Dialysis is a life-saving procedure for patients with end-stage renal disease (ESRD). However, patients undergoing dialysis often face various challenges, including the stigma associated with the procedure. The stigma can have negative effects on the patient’s psychological and social well-being. This blog explores the stigma associated with dialysis and its impact on patients’ lives.
Stigma Associated with Dialysis
Stigma is defined as a negative attribute that marks an individual as different from others and leads to social rejection or discrimination. Patients with ESRD who undergo dialysis are often stigmatized due to the visible physical changes associated with the procedure. These physical changes may include loss of hair, weight gain, and fatigue, among others.
In addition to physical changes, dialysis patients also face stigmatization due to misconceptions and myths surrounding the procedure. This stigma is often perpetuated by the media and society at large. Patients undergoing dialysis may be viewed as weak or lazy, and this can lead to discrimination or social exclusion.
The stigma associated with dialysis is a complex issue that requires further exploration. A study conducted by Rothermundt et al. (2007) found that depression and anxiety were prevalent among patients on chronic hemodialysis. The study also identified several risk factors for depression and anxiety, including age, gender, and comorbidities. The findings suggest that the stigma associated with dialysis can have a profound impact on a patient’s psychological well-being.
Impact of Stigma on Patients’ Lives
The stigma associated with dialysis can have a significant impact on patients’ lives. Dialysis patients may feel ashamed, embarrassed, or shunned due to the stigma, which can lead to social isolation and withdrawal from society. This can, in turn, lead to depression, anxiety, and other psychological problems.
Moreover, the stigma associated with dialysis can also affect patients’ physical health. Patients who feel stigmatized may be less likely to adhere to their dialysis treatment regimen, leading to poor health outcomes. This can also lead to decreased quality of life and increased healthcare costs.
A study conducted by Brown et al. (2010) found that the quality of life on peritoneal dialysis was better than on hemodialysis for older patients. The study identified several factors that contributed to the difference, including greater flexibility and independence with peritoneal dialysis. The findings suggest that addressing the stigma associated with dialysis can improve patient’s quality of life.
Addressing Stigma Associated with Dialysis
There is a need to address the stigma associated with dialysis to improve patients’ psychological and social well-being. This can be achieved through education and awareness campaigns aimed at dispelling myths and misconceptions surrounding dialysis. Healthcare providers can also play a role in addressing stigma by providing support and counseling to patients.
In addition, patients can play an active role in addressing stigma by speaking out about their experiences and advocating for their rights. This can help to reduce the stigma associated with dialysis and improve patients’ lives.
A study conducted by Newman et al. (1997) found that a multidimensional anemia education program for dialysis patients improved patients’ knowledge and self-efficacy. The program also led to improvements in hemoglobin levels and reduced the need for erythropoietin-stimulating agents. The findings suggest that education programs can be an effective way to address the stigma associated with dialysis.
Conclusion
In conclusion, the stigma associated with dialysis can have significant negative effects on patients’ lives. It is important to address this stigma through education, awareness, and advocacy to improve patients’ psychological and social well-being. Healthcare providers, patients, and society at large can all play a role in reducing the stigma associated with dialysis.
Further research is needed to better understand the stigma associated with dialysis and its impact on patients’ lives. The findings can help inform the development of interventions aimed at addressing the stigma and improving patients’ quality of life.
References
1. Devins GM, Mendelssohn DC, Barré PE, Taub KJ, Binik YM. Predialysis psychoeducational intervention extends survival in CKD: a 20-year follow-up. Am J Kidney Dis 2005;46:1088-98. 1. Brown EA, Johansson L, Farrington K, Gallagher H, Sensky T, Gordon F, et al. Broadening options for long-term dialysis in the elderly (BOLDE): differences in quality of life on peritoneal dialysis compared to haemodialysis for older patients. Nephrol Dial Transplant 2010;25:3755-63. 2. Finkelstein FO, Finkelstein SH. Depression in chronic dialysis patients: assessment and treatment. Nephrol Dial Transplant 2000;15:1911-3. 3. Goffman E. Stigma: Notes on the Management of Spoiled Identity. Englewood Cliffs, NJ: Prentice Hall; 1963. 4. Link BG, Phelan JC. Conceptualizing Stigma. Annu Rev Sociol 2001;27:363-85. 5. Martin-McDonald K, Rogers JR. Stigma and chronic kidney disease: stepping out of the shadows. Nephrol Nurs J 2011;38:291-8. 6. Newman SP, Blumenthal S, Revicki DA, et al. The effects of a multidimensional anemia education programme for dialysis patients. Nephrol Dial Transplant 1997;12:300-6. 7. Pifer TB, McCullough KP, Port FK, et al. Mortality risk in hemodialysis patients and changes in nutritional indicators: DOPPS. Kidney Int 2002;62:2238-45. 8. Rothermundt C, Krüger B, Meran J, et al. Depression and anxiety in patients on chronic hemodialysis: prevalence, incidence, and risk factors. Kidney Int 2007;72:1081-8. 9. Weiner DE, Scott T, Giang LM, et al. Cardiovascular disease and cognitive function in maintenance hemodialysis patients. Am J Kidney Dis 2011;58:773-81.
