September 23, 2024 • 37 mins
Welcome to the Diary of a Kidney Warrior Podcast, in partnership with Kidney Care UK. Hosted by Dee Moore, this episode aims to encourage, educate, and inspire listeners by exploring all aspects of kidney disease, related chronic illnesses and health.
In today's episode, Host Dee Moore speaks with Dialysis Nurse Alain Tria.
Alain shares invaluable tips and advice for Haemodialysis patients, whether you are new to the treatment or have been a Haemodialysis patient for some time. Learn about the importance of being an active part of your care, managing fluid restrictions, following a renal diet and staying active.
Alain also offers practical tips such as wearing loose clothing, avoiding heavy lifting with your fistula or graft arm and monitoring for signs of infection.
In addition to these insights, Alain provides a glimpse into his journey of becoming a Dialysis Nurse and the fulfilment he finds in his work. He emphasises the importance of not letting dialysis rule your life and encourages patients to find joy and normalcy despite their treatment schedules.
Whether you're a patient, a healthcare professional, or someone interested in learning more about haemodialysis, this episode is packed with valuable information and heartfelt encouragement. Tune in for an enlightening and supportive discussion.
Don't forget to subscribe to Diary of a Kidney Warrior podcast for more inspiring Interviews with Health Professionals.
Disclaimer
This podcast episode is not for the purpose of giving Medical advice. Consult your Consultant and medical team for specific medical advice. The information shared during this podcast episode is for educational purposes only.
Previous Diary of a Kidney Warrior Podcast Episodes referenced during this episode:
Episode 63: Holidays & Dialysis: The Freedom to Travel
Podbean
https://www.podbean.com/ew/pb-jgazw-1265619
Apple Podcasts
https://podcasts.apple.com/gb/podcast/diary-of-a-kidney-warrior-podcast/id1529196456?i=1000568698977
Spotify
https://open.spotify.com/episode/1uKHnns4PHS340I4o75eBL?si=KZ_pt_snTUKUd4ofvRvgeg
YouTube
Episode 72: Innovation in Fistula Options for Dialysis Patients
Podbean
https://www.podbean.com/ew/pb-84jiq-1308549
Apple Podcasts
https://podcasts.apple.com/gb/podcast/diary-of-a-kidney-warrior-podcast/id1529196456?i=1000585299468
Spotify
https://open.spotify.com/episode/5oOVmbhaR6Kztkt3YVEe6e?si=fvV4jhU-Si2Ufhxi90uXsw
YouTube
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:00):
5, 4, 3, 2, 1.
Let's go. Diary of a Kidney Warrior podcast in partnership with Kidney Care UK.
Sharing faith, knowledge, hope and love.
Hi and welcome to Diary of a Kidney Warrior podcast.
(00:20):
My name is Dee Moore and I am a kidney warrior. This podcast is dedicated to
encourage, educate and inspire as we explore all aspects of kidney disease,
related chronic illnesses and health.
If you have any questions or ideas for topics you would like me to cover,
please get in contact with me on social media using the handle Diary of a Kidney Warrior.
(00:45):
My guest today from Birmingham, England is dialysis nurse Alan Trier.
Alan joins me today to share tips and advice for hemodialysis.
Hi, and welcome to Diary of a Kidney Warrior podcast. How are you doing today, Alan?
Hi, I'm doing well. And you? You're all right? I'm good.
(01:08):
I'm good. I'm really excited about today's podcast because today we're going
to do something a little bit different than what we normally do with health
professional interviews, because normally,
because I'm the type of person that kind of likes to get to the point very quickly.
But sometimes I think actually we're losing a bit of information about the person behind the interview.
(01:30):
So we're actually going to do a bit of a spotlight on you, Alan,
as well as covering the topic of today.
And today's topic is tips and advice for hemodialysis, a nurse's Perspective.
I really like that title. I really do.
And I'm really excited to be discussing this with you, but also getting to know you, Alan.
(01:55):
Yes, it's a pleasure to be here.
So before we get into the spotlight on you, because we're going to be talking about,
hemodialysis today, I always like to start with a definition just to make it
clear for anyone listening because we're going to be talking about hemodialysis.
(02:16):
People might be thinking, what is hemodialysis? So I think we're going to start
with the definition and then the spotlight on yourself and then the tips and advice.
So my first question is, what is hemodialysis?
So for me, the simplest description of hemodialysis is it's the process of removing
(02:40):
or filtering out the waste or the toxins from the blood using an external machine
called the dialysis machine.
So that's the simplest explanation. If I may expound on that,
what happened is when a patient comes in to the clinic and they have their dialysis session, So,
they will be sit in a chair and then they will be connected on the machine through
(03:03):
their vascular access that it could be a fistula, a graft, or a central venous catheter.
And then we connect them through the vascular access to the machine and then
their blood goes to the machine through the dialyzer, which acts as a kidney,
this dialyzer. It's the filter.
It takes away the waste or the toxins from the blood and then there's another
(03:26):
tube that will return this clean blood going back to the patient.
So that's what really happens inside the dialysis clinic. Hopefully,
yeah, this will make it easier for the listener to see what's really going on
inside the dialysis clinic.
Yeah, I think that generally when people think of dialysis, they think of hemodialysis
(03:48):
and they picture somebody sat next to a machine and everything whirling around.
And in simple layman's terms, hemodialysis, when I think of it,
it's the take your blood out, clean it and put it back in.
I mean, would you agree that that's like the simplest way of explaining it? The simplest analogy.
Yeah, I agree. Yeah. And there were a couple of terms there that Alan used that
(04:12):
for anyone who wants more detail about it was covered in episode 72,
innovation in fistula options for dialysis patients, where we go in depth about
the different fistula options, also what a graft is, et cetera, et cetera.
So for anybody that wants information about the different vascular access,
(04:32):
check out episode 72 of Diary of a Kidney Warrior podcast.
Right. So now that we've explained the basics of what hemodialysis is,
and we appreciate it is way more complicated than that, but we're just kind
of breaking it down as simply as possible.
I want to go into a little bit of a spotlight on yourself, Alan,
(04:54):
to get to know you, and then we'll go into the advice and tips.
So So my first spotlight question, this is the first spotlight question I've ever asked.
So this is a first on Diary of a Kidney Warrior podcast. Here we go.
How did you become a dialysis nurse and why?
Just to give a quick backstory, the first ever time that I was exposed with
(05:18):
kidney disease was when I was a student nurse.
And because for one month I was assigned in a renal ward, so that was the first
ever I was seeing a renal patient for the first time I was still a student.
And then moving a bit forward, fast forward, when I became a nurse,
a registered nurse, I was working as an occupational health for almost five years.
(05:43):
And then during that time, I was doing several external training,
you know, just to gain more knowledge.
And one of the trainings that I did was hemodialysis.
And so for one month, I was in a dialysis clinic.
And at the the time, all I saw was a fistula patient, a patient with a fistula.
(06:04):
And also, that was the first time I'd seen a hemodialysis machine in my life.
