At haemodialysis - very tied up!

Tied up.

This is me tied up at haemodialysis. Needles in one arm, other arm in a cast and with blood pressure cuff on. For four and a half hours. Stopping my bleeding at the end of my session takes extra time (today around 1 hour!).

I'm still able to use a couple of fingers to drive my laptop and to keep me from being bored out of my mind. It is slow going though.

Many dialysis patients go for the 'Michael Jackson' one glove look, our hands/arms get irritatingly cold. When you are tethered to the machine with your blood circulating through the system, it gets very very cold.

Haemodialysis units need to be cool for infection control reasons.

Purple cast!

I had my wrist re-plastered yesterday. I was able to choose the colour. I went for purple. Looking very bright indeed!

Good news from the fracture clinic, I won't need surgery. I go back for a reassessment and cast change next week. I'd love to go multi colour, but that would be wasting materials.

I broke two bones in my wrist, the radius and ulna.

More info about modern day casts over at https://en.wikipedia.org/wiki/Orthopedic_cast

Broken wrist! Ouch!

Broken right wrist.
Ouch!

Last night I tripped outside in the dark and broke my wrist in two places. Lucky my fistula arm was okay, it was my right wrist.

So now I can't drive among other things (no dialysis machine set up or needling myself. This slows down my home haemodialysis training somewhat. Being a broken bone on a dialysis/renal patient, my arm will probably take longer to heal. I may even need an operation depending on how things heal. I'll find out more next week.

Big shout out to the Western General Footscray emergency department doctors, nurses and radiologists, they were great! Many thanks for making a very painful visit more comfortable. Big thanks to Greg and Danny who played a big part in keeping me calm.

Pedal power at Dialysis

I was reading on the Big D and me blog that exercising at dialysis by using a portable foot pedal exercise bike can improve dialysis treatment outcomes. See https://bigdandme.blog/2009/08/07/riding-an-exercise-bike-on-dialysis/ and https://bigdandme.blog/2009/10/02/riding-an-exercise-bike-dialysis-part-2/.

I'm very interested in how it can increase the removal of phosphate. I just seem to have too many dairy drinks and foods.

I wanted to find some other references that were more of a scientific nature. I found: 

- Time and exercise improve phosphate removal in hemodialysis patients.

Presented in part at the Australian and New Zealand Society of Nephrology Annual Scientific Meeting, Perth, Australia, September 1–3, 2003.

You can see the summary, but need a login to view the full article. See http://www.ajkd.org/article/S0272-6386(03)01221-6/pdf -

- A structured exercise programme during haemodialysis for patients with chronic kidney disease: clinical benefit and long-term adherence. 27th August 2015. See: http://bmjopen.bmj.com/content/5/8/e008709

- Aerobic exercise increases phosphate removal during hemodialysis: A controlled trial. January 2014. See
https://www.researchgate.net/publication/259805418_Aerobic_exercise_increases_phosphate_removal_during_hemodialysis_A_controlled_trial
 

- Intradialytic exercise improves physical function and reduces intradialytic hypotension and depression in hemodialysis patients. August 2017. See https://www.researchgate.net/publication/319299252_Intradialytic_exercise_improves_physical_function_and_reduces_intradialytic_hypotension_and_depression_in_hemodialysis_patients 

It would seem that this is good for you and can improve health outcomes. Turns out my unit has one cycling unit that can be attached to a dialysis chair. It is used for restless legs. I was going to look into purchasing one but will give this a go first. The one in our unit does not record anything (eg time, kms, etc), I'd probably prefer one that keeps track of things. If it works out well, I'll look at purchasing one (or trying for a donation).

Having measurements might be good encouragement for some. I've been reading on the Big D and me blog how another centre (in the US) use a bike pedal machine to run a race around Idaho. See news article here: http://tdn.com/news/local/dialysis-patients-improve-energy-treatment-through-cycling/article_90a03ce2-1aa0-11df-ac61-001cc4c03286.html (from Feb 15 2010)

I'll post some updates on this topic in a little while.