From Craiyon with prompt “comic picture of person with cognitive burden”
Recently I read an article written by a Type 1 Diabetic about the use of a Continuous Glucose Monitor as a central tenant to their diabetic control. In this article, the author used the term “Cognitive Burden” several times. I am not familiar with this terminology due in part to my concentration on STEM courses in college to obtain Engineering degrees. When possible, I try to backfill this void in my education. The following is such an attempt, a modest research effort on what is behind the term “Cognitive Burden” and how, if at all, does it relate to my current situation – being on Dialysis?
Introduction:
Cognitive burden refers to the mental workload or demand imposed on an individual’s cognitive resources, including attention, memory, and decision-making capacity. Patients undergoing dialysis have a high cognitive burden due to the nature of the treatment, which involves long hours of treatment, multiple sessions per week, and strict dietary and fluid restrictions. The aim of this blog is to explore the cognitive burden experienced by dialysis patients and its impact on their quality of life.
Literature Review:
Dialysis is a life-saving treatment for patients with end-stage renal disease (ESRD) who have lost the ability to filter waste and excess fluids from their bodies. However, the treatment imposes a high cognitive burden on patients, which can affect their quality of life. The cognitive burden may be attributed to the following factors:
Treatment duration and frequency: Dialysis treatment sessions can last for several hours-or every night in my case for PD patients, and patients may require multiple sessions per week. This can lead to fatigue, boredom, and reduced cognitive function.
Dietary and fluid restrictions: Dialysis patients are often required to follow strict dietary and fluid restrictions to prevent fluid overload and electrolyte imbalances. This can be challenging for patients and requires constant vigilance and self-monitoring, which can add to the cognitive burden.
Medication management: Dialysis patients often take multiple medications, including those for managing their kidney disease, comorbidities, and side effects of dialysis. Managing these medications can be complex and require careful attention to dosing, timing, and interactions with other medications. Using myself as an example, I am taking 16 different medications, all of which except one – OsteoBiflex, are prescribed. I take some at breakfast, some at night, one MWF, two every two weeks, etc. It gets complicated in a hurry.
Several studies have investigated the impact of a cognitive burden on dialysis patients’ quality of life. One study found that cognitive impairment was associated with poorer health-related quality of life and increased mortality in dialysis patients (Kurella Tamura et al., 2010). Another study found that cognitive function was a significant predictor of adherence to fluid restrictions among dialysis patients (Song et al., 2018). A systematic review also identified cognitive impairment as a common problem among dialysis patients and highlighted the need for further research to explore interventions to improve cognitive function in this population (Kurella Tamura et al., 2016).
Discussion:
The high cognitive burden experienced by dialysis patients can have significant implications for their quality of life and treatment outcomes. Patients may struggle with adhering to dietary and fluid restrictions, managing medications, and coping with the physical and emotional demands of dialysis. These challenges can lead to anxiety, depression, and reduced treatment adherence, which can, in turn, negatively impact their health and well-being.
To mitigate the cognitive burden experienced by dialysis patients, several interventions have been proposed. These include cognitive training programs, educational interventions to improve self-management skills, and technological solutions such as mobile apps and wearable devices to assist with medication management and monitoring of fluid intake. However, further research is needed to determine the efficacy and feasibility of these interventions in improving cognitive function and reducing the cognitive burden of dialysis.
Conclusion:
The cognitive burden is a significant challenge for dialysis patients, affecting their quality of life, treatment adherence, and outcomes. More research is needed to identify effective interventions to mitigate the cognitive burden experienced by dialysis patients and improve their cognitive function and quality of life. Healthcare providers should be aware of the cognitive burden imposed by dialysis treatment and work with patients to develop strategies to manage the cognitive demands of their treatment.