Fast forward, you know, the current times, here in the UK, when I got my pin
to practice as a nurse, I was looking for job opportunities.
And one of the job that I saw was looking for a dialysis nurse.
So I was thinking, oh, oh, I think I could do this.
(06:28):
So I applied, and luckily, the company responded to my application the following day.
And I did the interview. Everything went so smoothly. And then that's it, really.
And then I become a dialysis nurse.
And I can remember during my first few weeks, it's a bit overwhelming to see this machine.
(06:52):
And I was afraid of committing mistakes, you know, what to press,
and how to do this and that.
But I had a good mentor to train me for 12 weeks. Now it's over two years now
that I've been doing this.
So I'm very confident now with what I'm doing.
So in many ways, hemodialysis, being a dialysis nurse, came to you, really.
(07:15):
It was like it started with the placement that you had.
So the seed was planted there and then the advert popped up and you were like,
yeah, I'm going to go for it. Yeah, that's really it, really.
So looking back, it could be destiny, perhaps you could say that.
Yeah, absolutely. Sounds like it. Yes. Yeah, now I enjoy being a dialysis nurse.
(07:36):
It's really fulfilling job yeah so
what do you like most about your job oh that's a
great question i will say two things it's not just one i would say the thing
that i like the most first of all is it's an outpatient setting so what does
it mean patient just come and go because as a nurse i I didn't really see myself working in a ward.
(08:01):
So I like this kind of setting.
And the second one is somewhat related to my first answer.
Because patients come to the clinic three times a week, you get to know them better.
Because you see them three times a week, so you build this special bond,
this nurse-patient bond, which also develops into trust.
(08:23):
Us because this kind of work, it's a bit routine, but things become easier when
the patient trusts you, when you're doing the treatment on them.
So this is the two things that really I like the most about being a dialysis nurse.
So it's like you're being a friend or somewhat family, you know?
So it's not like, oh, I'm going to work, but it's like, oh, I will see this, I will see her.
(08:48):
So these two things really what makes it pleasurable to work as a dialysis nurse.
It really is wonderful to hear how passionate you are about your job and just
seeing that smile on your face when you're talking about your job.
I genuinely love when I see health professionals that are passionate about what they do.
Shout out to all the passionate health professionals out there that are listening
(09:11):
to the podcast. We salute you.
So let's move on now to the tips and advice part of the interview,
because in the time that you've been a dialysis nurse,
you've met so many different patients, you've worked with different health professionals
and nurses and your mentor.
So I'm sure there's loads of tips and advice that you have that can help not
(09:36):
only people who are listening to this, who are about to start hemodialysis,
but also people that have been a hemodialysis patient for some time.
And And maybe there's something that you could say to them that they're like,
oh, I didn't know that. That would be really, really helpful.
I do have to start with a disclaimer that we are not giving medical advice during this interview.
(10:01):
Consult your consultant, your medical team for specific medical advice.
What we're giving here is for educational purposes only.
So, yeah, I'm going to hand over to you with the first tip.
So what is your first tip or piece of advice for either someone who's just started
hemodialysis or is on hemodialysis that will help them navigate this journey?
(10:27):
Okay, so I think I will start with an advice first before I tackle the practical
tip. So, my first advice would be for the patient to be an active part of the treatment team.
Because if you're a newly patient diagnosed with kidney problems,
I highly encourage you to ask questions. What's the cause of the problem?
(10:49):
What can be done? What treatment is available?
Because by being an active part of the treatment plan, your anxiety fear will
disappear because you know what's going to happen.
And then secondly, this is very important to dialysis patients,
is with their fluid restriction.
(11:10):
My advice is really follow the
prescribed fluid restriction by your nephrologist or the renal dietician.
So for somebody listening who's new to all of this, I'll always try and explain
jargon as it pops up, just for anyone listening who doesn't understand.
So you mentioned the term fluid restriction. So for anyone who doesn't know
(11:32):
what a fluid restriction is, what is a fluid restriction?
So fluid restriction, by the term restriction, basically you limit the amount
of fluid you intake per day.
In most patients that I've seen, it's one litre a day.
Because your kidney is not anymore functioning as it used to be,
and you're drinking lots of fluid, so it tends to accumulate inside your body
(11:58):
because you're not peeing anymore.
So this fluid is accumulating inside your body.
So that's why the doctor will always tell you to restrict it to one liter, for example, a day.
Yes, I'm very familiar with that because I have my own fluid restriction.
So yeah, it is important. I can
vouch a thousand percent to stick
(12:21):
to your fluid restriction because yes what is
the consequence if you don't stick to your fluid restriction what will happen
if you get overloaded with fluid then you will have shortness of breath yeah
so you will feel really generally unwell so it could be life-threatening if
you're not disciplined enough to follow the restriction.
(12:43):
Right so we are having a light-hearted discussion
but at the end of the day there are serious implications
of not following the fluid restriction so
yes be an active part of your care and yes fluid restrictions make sure you
stick to it yeah so the third one will be somewhat related to the fluid restriction
(13:04):
it will be the following the diet that your renal dietician has prescribed sky
view because other than the fluid restriction,
the other important bit is your potassium level that we always check.
So because if you're not within the normal range, too low or too high is also
(13:24):
a serious effect or implication to your health.
So following the renal diet is also very important.
And for anyone looking for recipes or tips about what is safe to eat as a kidney patient,
Kidney Care UK's Kidney Kitchen has lots of recipes and recommendations by renal
(13:46):
dieticians. So do check it out.
So my fourth advice would be to stay active because even if you're a dialysis
patient, you can still do some exercise. Of course, there's a limit what you could do.
So you could always ask your doctor if you're not aware of what exercise you
could do, but you can still do exercise.
(14:08):
So staying active will also promote well-being and also doing exercise also
helps your mental health.
And there's also the benefit of helping with blood pressure as well by doing exercise.
Am I right in saying that? Yes. So yeah, it will also help with your cardiovascular health.
(14:28):
Then my fifth advice will be make the most of your dialysis time.
So what do I mean by that? Because normally, or most patients do four-hour session each time.
Because four hours is really a long time, which I can totally understand.
We have some patients who are still working, actively working.
(14:48):
So what they do, they bring their laptop and they do their reports while having dialysis.
We also have a very young patient who's still in university.
So she brings in her assignment and she does it while having dialysis.
So that's one of the example of making most of your time while having the dialysis session.
(15:09):
I can remember this student, one of her assignment was to interview some healthcare professional.
Professional and so she was able to do that easily you
know asking nurses you know so you could
also read and do you could listen to radio or watch telly because each chair
has their own telly so yeah you can also listen to diary of a kidney mario podcast
(15:33):
while you're having dialysis that's also a good way oh yes obviously yeah that's really good yeah,
That's coming from me, you know, an avid fan of your podcast. Oh, thank you. Yeah.
Okay. And then my sixth advice will be don't let the dialysis rule your life.
(15:55):
So what do I mean of this is because I know it can be a bit limiting.
You know, you feel in trouble because you have to come to the dialysis center
three times a week for four hours each time.
