Tag: setup (Page 16 of 43)

Since I have been on my new and latest dialysis prescription, I have been using only 1.5% solution fluids. This holds for both the 2L static treatment I employ about three hours before hooking up to the Liberty Cycler for the night, and the two 6L bags I employ during my night treatment. During the past seven days, I have noticed a developing trend, possibly, that my weight is creeping upwards. See the table below where I have provided the date, weight, and microfiltration values:

As you can ascertain, in a week my weight is up by two pounds which is not “normal” for me, and my dialysis microfiltration, while not steady, appears to be trending downward. So here’s the deal, I know from experience that if I quiz my dialysis team about this it will be suggested that I blend in some 2.5% solution. But I don’t have any number one, and number two, leg craps will certainly accrue if I start using 2.5% again. So I am on the horns of a dilemma: watch my weight creep up or toss and turn all night from leg cramps. Isn’t life wonderful on dialysis?

Yesterday, 4/28/2024 was my wife’s and my 62nd wedding anniversary. Boy, have things  changed since we were first married. Gasoline was less than a quarter a gallon. Computers and cell phones had not been invented. For $20, we could fill two paper shopping bags with enough great red meat to last us weeks. We both worked, she at Purdue where I was a student. We got up early and went to bed early. Life was good and uncomplicated. My kidneys worked. I could drink beer. Did I say life was good?

My wife of 62 years and I met on a blind date at Purdue which was arranged by one of my Navy buddies. We went bowling in October 1961 and were married the following April. I was a student at Purdue attending a program the Navy had at the time named NESEP, for Navy Enlisted Scientific Program. The NESEP incentive intended to provide the Navy with officers with intensive training in needed technical areas like Electrical Engineering to manage the nascent switch to digital technologies that were on the horizon for the Navy. Officers coming out the the US Naval Academy were just not as prepared as was needed. I ended up with a BSEE/MSEE, graduating with Distinction in four years.

This education, along with a perfect wife, has stood me in good stead for these many years. I can’t say how important and central to my general well-being and lately, dialysis care, my wife has been. She is and continues to be the most important reason I get up every morning with the mantra, “Never ring the bell!” Thank you, Linda, for who you are and what you are. I know that you are in my corner regardless of what dialysis throws at us. (The lead graphic is the cover of the anniversary card my wife gave me for our anniversary.)

This blog entry is being written Thursday afternoon late for publishing at 0800 Friday 26 April 2024. Wednesday evening I had a “good” PD experience – no alarms and woke up Thursday morning feeling good. I decided to make a run to town and go to Farm & Fleet to pick up a new battery for our JD ZTR lawn mower that refuses to start, go to Walmart for groceries, and to CVS to pick up a script for my wife. Three stops that even a patient on PD should be able to accomplish without difficulty.

I made it to Farm & Fleet and purchased the battery. I made it to Walmart but by the time I had finished purchasing $128.00 of groceries, I was wiped. Went on to CVS and picked up my wife’s script, and was even more wiped. Got home and my wife helped unload the groceries, I put the battery in the lawn mower and it started right up. I had it hooked to our trailer loaded with mulch and backed it out of the single garage (we have d double garage with a side anteroom and a complete single-car garage too in which we park our lawn mower, golf cart, and other assorted “stuff.”) I positioned the trailer/mulch where we want him to work this evening.

After this, I crashed on the couch. This morning my blood pressure was 97/62. I suspect during my shopping it dropped even more resulting in my being pooped. This is not like me and I don’t appreciate this happening one bit. While we will deal with it, we are seeking a more long-lasting solution.

In a previous blog, I reported on the first Xenotransplantation of a pig’s kidney into a human. A second has been reported by AP reporter Lauren Neergaard in the Health & Science section of the site nbcdfw.com. A condensed version of her article follows; at the bottom is the link to the original article.

Doctors at NYU Langone Health have successfully transplanted a genetically modified pig kidney into a New Jersey woman who was suffering from heart and kidney failure. Lisa Pisano’s condition made her ineligible for a traditional transplant, but doctors came up with a novel solution. They implanted a mechanical pump to keep her heart beating and, days later, transplanted the pig kidney. Pisano is the second patient to receive a pig kidney following a similar procedure at Massachusetts General Hospital. She is recovering well and has taken her first steps since the surgery. The experiment’s early results have been described as transformative, but further monitoring is required. The shortage of donated organs has led to the development of genetic modifications in pigs to make their organs more suitable for human transplantation. Several biotech companies are working on this, and there have been promising results in temporary transplants of pig kidneys and hearts into brain-dead bodies. However, previous attempts at pig heart transplants resulted in the patients’ deaths. The outcome of Pisano’s case, along with that of the Massachusetts General transplant recipient, will play a role in determining the future of xenotransplantation trials.

