I didn’t take many pictures the first time round on dialysis, I don’t know why. Although I blogged about all my health issues, I didn’t like people to actually see me on dialysis. There are only two pictures the one above and the one below. This time round I intend to blog all the way and I will take more pictures – I won’t be ashamed of dialysis.
For those of you who have never seen a dialysis machine here is the one I used to be attached to for 3 hours, 3 times a week for 3 and a half years.
So what have I got to look forward to when it comes to needing the dialysis, well there is the lovely Renal diet which consists of low phosphate, low potassium, low salt, as well as a strict fluid restriction (this was 500mls a day last time). On arrival to the dialysis unit (which has been rebuilt since the last time and is more light, airy and modern) I will have to weight myself. As well as cleaning the blood the dialysis machine also removes excess fluid, the amount of fluid removed depends on your dry weight. A dry weight is your weight without any excess fluid. (1 kilogram = 1 litre of fluid) So if my weight difference is 2kg I would have to remove 2 litres of fluid and an extra 500mls of washback (that is saline used to wash the blood back after dialysis) so my total fluid removal would be 2500mls. This part of the process is called ultrafiltration and the amount will vary from session to session.
Heamodialysis will consist of me having two needles (quite big ones) inserted into fistula in my arm (they will either reform my old one or create a new one during a surgical procedure where they join an artery and a vein). They are a bit painful when they are inserted but during the dialysis session you can’t feel a thing.
I have to keep my arm very still during the dialysis session to ensure the needles stay in the right place. If you want to see how a fistula is made and used click here, it probably explains it better than me.
This provides access to the bloodstream for haemodialysis. The fistula will buzz (or thrill) all the time which is a good thing as this means the blood is flowing through it freely. One needle is to carry blood out of my arm and the other to carry blood back to me after it has been cleaned.
So as well as removing fluid like I’ve already talked about, the machine’s main job is to remove toxins from my blood by cleaning it. While in the filtering system the blood flows through tubes made of a membrane that allows the waste products (which are much smaller than blood cells) to pass out through it. The waste products pass through the membrane into a dialysis solution (dialysate), then out of the machine. The “clean” blood is carried on through and returned safely to the body.
This happens over and over again throughout the dialysis session. Each time the “clean” blood is returned to the body, it picks up more waste products from the cells it circulates through, and brings these newly-collected toxins back to the dialyser (or artificial kidney – which is the white tube with the blue top and bottom on the picture) to be removed.
Fresh dialysate is passed through continuously to make the rate of the cleaning process as fast as possible.
The information it shows on the screen is the amount of fluid that is removed up until that point, the time left on the machine, the amount of fluid that will be taken off by the end of the session and the rate it is being taken off (how much each hour) It also tells you how much blood is flowing through the machine at that moment, and how much blood has been cleaned altogether which could be over 50litres!!!
The grey round things are the pumps that spin and push the blood round, this can go at different speeds depending on the strength of your fistula and other factors. The higher the pump speed the better the dialysis and the better my clearance which is how well I am dialyzing. The machine also shows the pressure of the blood going into the fistula by using a lights system, if the pressure gets too high or low the machine will beep. At the end of the dialysis session, the blood that is left in the tubes is washed back using saline.
So basically that’s dialysis in a nutshell. The main question I get asked is do you feel anything and does it hurt, the needles hurt a tiny bit going in but that’s it, you don’t feel a thing whilst dialysing, you don’t feel the blood going in or out. You just sit back and let the machine do all the work… after all it will be keeping me alive.