So I know it's a lot to take in. But you can still go on holiday.
I can remember one patient, I told him, you haven't been on holiday for many
(16:16):
years. Don't let it stop you from going on holiday.
Because there is this holiday dialysis that we call.
Of course, the only thing is you just have to plan in advance.
If you want to go on holiday, just plan it in advance.
And you can still do these things. And visiting
new places that you've never been before will also
help your well-being and also your mental health
(16:39):
so you don't feel like you're in trouble you cannot
do this you cannot do that but you can still have like a
normal life okay with limitation though
yeah i can understand that but don't let
it rule your life there's life around dialysis that's
what i want to say i think it's really powerful what you said about not allowing
dialysis to ruin your life because whether it's somebody who's just been diagnosed
(17:04):
and they've just found out that they have to go into dialysis or whether it's
someone who's been on dialysis for many, many years,
sometimes you can not see the wood for the trees.
And to go on holiday and have time out, time away.
Is so important. I mean, I recently went away for a few days and I had such a good time.
(17:28):
It really was an opportunity to recharge my batteries and come back feeling so, so good.
And it is possible as a hemodialysis patient or a peritoneal dialysis patient
to go on holiday, whether it's the UK or abroad.
And for more information about that, check out episode 63, Holidays and Dialysis.
(17:51):
Freedom to travel so it is actually possible for anyone
that doesn't realize it is actually possible so yeah
a really really powerful statement that was yeah
because breaking the cycle because some people they
see it oh it's an endless cycle that i have to go to
the clinic today so i can also feel that it's like
psychologically burdened you know not just physically but they
(18:13):
need also to relax and refresh themselves and give
a clean slate again that okay i've been out i've
been traveling then now and so at least it's like a new
restart from time to time i totally agree
100 all right so now
i'll go for my practical tips for dialysis patient.
Okay i'm looking forward to this my first
(18:34):
practical tip will be for those patients who come to dialysis not
to wear very tight clothes if you're wearing
long sleeves make sure it easily can be
rolled up so that the nurse can easily access your
fistula or graft or if it is a central
venous catheter make sure that your shirt top can
easily be unbuttoned or unzipped so that
(18:55):
the nurse can easily access your line so yeah
i mean because some people they tend to forget wearing lots of clothes
or very tight so it's a bit challenge you
know to access their site that's a really really
good practical tip because for me myself i have
a line as everyone knows so i tend to wear
a vest when i'm going into dialysis but also
(19:17):
if you've seen the reel on my social media i
have a top that has poppers on it so they can actually
pop open the sleeves to access my arms
and things like that so yeah it's a very good practical tip loose clothing definitely
yeah loose clothing then my second one will be this most especially for patient
(19:39):
with tissue or graft that be mindful that don't carry any heavy.
Bags on your arm with the fistula.
Make sure you use the other arm because it's not good for your fistula,
your axis to be carrying that weight.
And also when you're at home and sleeping, don't lie on that side.
And my third tip would be during hot weather temperature.
(20:03):
Instead of taking more fluids, you can chew on ice chips. So it will help with your thirstiness.
So without drinking too much fluid. So that's my third practical tip.
And then my fourth practical tip, perhaps I'm not sure how practical this will
be, but it's very useful, is if you can keep a weighing scale at home,
(20:28):
because some people might, with relation again to the fluid restriction,
maybe they do the restriction by having a measuring glass so that they know
how much they are drinking.
But one ideal thing to do as well is to maintain a record of your weight because
when it comes to dialysis, every patient knows their dry weight.
And what is dry weight? This is your weight without the excess fluid.
(20:52):
With so if you know your dry weight and then
you've got a waist at home then you can also
monitor your weight you could say oh i'm
doing too much water and also those things
that you cannot measure easily like if you like eating food with lots of sauces
or if you like fruit and vegetable you know because these things also contain
(21:14):
water that's a really important one because Because you don't realize that when
you're eating these things, they contain water.
If you think of fruits that have a high water content and you're eating that,
that can easily be not included in your mind when you're thinking of your fluid restriction.
So, yeah, watch out for, I mean, they're beautiful to eat and kidney friendly.
(21:37):
But be aware of the water content.
Things like watermelon, things like that can add to your fluid restriction.
Yeah because without realizing it it all
adds up you know definitely can i
bolt onto that because you mentioned about a scale and i
think it's important to say also that bearing
in mind what you're wearing when you're weighing yourself because
(22:00):
when i first started hemodialysis i was
wearing quite heavy i didn't realize how heavy the
clothes were and that is going to be
factored in when they weigh you and they're looking at your
dry weight and your restrictions and all all the rest of it if you're
wearing super heavy clothes it's giving the
wrong impression of what your weight actually is so think
(22:20):
about lightweight clothes and then wear the
same clothes i have a uniform that i wear to dialysis so consistently wearing
the same clothes means that i've got consistency in terms of when i weigh myself
and bear that in mind when you wear yourself at home if you're weighing yourself
naked compared to weighing yourself when you've got clothes on,
(22:43):
And also bearing in mind that some scales do tell you the water content of your
body and some scales have a fat measuring thing.
So it's a good way of seeing what the difference is.
Which will help maintain your dry weight. So that's my practical tip. I hope that makes sense.
That's my practical tip to add on to what you've just said. Sorry to interrupt. Here we go.
(23:07):
Oh, no. And then my other tip would be for those people with fistula and graft,
I mean, some people, because they are afraid of, after they remove the dressing,
they're afraid of it getting wet, but you can actually wash it with water and salt.
And if you see a scar, don't scratch it, please. is.
And then for those people with the central venous catheter, we all know that
(23:30):
it's very susceptible with infection.
So we don't want it getting wet. So it's very difficult really to have a shower with it.
But my practical tip would be really, if you see that it got wet,
then make sure when you get back to your dialysis session, just tell the nurse
to change your dressing.
Because it's better to change your dressing than a bacteria getting into your exit site.
(23:53):
I keep telling my patient that
I don't mind changing your dressing even every session if it needs to.
Definitely better to be safe than sorry. So yeah, making sure you stay on top
of that dressing if you've got a line.
And then my other tip, it applies to fistula graft or with CBC line that always
check for signs of infection.
(24:15):
If it is one to touch, is it pain or if it is a line, If there's a green or
yellow drainage, just report it straight away to the nurse so that we can do something about it.
Because one thing is we always avoid infection or try to control it as quick as possible.
Because there's some patients that they don't say anything. And then once it's
(24:38):
really, that's the only time that they will say something. thing.
So only just a little hint that it could be a sign of infection,
like if you've got a fever, what I just said earlier.
So yeah, just tell everything to the nurse, and then we'll do the rest.
Another tip of mine, well, okay, it's actually just more like a reminder,
(24:59):
a reminder for patients with grafts or fistula that we cannot use your arm with
the fistula to take blood pressure.