(Link) to the original article. The lead photo is from this link.

The past week I have been attempting to accomplish some heavy-duty yard work. Here in North Texas where we live, Spring can be short and before you turn around we’re in for suffering heat, as high as 112 F or so. So we have a rather narrow window to get our yards in order before Satan’s Inferno hits.

Tuesday I worked on a bed, we have on the order of 15 flower beds on our 0.52-acre homestead, which is in full sun and borders the side of our main garage. It is mostly clay but grows weeds well. I installed a border around it, made a brick runoff for the drain spout, and augered holes for 12 tomato plants. At this point, I ran out of git up and go. See the lead picture.

In normal times, I would have done this without breaking a sweat. But with my PD-associated low blood pressure, I’m a different person. I have to frequently stop for a breath, and break up any work into chunks. Upon arising Tuesday my blood pressure was 111/74. When I took it before lunch it was 90/57. I have ascertained that once my diastolic drops below 60, I start to feel bummer. Get light-headed and cannot work. Have to sit down. After I rest for five minutes or so I generally can have another go at it.

So here’s the deal. Is this due to dialysis, or is it because I am, after all, 85? I like to think it is dialysis-related. And no, I’m using only 1.5% dialysis solution. And yes, I have worked more salt into my diet. And still, I am experiencing blood pressure readings toward the lower safe boundary.

The most searched subject on this blog is “Alarms.” Seems almost all users of the subject machine experience them, some more than others. In this blog I am going to relate my experience with alarms, and what I have found to somewhat mitigate their occurrence.

First of all, I would like to state up front that Fresenius knows full well that its Liberty Cycler has “alarm challenges.” When they were in the PR mode in pre-rollout of a new Cycler, now since abandoned for business reasons, they touted its reduced alarm rate. Alas, it does not appear that this improved cycler will be available, period. My Dialysis Team, in particular, my nurse, has been most helpful in attempting to troubleshoot alarms. Let’s jump into alarms.

What are alarms? The Cycler throws obnoxious beeping alarms when it determines that something in the Drain-Fill cycle is not going according to its parameters. In general, it appears that the pneumatic pumps in the Cycler have more oomph in the Fill cycle than in the Drain cycle. I have always experienced more alarms during Drain than Fill, by a long shot. This is particularly true if you are slightly lying on or have a bend or kink in your catheter line. But I digress – some history.

I started on PD using the Liberty Cyler on 9/30/2022. At first, I experienced a few alarms, but not so many that I couldn’t handle them sleep-wise. Over time, they increased to the level that I was having multiple alarms, mainly drain, each night, and had to get up out of bed in a verticle position for drains to complete, as much as on every drain. I started calling tech support documenting what was going on and was finally issued a new Cycler. This seemed to alleviate the alarm problem but again, over time I was back to the old alarm situation. Yet another replacement Cycler and the same story. So we had pretty much eliminated the Cycler as being the problem. That left me. Of course, this is what Fresenius tech support said all along.

In concert with my dialysis team, it was decided that I needed to have my catheter placement looked at which required me to go back to the hospital and have a surgeon again look at it which I did. So now I’m on my third Cycler and second catheter placement which seems to be working. In three weeks, I generally have four alarms, This is out of a possible 184 drain/fills which is more than acceptable. What is the secret? I have found through trial and error that I cannot sleep on my left side during any drain cycle, and have to be careful during fills. I can sleep on my back in general but have to make certain my catheter line is flaked out straight from my left side toward the cycler. I should note here that my catheter is positioned on the right side of my body and runs from right to left across my stomach. A natural position for it it exit without obstruction is from left to right thus having to make certain it runs straight to my left side which is also the side where the Cycler is located. My best sleep position is on my right side. While on my right side, I make certain my catheter line is running free and not kinked over my side and toward the Cycler. Turns out my wife of 62 years is prone to sleeping on her right side so as often as not I snuggle up to her back and that’s where I wake up in the morning, alarm-free.

While my configuration may not work for you, the point is there is some optimum sleep-catheter configuration that should minimize alarms. I doubt those of us on PD using the Fresenius Liberty Cycler will ever be without alarms.