References:
Kurella Tamura, M., Yaffe, K., Hsu, C. Y., Yang, J., Sozio, S., Fischer, M., … Go, A. S. (2010). Cognitive impairment and poor health literacy are associated with mortality in hemodialysis. Journal of the American Society of Nephrology, 21(11), 1970–1979.
Song, M. K., Lin, F. C., Gilet, C. A., Arnold, R. M., Bridgman, J. C., Ward, S. E., & Dunbar-Jacob, J. (2018). Symptom clusters in patients with end-stage renal disease prior to starting dialysis. Journal of Pain and Symptom Management, 55(1), 153-160. doi: 10.1016/j.jpainsymman.2017.08.026
Kurella Tamura, M., Xie, D., Yaffe, K., Cohen, D. L., Teal, V., Kasner, S. E., … Hsu, C. Y. (2016). Vascular risk factors and cognitive impairment in chronic kidney disease: The Chronic Renal Insufficiency Cohort (CRIC) Study. Clinical Journal of the American Society of Nephrology, 11(7), 1144–1153. doi: 10.2215/CJN.11951115
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:
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.
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.
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.
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.”
Going into this Friday’s Fresenius Dialysis Team Meeting starring me, last Monday I provided my Dialysis Nurse and Dietician the correspondence below in the form of an email. It, as you can see for yourself, provided specifics of what I anticipated, as a minimum be covered. Tomorrow’s blog will provide a synopsis of the results. My bottom line herein is that you have a responsibility to be an active participant in your care. Who can care better for you than yourself?
Discussion Points for 3/10/2023 Henry Feeser Dialysis Team Meeting
Get on the kidney transplant list ASAP per discussion last week
Discuss Cognitive Decline & Dialysis:
Dietary Aspects – Specific areas to improve?
Testing – What does Fresenius do/support?
What be on the watch for? You? Me? Spouse?
Laxative Use – Linked to dementia risk?
Test for B12 – Complete Blood Count (CBC)? Am not aware of any testing to insure my adequacy?
Vitamin Supplements/Dietary Modifications to combat?
3/1/2023 Lab Results Discussion:
Albumin was 3.4 and declined. 4.0 or higher. What do about it?
nPCR 1.2 or higher. (normalized Protein Catabolic Rate) Less than 0.8 equates to malnutrition but I am gaining weight and good appetite. BMI is just under 24.
wKr/V 1.95 goal 2.0 or higher (getting enough dialysis to adequately clean my blood) w=weekly?, K=clearance liters/minute, t=time duration of treatment, V=volume-amount of body fluid liters
Calcium 8.3 goal 8.5 to 10. Down from Feb reading. Increase Meds per our previous discussions?
Creatinine bouncing around low sixes which maps to an eGFR of 8. Recent VA/LabCorp was 9
Bottom Line: How am I doin’???? Active Management – I own IT!!!!
Concept of Social Portfolio and eating ice cream with friends
On 22 Feb 2023, WSJ ran a special section titled “Guide To Wealth.” In this section on page S3, there is an article titled “Why Your Retirement Plan Should Include Ice Cream” by Andrew Welsch. After reading his article and pondering about it – he tied in the concept of “Social Portfolio,” I began to picture his musing directly applying to those of us who are tied to a regime of dialysis, and for me, Peritoneal Dialysis.
To paraphrase him to some extent, he suggests the little things in life are what make us smile, like going out for an ice cream cone. Going out for an ice cream cone is a proxy for quality of life. You need mobility, freedom, and some cash in your pocket to get an ice cream cone. Being able to do so implies the maintenance of a higher quality of life, herein while on dialysis. Welsch extended this concept to not just getting to an ice cream cone, but who will you have one with? This is where he introduced the concept of the social portfolio. Do you have friends to share an ice cream cone with? Will you be able to find new friends while on dialysis? It takes time, which directly is a function of the quality of life you are experiencing.
With all of these strange concepts floating around in my brain, and now I’ve added something called a social portfolio, it became starkly apparent I needed to know more about this squishy thing. (It’s squishy because as an engineer if I can’t attach numbers to an entity and put it into a formula to predict the future with an acceptable degree of accuracy, it’s squishy.) I turned to my trusty companion AI bot, Notion, and with editing, produced the following for our common edification:
Introduction
Dialysis patients face numerous challenges that can negatively affect their quality of life. One of these challenges is social isolation, which is common in this population due to the need for frequent medical appointments and treatment sessions. A social portfolio is a valuable tool that can help dialysis patients manage their social lives and maintain a sense of normalcy. This blog will explore the role of the social portfolio in dialysis patients, with a focus on peritoneal dialysis.