Make sure that it's always on the other arm. Some people, they
tend to forget get that taking that patient they will have their
arm with the one with the fistula so that's just
a simple reminder because some people they tend to forget
and i think that's also a good reminder for people who have a line and they're
(25:24):
preparing to get a fistula the same applies not to use the arm that they're
going to use for the fistula and they do have bracelets that you can wear as
a reminder from kidney care uk so do check those out from the website site.
Can I add to my own practical tips as well? Yes.
As we're having this conversation, because as somebody that's recently started
(25:47):
hemodialysis this year, I definitely have some tips that I would like to share.
And the first one is bring a blanket because you can get really,
really cold while you're on hemodialysis.
So I always have a blanket with me. and I also have a little mini suitcase on wheels.
(26:08):
As strong as you may feel when you're going into hemodialysis,
you might feel quite drained afterwards.
So it definitely helps carrying your stuff might be quite difficult.
So if it's in the suitcase, you can just wheel that thing along and you don't
have to worry about carrying it.
And then it also addresses your tip about carrying
(26:29):
it on the arm yes you don't have
to carry it on the arm then your arms are completely free and
there's no pressure on your arm so it actually ties into one of
your tips so i'm happy about that good tips yes too thank you i mean i mean
when it comes here with the blanket most patients doing dialysis their main
complaints will be oh i feel cold you know can you turn on the heating because
(26:53):
Because their blood comes out and then goes back in.
So they're really prone to being cold.
They can feel cold quite easily.
So unfortunately, in the clinics, we don't really provide blankets.
So it's a good tip that you bring your own blanket.
It's also to prevent infection. So basically, you better bring your own.
Yeah, so that's a good one.
(27:13):
And another one that I've learned through doing as well is because my blood
pressure can be on the lower side, I'm prone to get really bad cramps when I'm on the machine.
So a tip that I have learned is there's a profile on the machine where the amount
of fluid you can actually adjust it over the time.
(27:34):
So the way I have it, it goes up and down over the course of the treatment.
And I have found that that has absolutely almost completely and completely reduced.
Taken away the severe cramps that I would get. So that's a hot tip.
And some people might start their hemodialysis session where they don't take
(27:57):
any fluid off for the first 30 minutes and then they kind of take the fluid
off steadily for the rest of the session.
But in my case, I'm alternating between higher and lower from the beginning
and it certainly has helped with the cramps.
So that's my My final practical tip.
Yeah, that's a good one. Because I remember a few patients, because they've
(28:20):
been dialysing for so many years, they also know what's best for them.
They will say, oh, nurse, do more now in the first two hours and do less on
the last two hours. So it works for them.
So like you, yours is up and down, up and down.
So yeah, we have this profile that you can choose how to pull fluid out of the
patient, patient how big or how small it is per hour, per minute,
(28:44):
or half an hour. So yeah, that's really a good tip.
That's a good call. And my final tip will be, because in our clinic,
we give teas to the patient.
And then some patients, they bring their own food and bring their own drink.
And my final tip is, if you will bring your own drink, make sure that it's not
(29:04):
too much, not like 500 mils or less is better. Because when we do the treatment,
we set the amount of fluid that we will take.
But if you're drinking more while you're on dialysis, after the dialysis session,
and then you weigh yourself post-treatment, you will see that,
oh, nothing has been reduced.
I'm finishing the same way as I came in. So my tip is don't also drink too much
(29:29):
fluid while you're having dialysis.
And I think that is a really, really, really important one to end on,
because while you're sat there and if you are busy and getting on with something,
you might not realize actually that you're drinking so much.
And then, and like you said, defeating the whole object of having the excess
(29:49):
fluid removed because you're just drinking it back on.
Yes. Is there like a general, I know that we're not giving medical advice during this interview.
But is there a standard amount of fluid that is recommended that's okay to drink
while you're having dialysis?
(30:09):
Well, for me, from what I have experienced is.
Maybe just like a glass will do. But more than that, I think it will be too much.
Yeah, it's defeating the object. Yeah. Because we had several patients who they
came in at X amount of weight and then they came out the same.
Because they didn't realize that they were drinking too much.
Right. So would a practical tip be bring in a specific bottle with lines on
(30:33):
it so you know exactly how much so you know not to drink more.
So if you've got your bottle, then don't drink the cup of tea on top of that
because that's also going to add.
So make sure it's either your cup of tea or a measured amount that you're bringing in to drink.
Yes, that's correct. Yeah.
We've covered some great tips and advice today for hemodialysis patients,
(30:58):
whether you're new to hemodialysis or have been on hemodialysis for some time.
I hope there's loads in there that will help you. we've looked at being an active
part of your care, fluid restrictions, following the diet by your dietician,
staying active, making the most of your time on dialysis.
Don't let dialysis ruin your life. Wear loose clothing, be mindful that you
(31:23):
don't carry heavy bags on your fistula or graft arm or lie on that side when
you're sleeping at night.
Using ice cubes as a way of helping with fluid restrictions,
keeping a weighing scale at home.
Don't scratch your fistula scabs. Don't get your line wet.
(31:44):
Always check for signs of infection on your line if you have a line and don't
out drink your fluid restriction and bearing in mind that if you drink whilst on the machine,
still stick to your fluid restrictions and also mine about the suitcase and
profile on the machine and blanket.
(32:06):
So, yeah, lots and lots and lots of great tips there.
So I'm asking a question that's a little bit different to what I would normally be ending with.
So I have two final last questions. And the first is, what advice can you give
to nurses who are aspiring to become a dialysis nurse someday?
(32:29):
My advice would be for those nurses who are aspiring to become a dialysis nurse someday,
day if you like a job that there's a
routine you know it's like more in general sense
dialysis nurse we do things in a pattern it's
a routine that we put on patient we take off patient if you
like that kind of job and also it's an
(32:50):
outpatient you know they just come and go so i
would suggest that you try become a dialysis
nurse and based on my own experience you
don't need a prior experience of applying
to become a diagnosis nurse there's a training you will
be mentored and trained for 12 weeks
and i can remember that it was overwhelming me at first but now i'm not afraid
(33:15):
and if you're not afraid of the blood seeing that's all your shift then go for
it yeah because some people even healthcare professionals they cannot take too
much blood But mentally,
it's too much to some people.
And also, if you don't mind middling or cannulating patient.
Then go for it. That will be my advice.
(33:36):
It's a very rewarding job. I can remember as well, because when patient eventually
got transplanted, sometimes they
leave us notes, you know, thanking us for looking after them really well.
It's very self-fulfilling. I mean, that's a kind of reward where nothing can
amount to if you have been appreciated by your patient.
(33:57):
So that's a very self-fulfilling one.
Oh, that's really, really lovely to hear.
My final question is, what word of encouragement do you have for the listeners?
I would say, live your life. Don't limit yourself.
I know there are already some restrictions and limitations to what you can do.
(34:18):
But as I said earlier, there's life around dialysis.
I can understand some people maybe who are being recently diagnosed with kidney disease.
First thing is really, there should be self-acceptance.
But I know this is easier said than done, but it's a process, it's a journey.
(34:38):
But once you get that acceptance of your current situation, then things will become more easier.
