May 11 2010
Who Administers Hemodialysis?
In general, hemodialysis is performed in a dialysis center by technicians trained in the care of patients who are supervised by nurses. Medicare pays three hemodialysis treatments per week. If you choose to undergo treatment at a center, it will be for a fixed schedule, three times a week, on Mondays, Wednesdays and Fridays or Tuesdays, Thursdays and Saturdays. If you get the schedule of your choice, you may request to be put on a waiting list for a schedule of your choice. In special cases, you may exchange your time with someone else. You will need to plan well your dialysis program if you work or have children to care. Some centers provide dialysis treatments during the night in the middle. This treatment is done over a longer period at night, while sleeping in the middle. This type of dialysis reduces the limitations on food and fluid intake, and also it provides more time during the day to work, care for their children and do hobbies and other activities.
You can choose to learn to make their own hemodialysis treatments at home. When you are the only patient, it may become more frequent dialysis treatments or lasting almost replaced the normal work performed by healthy kidneys. Daytime hemodialysis at home (DHHD for short in English) is performed 5-7 days a week for 2 to 3 hours per session and you organize the schedule. If your health insurance plan would pay more than three treatments, you could be brief treatments during the morning or afternoon. Nocturnal home hemodialysis (NHHD by its acronym in English) is done in 3-6 nights a week while you sleep. Whether you choose the DHHD or NHHD, this will allow food and a normal fluid intake, with fewer blood pressure medications and other health problems. Most programs ask patients to do home hemodialysis have a skilled attendant during treatments. Learning to be hemodialysis is like learning to drive a car: it takes a few weeks and, initially, is alarming but then becomes a routine. The dialysis center provides the equipment and training, and assistance by phone 24 hours if you have any questions or problems. New machines for home dialysis are smaller and easier to use than the equipment used in schools.
You have options of dialysis centers and many cities have more than one site to choose from. You can visit a center to see if there are treatments you want or the time it needs. Some centers allow the use of laptops or cell phones or receive visits, others not. Medicare has a list of all centers in the United States on its Web site at www.medicare.gov / dialysis (in English), which shows the quality ratings of each school. Your health plan may have a list of sites where you can go. If you choose a treatment option in a school, it must be near your home to reduce your travel time. If the treatment is done at home, once you are trained, you should only go to the center once a month. So, the center can be as far as you want to travel once a month.
Possible Complications of Dialysis
Vascular access problems are the most common reason for hospitalization among people receiving hemodialysis. Some common problems include infection, blockage by clotting and poor circulation. These problems may prevent their treatments to succeed. You might have to undergo repeated surgeries to achieve a properly functioning access.
Other problems may be caused by rapid changes in water and chemical balance of your body during treatment. Muscle cramps and hypotension (a sudden drop in blood pressure) are two common side effects. Hypotension can make you feel weak, dizzy or sick to your stomach.
Probably need a few months to adjust to hemodialysis. Side effects can often be dealt with swiftly and easily, so you should inform your doctor and dialysis staff suffered any side effects. You can avoid many side effects if you follow a proper diet, limiting fluid intake and taking medications as directed.