So this is haemodialysis, I'm doing it three days a week (warning: needles and blood)

This post is mainly for my family, but also for others who are interested in what my haemodialysis treatments involve. If you don't like the site of needles or blood, best not to watch the videos.

I'm kind of training for home haemodialysis at the moment. I can set up the machine and I have needled (1) myself. I couldn't do much more than that as my fistula needed some repairs. You've seen a picture of my recently operated on fistula. It usually looks better than that, I'll post another picture soon.

Here is a video of the set up of a fresenius 5008 dialysis machine. We use these at my centre. I will use a variation of this unit when I do the home training. This video is very long (15 or so mins): https://www.youtube.com/watch?v=6DM-3v0jYd4

The next video is of a nurse cannulating and connecting a patient to the dialysis machine. It's a life support machine, without it, I'd eventually stop working altogether.

When I go home, we will use needles that have quite long lines for connecting and disconnecting from the machine. The long lines also makes it easier to pull the needles out at the end.  Pulling the needles out is usually performed with the hand that has the fistula in it. The other hand needs to apply pressure over the needle site to stop the bleeding (for me that can sometimes take a very long time!).  This video goes for 8 or so minutes and involves needles and blood. Don't watch if you get queasy. https://www.youtube.com/watch?v=Z_ZcDE-PTgI

I currently do this three days a week. I'm on the machine for 4.5 hours, most people in Australia do 5 hours three days a week. People that do less are people who don't weigh much. When on home haemodialysis I can spend more time on the machine. This will result in better dialysis and clearances of toxins. It also means that to some extent you have fewer dietary restrictions. The longer you can stay hooked up the better your overall health will be.

I spend around 20-60 mins driving into dialysis and home after. There is the time to set the machine up. There is also the time it takes to connect and disconnect me and the machine. I've mentioned my bleeding time records.

I still have bad bleeding days even when my fistula is working great. Usually the reason is because my INR is too high (blood thinning indicator). Info about INR at wikipedia here: https://en.wikipedia.org/wiki/Prothrombin_time#International_normalized_ratio

Powerful Owl Social Media Campaign - The Guardian Australia's Bird of the Year 2017

The Guardian's bird of the year competition 2017 is an opportunity to highlight the plight of the Powerful owl. 

With the recent news about automated voting for the Powerful owl, I'm guessing there was a bit of hactivism going on by people who really care about this bird. 

Ref: https://www.theguardian.com/environment/ng-interactive/2017/nov/20/australian-bird-of-the-year-2017-vote-for-your-favourite (see info right at the end).
   

Powerful owl picture sourced from http://www.eastgippsland.net.au/gallery/birds-of-east-gippsland

What can we do with a 6 day social media campaign?    

The ibis, aka the bin chook, will get another opportunity to star in this Australian bird competition (should it be annual). It eats rubbish out of bins and drinks bin juice. The Powerful owl is losing it's home through land clearing.

The Powerful owl is on the IUCN Red List of Threatened Species, although it is marked as of 'least concern." Ref: https://en.wikipedia.org/wiki/IUCN_Red_List#2012_release and http://www.iucnredlist.org/ 

Such a powerful bird with super instincts it is able to relocate to other areas.  While they will probably survive, do we really want to force them to move and adapt their ways? This is already being seen now by me* and others, that is why it is important to do something now to save their habitat from greater loss.
 

Save the Powerful owl by voting for it and spreading the word. Raise public awareness around native animal habitat loss due to the clearing of our bio diverse forests.

Please no more automated voting, turn this into a social media campaign.

Spread the wise word.  

Voting is open until the 9th of December. One vote per real person.

Link to 'The Guardian' 2017 bird of the year vote:  https://www.theguardian.com/environment/ng-interactive/2017/nov/20/australian-bird-of-the-year-2017-vote-for-your-favourite

Wikipedia info about the Powerful owl at https://en.wikipedia.org/wiki/Powerful_owl 

 

* My partner found an interesting large feather, my 3 year old nephew asked if it was a 'zebra feather?' We looked for pictures of the feather online and found that it might be a Powerful owl feather. What do you think?