And like my advice earlier, being an active part of the treatment plan,
because it will help you greatly.
If you know what's happening and what's about to happen, it will help you greatly with your journey.
(34:59):
And like I said, there's life out there. Don't limit yourself.
I mean, you can still have a normal life, okay, with limitation though.
That's the important bit.
But there's help. If you're confused about something, you can always ask your
nurse, any healthcare professional.
We're here to answer your questions.
(35:19):
There's no silly question, really.
Anything that you're in doubt out with us, just always us.
There's help out there. We're here for you. That is a wonderful,
wonderful word to end on.
Thank you so, so much for joining me.
Thank you for all the tips, advice, and encouragement that you've shared today.
(35:43):
It's been an absolute pleasure interviewing you today. Thank you so, so much.
Dee, it's my honor to be here. While we were chatting off the record,
I told you that I am one of your listeners.
I didn't see it myself that I will be here today, but it's a pleasure and an
honor to be interviewed by you and somewhat share some of my knowledge, some of my tips.
(36:06):
I wish you all the best and all the success to come.
And I hope this reaches to any part of the world because as I said,
this is a very informative and very useful podcast for kidney patients and for
also healthcare professionals.
I even told you before, you know, off the record that while listening to your
podcast, I'm learning new things. Thank you.
(36:29):
Thank you for listening to Diary of a Kidney Warrior podcast.
And don't forget that you can contact me on social media using the handle Diary of a Kidney Warrior.
Please do subscribe to the podcast and please do tell a friend.
New episodes of this podcast are released every other Monday.
(36:52):
Until next time, take care and choose to live. Diary of a Kidney Warrior.
Sharing faith, knowledge, hope, and love.
5, 4, 3, 2, 1.
Let's go. Diary of a Kidney Warrior podcast in partnership with Kidney Care UK.
Sharing faith, knowledge, hope and love.
Hi and welcome to Diary of a Kidney Warrior podcast.
(00:20):
My name is Dee Moore and I am a kidney warrior. This podcast is dedicated to
encourage, educate and inspire as we explore all aspects of kidney disease,
related chronic illnesses and health.
If you have any questions or ideas for topics you would like me to cover,
please get in contact with me on social media using the handle Diary of a Kidney Warrior.
(00:45):
My guest today from Birmingham, England is dialysis nurse Alan Trier.
Alan joins me today to share tips and advice for hemodialysis.
Hi, and welcome to Diary of a Kidney Warrior podcast. How are you doing today, Alan?
Hi, I'm doing well. And you? You're all right? I'm good.
(01:08):
I'm good. I'm really excited about today's podcast because today we're going
to do something a little bit different than what we normally do with health
professional interviews, because normally,
because I'm the type of person that kind of likes to get to the point very quickly.
But sometimes I think actually we're losing a bit of information about the person behind the interview.
(01:30):
So we're actually going to do a bit of a spotlight on you, Alan,
as well as covering the topic of today.
And today's topic is tips and advice for hemodialysis, a nurse's Perspective.
I really like that title. I really do.
And I'm really excited to be discussing this with you, but also getting to know you, Alan.
(01:55):
Yes, it's a pleasure to be here.
So before we get into the spotlight on you, because we're going to be talking about,
hemodialysis today, I always like to start with a definition just to make it
clear for anyone listening because we're going to be talking about hemodialysis.
(02:16):
People might be thinking, what is hemodialysis? So I think we're going to start
with the definition and then the spotlight on yourself and then the tips and advice.
So my first question is, what is hemodialysis?
So for me, the simplest description of hemodialysis is it's the process of removing
(02:40):
or filtering out the waste or the toxins from the blood using an external machine
called the dialysis machine.
So that's the simplest explanation. If I may expound on that,
what happened is when a patient comes in to the clinic and they have their dialysis session, So,
they will be sit in a chair and then they will be connected on the machine through
(03:03):
their vascular access that it could be a fistula, a graft, or a central venous catheter.
And then we connect them through the vascular access to the machine and then
their blood goes to the machine through the dialyzer, which acts as a kidney,
this dialyzer. It's the filter.
It takes away the waste or the toxins from the blood and then there's another
(03:26):
tube that will return this clean blood going back to the patient.
So that's what really happens inside the dialysis clinic. Hopefully,
yeah, this will make it easier for the listener to see what's really going on
inside the dialysis clinic.
Yeah, I think that generally when people think of dialysis, they think of hemodialysis
(03:48):
and they picture somebody sat next to a machine and everything whirling around.
And in simple layman's terms, hemodialysis, when I think of it,
it's the take your blood out, clean it and put it back in.
I mean, would you agree that that's like the simplest way of explaining it? The simplest analogy.
Yeah, I agree. Yeah. And there were a couple of terms there that Alan used that
(04:12):
for anyone who wants more detail about it was covered in episode 72,
innovation in fistula options for dialysis patients, where we go in depth about
the different fistula options, also what a graft is, et cetera, et cetera.
So for anybody that wants information about the different vascular access,
(04:32):
check out episode 72 of Diary of a Kidney Warrior podcast.
Right. So now that we've explained the basics of what hemodialysis is,
and we appreciate it is way more complicated than that, but we're just kind
of breaking it down as simply as possible.
I want to go into a little bit of a spotlight on yourself, Alan,
(04:54):
to get to know you, and then we'll go into the advice and tips.
So So my first spotlight question, this is the first spotlight question I've ever asked.
So this is a first on Diary of a Kidney Warrior podcast. Here we go.
How did you become a dialysis nurse and why?
Just to give a quick backstory, the first ever time that I was exposed with
(05:18):
kidney disease was when I was a student nurse.
And because for one month I was assigned in a renal ward, so that was the first
ever I was seeing a renal patient for the first time I was still a student.
And then moving a bit forward, fast forward, when I became a nurse,
a registered nurse, I was working as an occupational health for almost five years.
(05:43):
And then during that time, I was doing several external training,
you know, just to gain more knowledge.
And one of the trainings that I did was hemodialysis.
And so for one month, I was in a dialysis clinic.
And at the the time, all I saw was a fistula patient, a patient with a fistula.
(06:04):
And also, that was the first time I'd seen a hemodialysis machine in my life.
Fast forward, you know, the current times, here in the UK, when I got my pin
to practice as a nurse, I was looking for job opportunities.
And one of the job that I saw was looking for a dialysis nurse.
So I was thinking, oh, oh, I think I could do this.
(06:28):
So I applied, and luckily, the company responded to my application the following day.
And I did the interview. Everything went so smoothly. And then that's it, really.
And then I become a dialysis nurse.
And I can remember during my first few weeks, it's a bit overwhelming to see this machine.
(06:52):
And I was afraid of committing mistakes, you know, what to press,
and how to do this and that.
But I had a good mentor to train me for 12 weeks. Now it's over two years now
that I've been doing this.
So I'm very confident now with what I'm doing.
So in many ways, hemodialysis, being a dialysis nurse, came to you, really.
(07:15):
It was like it started with the placement that you had.