The Social Portfolio
The social portfolio is a document that contains important information about a patient’s social life. It includes contact information for family, friends, and healthcare providers, as well as details about support groups, hobbies, and other activities. The social portfolio is designed to help patients stay connected with their social network and maintain a healthy balance between their medical treatments and their personal lives.
Social Isolation in Dialysis Patients
Social isolation is a common problem among dialysis patients, as they often have to spend several hours a week receiving treatment. This can make it difficult for them to maintain normal relationships with family and friends and can lead to feelings of loneliness and depression. Social isolation can also impact a patient’s physical health, as it has been linked to an increased risk of cardiovascular disease, cognitive decline, and premature death.
The Role of the Social Portfolio in Dialysis Patients
The social portfolio can be an effective tool for combating social isolation in dialysis patients. By providing patients with a comprehensive list of contacts and activities, the social portfolio can help them stay connected with their social network and maintain a sense of normalcy. It can also help patients identify support groups and other resources that can provide them with emotional and practical support.
Peritoneal Dialysis and the Social Portfolio
Peritoneal dialysis (PD) is a type of dialysis that uses the lining of the abdomen to filter waste products from the blood. PD is often done at home, which can make it easier for patients to maintain their social lives. However, even patients with PD can still experience social isolation, especially if they have limited mobility or live in remote areas.
The social portfolio can be particularly valuable for PD patients, as it can help them stay connected with their social network and maintain a sense of normalcy while receiving treatment at home. PD patients can use their social portfolio to identify local support groups, connect with other patients online, and find activities that they can participate in from home.
Conclusion
In conclusion, a social portfolio is a valuable tool that can help dialysis patients manage their social lives and combat social isolation. PD patients, in particular, can benefit from the social portfolio, as it can help them maintain their social lives while receiving treatment at home. It is important for healthcare providers to encourage patients to create a social portfolio and to provide them with the resources they need to stay connected with their social network.
References:
Marquez-Herrera EC, et al. Social isolation and health-related quality of life in chronic kidney disease. J Ren Care. 2017 Mar;43(1):10-18.
Bossola M, et al. Social support and chronic kidney disease: an update. J Nephrol. 2018 Feb;31(1):15-22.
Chan R, et al. Social isolation and loneliness among patients receiving dialysis: a cross-sectional survey. Hemodial Int. 2019 Apr;23(2):274-282.
Lopes AA, et al. Social support and mortality in patients undergoing long-term hemodialysis. Am J Kidney Dis. 2004 Sep;44(3):471-9.
Brown EA, et al. Peritoneal Dialysis—Today and Tomorrow: State of the Art and Future Directions. J Am Soc Nephrol. 2020 Mar;31(3):406-422.
Crabtree JH, et al. Quality of life among patients receiving different renal replacement therapies: a systematic review and meta-analysis. Am J Kidney Dis. 2017 Oct;70(4):548-558.
Gilmartin H. Peritoneal Dialysis: A Review of the Evidence. Clin J Am Soc Nephrol. 2019 Mar;14(3):425-433.
Purnell TS, et al. Social Support, Quality of Life, and Clinical Outcomes in Hemodialysis Patients. Am J Kidney Dis. 2005 Oct;46(4):661-9.
Wong CKH, et al. Social support and health-related quality of life in patients undergoing hemodialysis in Hong Kong. Int J Environ Res Public Health. 2019 Jul;16(13):2396.
Lopes GB, et al. Social support and chronic kidney disease: A scoping review. Braz J Med Biol Res. 2018 Jul;51(10):e7446.
From Craiyon using the prompt “picture culture and religion in the USA”
Dialysis treatment is a significant and life-saving procedure that helps patients with end-stage renal disease (ESRD) to filter their blood and remove waste products from their bodies. The acceptance of dialysis treatment depends on various factors, including culture and religion. While some cultures and religions accept dialysis treatment, others view it as a taboo or a violation of their beliefs. In this essay, we will explore the positive and negative impacts of culture and religion on the acceptance of dialysis treatment in the US.