Chronic Kidney Disease is projected to be the 5th leading cause of death globally by 2040. Folks, it’s not getting any better. Currently, about 10% of the world’s population is affected by CKD. In 1990 it was the 27th leading cause of death, and by 2010 has risen to 18th. by 2040 it’s expected to skyrocket to 5th.

Here’s the basic research behind these projections from Perplexity:

AstraZeneca has conducted a comprehensive study called “IMPACT CKD” that provides a 10-year forecast on the impact of chronic kidney disease (CKD) across clinical, economic, societal, and environmental dimensions.234 The key findings from the IMPACT CKD study include:

• The study projects that by 2032, up to 16.5% of the population in 8 countries (US, Brazil, UK, Spain, Germany, Netherlands, China, Australia) could suffer from CKD, with a staggering 59.3% rise in advanced-stage cases.23
• The number of people with advanced CKD in these countries is expected to reach nearly 125 million by 2032, a 25% increase from 2022.23
• The economic burden of renal replacement therapy, including dialysis and transplants, is forecast to exceed $186 billion.23
• Dialysis requirements are projected to surge by over 75%, significantly contributing to the healthcare sector’s carbon footprint – equivalent to adding 17.3 million cars’ worth of CO2 emissions.2

The IMPACT CKD study is part of AstraZeneca’s “Accelerating Change Together (ACT) for CKD” initiative, which aims to improve understanding and outcomes of CKD globally. The findings underscore the urgent need for proactive measures to address the growing CKD burden through earlier diagnosis, optimized treatment, and effective policy reforms.24

What can readers of this blog do about this in their own back yard? If you or yours has diabetes hypertension or both have your kidneys checked out annually as part of your annual physical. A simple blood test produces eGFR which is the gold standard (It’s what the US VA looks at and only this) for the status of one’s kidneys. Do it.

Late Tuesday afternoon I was working with a high school senior that we have hired to help us with out 15+ flower beds. He was unloading mulch from our BMW X5 and I was walking from the garage toward him where he was parked in the driveway unloading. My feet lost purchase in mulch that had eased onto the driveway and I fell full frontal forward, scraping a raised sprinkler head on the way down. I ended up with a large scrape across my chest, where my catheter hangs and my stomach access lies, and a huge bruise on my forearm where I landed with all my weight on it. See the lead photo of my arm.

I have been feeling better and better since my last prescription change, and am not prone to falling per se. While this MAY BE an outlier, it is still worth considering what research into the following question offers: “Are patients on PD more prone to falling?” This is what Poe had to say about this topic:

The impact of PD on the risk of falling depends on several factors, including the patient’s overall health, age, comorbidities, and any existing mobility issues.

While there is no direct causal relationship between PD and an increased risk of falling, certain factors associated with PD may contribute to a higher risk. For example:

Fluid and electrolyte imbalances: PD can affect fluid and electrolyte levels in the body, potentially leading to dizziness, weakness, or changes in blood pressure that may increase the risk of falling.

Muscle weakness: If a person on PD experiences muscle wasting or weakness, their balance and coordination could be compromised, potentially increasing the risk of falling.

Underlying health conditions: Many individuals who require PD have underlying health conditions that can impact their mobility and balance, such as diabetes, peripheral neuropathy, or musculoskeletal disorders. These conditions can increase the risk of falling.

Of the possibilities above, I am to a degree suffering from muscle weakness due to dialysis, and also have been diagnosed as having peripheral neuropathy as a result of being a diabetic. I am receiving VA Disability for the latter in both legs. So I suggest readers on PD take this as a warning and lesson learned; out of the blue, so to speak, you may fall through no fault of your own. How to preclude the occurrence is beyond my skill set.

In yesterday’s blog, I wrote about the central position urine has in the calculation of Kt/V, the output of the PD Adequacy Test that informs us as to how well our dialysis is working. Let’s face it, kidneys are about manufacturing urine in our bodies and the eventual discharge of same, whether male or female. Being on dialysis is a result of our kidney’s failure to produce a “normal” amount of urine, that is, to remove waste products from our bodies.

https://www.unilad.com/news/health/peeing-sitting-down-as-a-man-better-806567-20240415Getting the urine out of our bodies is pretty elementary; in general, men in the US are taught and expected to stand up while urinating and by and large, but not in all cultures, women sit while urinating. In an article in UNILAD titled “Doctor claims men in the US are peeing incorrectly and reveals why,” Poppy Bilderberg on April 15, 2024, wrote “…the sitting position is ‘probably the most efficient way’ to properly empty your bladder.” (Link)

So for the men reading this blog, you now must revise centuries of ingrained peeing posture and just sit down when you pee. Good luck with that!