So the seed was planted there and then the advert popped up and you were like,
yeah, I'm going to go for it. Yeah, that's really it, really.
So looking back, it could be destiny, perhaps you could say that.
Yeah, absolutely. Sounds like it. Yes. Yeah, now I enjoy being a dialysis nurse.
(07:36):
It's really fulfilling job yeah so
what do you like most about your job oh that's a
great question i will say two things it's not just one i would say the thing
that i like the most first of all is it's an outpatient setting so what does
it mean patient just come and go because as a nurse i I didn't really see myself working in a ward.
(08:01):
So I like this kind of setting.
And the second one is somewhat related to my first answer.
Because patients come to the clinic three times a week, you get to know them better.
Because you see them three times a week, so you build this special bond,
this nurse-patient bond, which also develops into trust.
(08:23):
Us because this kind of work, it's a bit routine, but things become easier when
the patient trusts you, when you're doing the treatment on them.
So this is the two things that really I like the most about being a dialysis nurse.
So it's like you're being a friend or somewhat family, you know?
So it's not like, oh, I'm going to work, but it's like, oh, I will see this, I will see her.
(08:48):
So these two things really what makes it pleasurable to work as a dialysis nurse.
It really is wonderful to hear how passionate you are about your job and just
seeing that smile on your face when you're talking about your job.
I genuinely love when I see health professionals that are passionate about what they do.
Shout out to all the passionate health professionals out there that are listening
(09:11):
to the podcast. We salute you.
So let's move on now to the tips and advice part of the interview,
because in the time that you've been a dialysis nurse,
you've met so many different patients, you've worked with different health professionals
and nurses and your mentor.
So I'm sure there's loads of tips and advice that you have that can help not
(09:36):
only people who are listening to this, who are about to start hemodialysis,
but also people that have been a hemodialysis patient for some time.
And And maybe there's something that you could say to them that they're like,
oh, I didn't know that. That would be really, really helpful.
I do have to start with a disclaimer that we are not giving medical advice during this interview.
(10:01):
Consult your consultant, your medical team for specific medical advice.
What we're giving here is for educational purposes only.
So, yeah, I'm going to hand over to you with the first tip.
So what is your first tip or piece of advice for either someone who's just started
hemodialysis or is on hemodialysis that will help them navigate this journey?
(10:27):
Okay, so I think I will start with an advice first before I tackle the practical
tip. So, my first advice would be for the patient to be an active part of the treatment team.
Because if you're a newly patient diagnosed with kidney problems,
I highly encourage you to ask questions. What's the cause of the problem?
(10:49):
What can be done? What treatment is available?
Because by being an active part of the treatment plan, your anxiety fear will
disappear because you know what's going to happen.
And then secondly, this is very important to dialysis patients,
is with their fluid restriction.
(11:10):
My advice is really follow the
prescribed fluid restriction by your nephrologist or the renal dietician.
So for somebody listening who's new to all of this, I'll always try and explain
jargon as it pops up, just for anyone listening who doesn't understand.
So you mentioned the term fluid restriction. So for anyone who doesn't know
(11:32):
what a fluid restriction is, what is a fluid restriction?
So fluid restriction, by the term restriction, basically you limit the amount
of fluid you intake per day.
In most patients that I've seen, it's one litre a day.
Because your kidney is not anymore functioning as it used to be,
and you're drinking lots of fluid, so it tends to accumulate inside your body
(11:58):
because you're not peeing anymore.
So this fluid is accumulating inside your body.
So that's why the doctor will always tell you to restrict it to one liter, for example, a day.
Yes, I'm very familiar with that because I have my own fluid restriction.
So yeah, it is important. I can
vouch a thousand percent to stick
(12:21):
to your fluid restriction because yes what is
the consequence if you don't stick to your fluid restriction what will happen
if you get overloaded with fluid then you will have shortness of breath yeah
so you will feel really generally unwell so it could be life-threatening if
you're not disciplined enough to follow the restriction.
(12:43):
Right so we are having a light-hearted discussion
but at the end of the day there are serious implications
of not following the fluid restriction so
yes be an active part of your care and yes fluid restrictions make sure you
stick to it yeah so the third one will be somewhat related to the fluid restriction
(13:04):
it will be the following the diet that your renal dietician has prescribed sky
view because other than the fluid restriction,
the other important bit is your potassium level that we always check.
So because if you're not within the normal range, too low or too high is also
(13:24):
a serious effect or implication to your health.
So following the renal diet is also very important.
And for anyone looking for recipes or tips about what is safe to eat as a kidney patient,
Kidney Care UK's Kidney Kitchen has lots of recipes and recommendations by renal
(13:46):
dieticians. So do check it out.
So my fourth advice would be to stay active because even if you're a dialysis
patient, you can still do some exercise. Of course, there's a limit what you could do.
So you could always ask your doctor if you're not aware of what exercise you
could do, but you can still do exercise.
(14:08):
So staying active will also promote well-being and also doing exercise also
helps your mental health.
And there's also the benefit of helping with blood pressure as well by doing exercise.
Am I right in saying that? Yes. So yeah, it will also help with your cardiovascular health.
(14:28):
Then my fifth advice will be make the most of your dialysis time.
So what do I mean by that? Because normally, or most patients do four-hour session each time.
Because four hours is really a long time, which I can totally understand.
We have some patients who are still working, actively working.
(14:48):
So what they do, they bring their laptop and they do their reports while having dialysis.
We also have a very young patient who's still in university.
So she brings in her assignment and she does it while having dialysis.
So that's one of the example of making most of your time while having the dialysis session.
(15:09):
I can remember this student, one of her assignment was to interview some healthcare professional.
Professional and so she was able to do that easily you
know asking nurses you know so you could
also read and do you could listen to radio or watch telly because each chair
has their own telly so yeah you can also listen to diary of a kidney mario podcast
(15:33):
while you're having dialysis that's also a good way oh yes obviously yeah that's really good yeah,
That's coming from me, you know, an avid fan of your podcast. Oh, thank you. Yeah.
Okay. And then my sixth advice will be don't let the dialysis rule your life.
(15:55):
So what do I mean of this is because I know it can be a bit limiting.
You know, you feel in trouble because you have to come to the dialysis center
three times a week for four hours each time.
So I know it's a lot to take in. But you can still go on holiday.
I can remember one patient, I told him, you haven't been on holiday for many
(16:16):
years. Don't let it stop you from going on holiday.
Because there is this holiday dialysis that we call.
Of course, the only thing is you just have to plan in advance.
If you want to go on holiday, just plan it in advance.
And you can still do these things. And visiting
new places that you've never been before will also
help your well-being and also your mental health
(16:39):
so you don't feel like you're in trouble you cannot
do this you cannot do that but you can still have like a
normal life okay with limitation though
yeah i can understand that but don't let
it rule your life there's life around dialysis that's
what i want to say i think it's really powerful what you said about not allowing
dialysis to ruin your life because whether it's somebody who's just been diagnosed
(17:04):
and they've just found out that they have to go into dialysis or whether it's
someone who's been on dialysis for many, many years,
sometimes you can not see the wood for the trees.