Culture and Dialysis Treatment
Culture plays a significant role in determining the acceptance of dialysis treatment in the US. In many cultures, family members are the primary caregivers, and the idea of handing over the care of a loved one to a stranger can be daunting. In some cultures, such as the Hispanic culture, the family is the primary decision-maker, and the patient may not have a say in their treatment options. This can lead to a lack of understanding of the benefits of dialysis treatment, resulting in a reluctance to accept it. (1)
On the other hand, some cultures, such as the African American culture, have been disproportionately affected by ESRD. They are more likely to accept dialysis treatment due to the high prevalence of the disease in their community. In addition, African Americans have a tradition of relying on religion to cope with their illnesses. This has led to the incorporation of religion into their dialysis treatment, such as prayer and religious music during treatment sessions. This helps to make the treatment more acceptable and less intimidating. (2)
Religion and Dialysis Treatment
Religion also plays a significant role in the acceptance of dialysis treatment in the US. Some religions, such as Christianity and Judaism, view life as sacred and believe that it is their responsibility to preserve it. Therefore, they are more likely to accept dialysis treatment as a way of prolonging life. However, other religions, such as Jehovah’s Witnesses, object to blood transfusions, which are often necessary during dialysis treatment. This can lead to a conflict between the patient’s religious beliefs and the recommended treatment. (3)
In addition, some religions have specific dietary restrictions that may conflict with the dietary requirements for dialysis patients. For example, the Islamic religion prohibits the consumption of pork and alcohol, which are often found in the dialysis diet. This can lead to a reluctance to accept the treatment, as it may be seen as a violation of their religious beliefs. (4)
Positive Impact of Culture and Religion on Dialysis Treatment
Culture and religion can have a positive impact on the acceptance of dialysis treatment. For instance, some cultures and religions believe in the importance of family and community support in healthcare. Patients who have strong family and community support are more likely to accept dialysis treatment than those who do not. In addition, religion can provide a sense of comfort and hope to patients, which can help to alleviate the stress and anxiety associated with dialysis treatment. (5)
Moreover, some cultures and religions have a tradition of relying on alternative or complementary medicine to treat illnesses. These practices, such as acupuncture and herbal medicine, can be incorporated into the treatment plan alongside dialysis treatment. This can help to make the treatment more acceptable and less intimidating to patients who are hesitant to accept it. (6)
Negative Impact of Culture and Religion on Dialysis Treatment
While culture and religion can have a positive impact on the acceptance of dialysis treatment, they can also have negative effects. For example, in some cultures and religions, illness is seen as a punishment or a test of faith. Patients who hold these beliefs may be hesitant to accept dialysis treatment, as they see it as interfering with the will of a higher power.
Moreover, cultural and religious practices that conflict with the recommended treatment can lead to a reluctance to accept dialysis treatment. For instance, some cultures and religions view blood transfusions as a violation of their beliefs. Patients who hold these beliefs may refuse the treatment, even if it is necessary for their survival. (7)
Conclusion
In conclusion, culture and religion play a significant role in the acceptance of dialysis treatment in the US. Healthcare providers should be aware of the cultural and religious beliefs of their patients and work towards finding a treatment plan that is acceptable to both the patient and their beliefs. The incorporation of culture and religion into the treatment process can have a positive impact on the acceptance of dialysis treatment. However, conflicts between cultural and religious beliefs and the recommended treatment can lead to a reluctance to accept the treatment, which can have negative consequences for the patient’s health. Therefore, it is essential to find a balance between respecting cultural and religious beliefs and providing the necessary medical care to ensure the best possible outcome for the patient.
References
Lopez-Quintero, C., Freeman, D. H., Neighbors, H. W., & Engelhardt, J. (2009). Culture and end-of-life care in the Hispanic community: ethnic considerations in dialysis. Advances in Chronic Kidney Disease, 16(6), 476-482.
Williams, D. R. (2012). African American renal disease: recent progress and future directions. Current Opinion in Nephrology and Hypertension, 21(3), 289-294.
Kuczewski, M. G. (2015). Jehovah’s Witnesses and the meaning of the transfusion taboo. Theoretical Medicine and Bioethics, 36(1), 45-62.
Khattak, F., Salim, A., & Islam, M. (2015). Religious and cultural aspects of organ donation among Muslims: a systematic review. Journal of Religion and Health, 54(2), 432-445.
Puchalski, C. M., & Romer, A. L. (2000). Taking a spiritual history allows clinicians to understand patients more fully. Journal of Palliative Medicine, 3(1), 129-137.
Lee, M. S., & Chen, K. W. (2007). Sustaining the spirit: a grounded theory study of spirituality in the lives of Taiwanese patients receiving hemodialysis. Journal of Nursing Research, 15(3), 197-208.
Hedayat, K. M., & Pirzadeh, R. (2014). Cultural and religious considerations in palliative care. International Journal of Preventive Medicine, 5(Suppl 2), S179-S182.
