The words cause great worry: “Your kidneys are failing, you must go on dialysis.” At first, it seems a cruel sentence. Dialysis means a machine takes over, and you will be tied to it three to five times a week or more for the rest of your life.
That’s how I felt when I learned the news. Thirteen years later, I’m still alive, thanks to that machine, the people behind it and my family and friends.
My best advice came from my doctor, P. Suresh Nuchikat, director of dialysis at Aultman Hospital. His mother died of kidney disease.
“It’s a lot like a second job, an important one,” he said.
Dialysis will affect every aspect of your life, from eating the strict diet to planning your life around the unending treatments. Your relationships will change. Your reward is life beyond the machine, which eventually becomes your best friend.
The dialysis clinic is the last stop for many suffering End Stage Renal Disease. This and their other diseases are the reason behind the high mortality of dialysis patients. More than 90 percent of those who started dialysis with me are gone.
ATTITUDE IS EVERYTHING
I soon found that attitude is about 80 percent of the process. Some people give up, skip treatments and die within a week or so. Others accept Dr. Nuchikat’s second job, because it is.
You must learn about it. I found this and adjusting my life takes away fear. You learn to cope with it no matter what. (There are no holidays, no snow days.) That’s the personal choice for all who face it.
I tell new patients that dialysis seems abusive. In one session, your blood flows 65 times or more through a filter in the machine. Needles are inserted into your fistula, the surgical connection of two blood vessels, usually in your arm. The average treatment is about three hours.
We arrive at the center with blood filled with water and toxins which would have been filtered by our kidneys. The early devices basically were guesswork. A patient had to be weighed during treatments to see how much liquid had been removed.
The new machines are electronic and monitor everything automatically.
The experience is surprising. You’d figure there would be some pain as your blood courses from your access to the machine and back again. There isn’t, and many patients sleep or watch TV.
When I got out of the chair after my first treatment, I passed out cold. That’s common, called “crashing.” Your blood pressure is too low and you took too much weight off.
The nurses caught me and soon brought me back. They said a lot of new patients do this. Your blood volume decreases when you remove fluid from it. That lowers your blood pressure, and that lowers the amount of oxygen reaching your brain. The key to dialysis is finding the right amount of fluid to remove without crashing.
On routine days, I had about a half-hour to drive home. Then my body went into a form of mild shock with the cleansed condition of my blood. I headed for bed, slept three hours and was fine for the rest of the day.
A big change happened four years ago when Aultman started blood dialysis with a NxStage home machine. I do five treatments instead of three, and that’s a lot easier on my body. It smoothes out the peaks and valleys as my body shifts from a highly toxic condition to temporarily clean.
The only bad part was leaving the center. The crew and the patients at Aultman became my family. I missed them, and still do. Such is the price of progress.
PROGRESS
Your kidneys are one of the few organs that can fail and be replaced by a machine. Aultman Hospital’s dialysis unit began operations in 1989. Since then, 28 other centers have opened at area hospitals and free-standing clinics.
Dr. Nuchikat is Aultman’s first and only dialysis director. Since he began, the hospital has more than doubled its dialysis capacity.
“Stark County is seeing increases just like other areas are,” he said. People living longer is part of it, but he blames the increase on lifestyles, mainly obesity.
Dr. Arup Maitra, Dr. Nuchikat’s associate, sees no slowing down in the dialysis trend, “increasing 6 to 8 percent a year. Diabetes is driving it. It must be brought under control,” he said.
He and Dr. Nuchikat are seeing younger dialysis patients. “It takes about 10 to 15 years of diabetes before needing dialysis,” Dr. Maitra said.
The treatment’s cost, about $1,500 a week, is paid 80 percent by Medicare (for all ages) and 100 percent for those on Medicaid. Private insurance and personal savings make up the rest.
“Kidney transplants are not relieving the problem,” Dr. Maitra said. “There are just not enough organs available. And then, patients must take very expensive drugs for the rest of their lives. After three years, Medicare does not pay for them.”
More than 80 percent of dialysis patients are diabetics. In my case, I had kidney cancer three times. Mary Lou Hiles, 80, suddenly lost control of her kidneys and immediately went on dialysis. She is not a diabetic.
“When I first started, I didn’t want to do it. Then I found the wonderful people here. I’m doing well now. I love the nurses,’ she said.
Mary Lou is back to her favorite hobby, cooking for others. She caters holiday food events at the center for the staff, patients and families — “payback time.”
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