And to go on holiday and have time out, time away.
Is so important. I mean, I recently went away for a few days and I had such a good time.
(17:28):
It really was an opportunity to recharge my batteries and come back feeling so, so good.
And it is possible as a hemodialysis patient or a peritoneal dialysis patient
to go on holiday, whether it's the UK or abroad.
And for more information about that, check out episode 63, Holidays and Dialysis.
(17:51):
Freedom to travel so it is actually possible for anyone
that doesn't realize it is actually possible so yeah
a really really powerful statement that was yeah
because breaking the cycle because some people they
see it oh it's an endless cycle that i have to go to
the clinic today so i can also feel that it's like
psychologically burdened you know not just physically but they
(18:13):
need also to relax and refresh themselves and give
a clean slate again that okay i've been out i've
been traveling then now and so at least it's like a new
restart from time to time i totally agree
100 all right so now
i'll go for my practical tips for dialysis patient.
Okay i'm looking forward to this my first
(18:34):
practical tip will be for those patients who come to dialysis not
to wear very tight clothes if you're wearing
long sleeves make sure it easily can be
rolled up so that the nurse can easily access your
fistula or graft or if it is a central
venous catheter make sure that your shirt top can
easily be unbuttoned or unzipped so that
(18:55):
the nurse can easily access your line so yeah
i mean because some people they tend to forget wearing lots of clothes
or very tight so it's a bit challenge you
know to access their site that's a really really
good practical tip because for me myself i have
a line as everyone knows so i tend to wear
a vest when i'm going into dialysis but also
(19:17):
if you've seen the reel on my social media i
have a top that has poppers on it so they can actually
pop open the sleeves to access my arms
and things like that so yeah it's a very good practical tip loose clothing definitely
yeah loose clothing then my second one will be this most especially for patient
(19:39):
with tissue or graft that be mindful that don't carry any heavy.
Bags on your arm with the fistula.
Make sure you use the other arm because it's not good for your fistula,
your axis to be carrying that weight.
And also when you're at home and sleeping, don't lie on that side.
And my third tip would be during hot weather temperature.
(20:03):
Instead of taking more fluids, you can chew on ice chips. So it will help with your thirstiness.
So without drinking too much fluid. So that's my third practical tip.
And then my fourth practical tip, perhaps I'm not sure how practical this will
be, but it's very useful, is if you can keep a weighing scale at home,
(20:28):
because some people might, with relation again to the fluid restriction,
maybe they do the restriction by having a measuring glass so that they know
how much they are drinking.
But one ideal thing to do as well is to maintain a record of your weight because
when it comes to dialysis, every patient knows their dry weight.
And what is dry weight? This is your weight without the excess fluid.
(20:52):
With so if you know your dry weight and then
you've got a waist at home then you can also
monitor your weight you could say oh i'm
doing too much water and also those things
that you cannot measure easily like if you like eating food with lots of sauces
or if you like fruit and vegetable you know because these things also contain
(21:14):
water that's a really important one because Because you don't realize that when
you're eating these things, they contain water.
If you think of fruits that have a high water content and you're eating that,
that can easily be not included in your mind when you're thinking of your fluid restriction.
So, yeah, watch out for, I mean, they're beautiful to eat and kidney friendly.
(21:37):
But be aware of the water content.
Things like watermelon, things like that can add to your fluid restriction.
Yeah because without realizing it it all
adds up you know definitely can i
bolt onto that because you mentioned about a scale and i
think it's important to say also that bearing
in mind what you're wearing when you're weighing yourself because
(22:00):
when i first started hemodialysis i was
wearing quite heavy i didn't realize how heavy the
clothes were and that is going to be
factored in when they weigh you and they're looking at your
dry weight and your restrictions and all all the rest of it if you're
wearing super heavy clothes it's giving the
wrong impression of what your weight actually is so think
(22:20):
about lightweight clothes and then wear the
same clothes i have a uniform that i wear to dialysis so consistently wearing
the same clothes means that i've got consistency in terms of when i weigh myself
and bear that in mind when you wear yourself at home if you're weighing yourself
naked compared to weighing yourself when you've got clothes on,
(22:43):
And also bearing in mind that some scales do tell you the water content of your
body and some scales have a fat measuring thing.
So it's a good way of seeing what the difference is.
Which will help maintain your dry weight. So that's my practical tip. I hope that makes sense.
That's my practical tip to add on to what you've just said. Sorry to interrupt. Here we go.
(23:07):
Oh, no. And then my other tip would be for those people with fistula and graft,
I mean, some people, because they are afraid of, after they remove the dressing,
they're afraid of it getting wet, but you can actually wash it with water and salt.
And if you see a scar, don't scratch it, please. is.
And then for those people with the central venous catheter, we all know that
(23:30):
it's very susceptible with infection.
So we don't want it getting wet. So it's very difficult really to have a shower with it.
But my practical tip would be really, if you see that it got wet,
then make sure when you get back to your dialysis session, just tell the nurse
to change your dressing.
Because it's better to change your dressing than a bacteria getting into your exit site.
(23:53):
I keep telling my patient that
I don't mind changing your dressing even every session if it needs to.
Definitely better to be safe than sorry. So yeah, making sure you stay on top
of that dressing if you've got a line.
And then my other tip, it applies to fistula graft or with CBC line that always
check for signs of infection.
(24:15):
If it is one to touch, is it pain or if it is a line, If there's a green or
yellow drainage, just report it straight away to the nurse so that we can do something about it.
Because one thing is we always avoid infection or try to control it as quick as possible.
Because there's some patients that they don't say anything. And then once it's
(24:38):
really, that's the only time that they will say something. thing.
So only just a little hint that it could be a sign of infection,
like if you've got a fever, what I just said earlier.
So yeah, just tell everything to the nurse, and then we'll do the rest.
Another tip of mine, well, okay, it's actually just more like a reminder,
(24:59):
a reminder for patients with grafts or fistula that we cannot use your arm with
the fistula to take blood pressure.
Make sure that it's always on the other arm. Some people, they
tend to forget get that taking that patient they will have their
arm with the one with the fistula so that's just
a simple reminder because some people they tend to forget
and i think that's also a good reminder for people who have a line and they're
(25:24):
preparing to get a fistula the same applies not to use the arm that they're
going to use for the fistula and they do have bracelets that you can wear as
a reminder from kidney care uk so do check those out from the website site.
Can I add to my own practical tips as well? Yes.
As we're having this conversation, because as somebody that's recently started
(25:47):
hemodialysis this year, I definitely have some tips that I would like to share.
And the first one is bring a blanket because you can get really,
really cold while you're on hemodialysis.
So I always have a blanket with me. and I also have a little mini suitcase on wheels.
(26:08):
As strong as you may feel when you're going into hemodialysis,
you might feel quite drained afterwards.
So it definitely helps carrying your stuff might be quite difficult.
So if it's in the suitcase, you can just wheel that thing along and you don't
have to worry about carrying it.
And then it also addresses your tip about carrying
(26:29):
it on the arm yes you don't have
to carry it on the arm then your arms are completely free and
there's no pressure on your arm so it actually ties into one of
your tips so i'm happy about that good tips yes too thank you i mean i mean
when it comes here with the blanket most patients doing dialysis their main
complaints will be oh i feel cold you know can you turn on the heating because
(26:53):
Because their blood comes out and then goes back in.
So they're really prone to being cold.
They can feel cold quite easily.
So unfortunately, in the clinics, we don't really provide blankets.
So it's a good tip that you bring your own blanket.
It's also to prevent infection. So basically, you better bring your own.
Yeah, so that's a good one.
(27:13):
And another one that I've learned through doing as well is because my blood
pressure can be on the lower side, I'm prone to get really bad cramps when I'm on the machine.
So a tip that I have learned is there's a profile on the machine where the amount
of fluid you can actually adjust it over the time.
(27:34):
So the way I have it, it goes up and down over the course of the treatment.
And I have found that that has absolutely almost completely and completely reduced.
Taken away the severe cramps that I would get. So that's a hot tip.
And some people might start their hemodialysis session where they don't take
(27:57):
any fluid off for the first 30 minutes and then they kind of take the fluid
off steadily for the rest of the session.
But in my case, I'm alternating between higher and lower from the beginning
and it certainly has helped with the cramps.
So that's my My final practical tip.
Yeah, that's a good one. Because I remember a few patients, because they've
(28:20):
been dialysing for so many years, they also know what's best for them.
They will say, oh, nurse, do more now in the first two hours and do less on
the last two hours. So it works for them.
So like you, yours is up and down, up and down.
So yeah, we have this profile that you can choose how to pull fluid out of the
patient, patient how big or how small it is per hour, per minute,
(28:44):
or half an hour. So yeah, that's really a good tip.
That's a good call. And my final tip will be, because in our clinic,
we give teas to the patient.
And then some patients, they bring their own food and bring their own drink.
And my final tip is, if you will bring your own drink, make sure that it's not
(29:04):
too much, not like 500 mils or less is better. Because when we do the treatment,
we set the amount of fluid that we will take.
But if you're drinking more while you're on dialysis, after the dialysis session,
and then you weigh yourself post-treatment, you will see that,
oh, nothing has been reduced.
I'm finishing the same way as I came in. So my tip is don't also drink too much
(29:29):
fluid while you're having dialysis.
And I think that is a really, really, really important one to end on,
because while you're sat there and if you are busy and getting on with something,
you might not realize actually that you're drinking so much.
And then, and like you said, defeating the whole object of having the excess
(29:49):
fluid removed because you're just drinking it back on.
Yes. Is there like a general, I know that we're not giving medical advice during this interview.
But is there a standard amount of fluid that is recommended that's okay to drink
while you're having dialysis?
(30:09):
Well, for me, from what I have experienced is.
Maybe just like a glass will do. But more than that, I think it will be too much.
Yeah, it's defeating the object. Yeah. Because we had several patients who they
came in at X amount of weight and then they came out the same.
Because they didn't realize that they were drinking too much.
Right. So would a practical tip be bring in a specific bottle with lines on
(30:33):
it so you know exactly how much so you know not to drink more.
So if you've got your bottle, then don't drink the cup of tea on top of that
because that's also going to add.
So make sure it's either your cup of tea or a measured amount that you're bringing in to drink.
Yes, that's correct. Yeah.
We've covered some great tips and advice today for hemodialysis patients,
(30:58):
whether you're new to hemodialysis or have been on hemodialysis for some time.
I hope there's loads in there that will help you. we've looked at being an active
part of your care, fluid restrictions, following the diet by your dietician,
staying active, making the most of your time on dialysis.
Don't let dialysis ruin your life. Wear loose clothing, be mindful that you
(31:23):
don't carry heavy bags on your fistula or graft arm or lie on that side when
you're sleeping at night.
Using ice cubes as a way of helping with fluid restrictions,
keeping a weighing scale at home.
Don't scratch your fistula scabs. Don't get your line wet.
(31:44):
Always check for signs of infection on your line if you have a line and don't
out drink your fluid restriction and bearing in mind that if you drink whilst on the machine,
still stick to your fluid restrictions and also mine about the suitcase and
profile on the machine and blanket.
(32:06):
So, yeah, lots and lots and lots of great tips there.
So I'm asking a question that's a little bit different to what I would normally be ending with.
So I have two final last questions. And the first is, what advice can you give
to nurses who are aspiring to become a dialysis nurse someday?
(32:29):
My advice would be for those nurses who are aspiring to become a dialysis nurse someday,
day if you like a job that there's a
routine you know it's like more in general sense
dialysis nurse we do things in a pattern it's
a routine that we put on patient we take off patient if you
like that kind of job and also it's an
(32:50):
outpatient you know they just come and go so i
would suggest that you try become a dialysis
nurse and based on my own experience you
don't need a prior experience of applying
to become a diagnosis nurse there's a training you will
be mentored and trained for 12 weeks
and i can remember that it was overwhelming me at first but now i'm not afraid
(33:15):
and if you're not afraid of the blood seeing that's all your shift then go for
it yeah because some people even healthcare professionals they cannot take too
much blood But mentally,
it's too much to some people.
And also, if you don't mind middling or cannulating patient.
Then go for it. That will be my advice.
(33:36):
It's a very rewarding job. I can remember as well, because when patient eventually
got transplanted, sometimes they
leave us notes, you know, thanking us for looking after them really well.
It's very self-fulfilling. I mean, that's a kind of reward where nothing can
amount to if you have been appreciated by your patient.
(33:57):
So that's a very self-fulfilling one.
Oh, that's really, really lovely to hear.
My final question is, what word of encouragement do you have for the listeners?
I would say, live your life. Don't limit yourself.
I know there are already some restrictions and limitations to what you can do.
(34:18):
But as I said earlier, there's life around dialysis.
I can understand some people maybe who are being recently diagnosed with kidney disease.
First thing is really, there should be self-acceptance.
But I know this is easier said than done, but it's a process, it's a journey.
(34:38):
But once you get that acceptance of your current situation, then things will become more easier.
And like my advice earlier, being an active part of the treatment plan,
because it will help you greatly.
If you know what's happening and what's about to happen, it will help you greatly with your journey.
(34:59):
And like I said, there's life out there. Don't limit yourself.
I mean, you can still have a normal life, okay, with limitation though.
That's the important bit.
But there's help. If you're confused about something, you can always ask your
nurse, any healthcare professional.
We're here to answer your questions.
(35:19):
There's no silly question, really.
Anything that you're in doubt out with us, just always us.
There's help out there. We're here for you. That is a wonderful,
wonderful word to end on.
Thank you so, so much for joining me.
Thank you for all the tips, advice, and encouragement that you've shared today.
(35:43):
It's been an absolute pleasure interviewing you today. Thank you so, so much.
Dee, it's my honor to be here. While we were chatting off the record,
I told you that I am one of your listeners.
I didn't see it myself that I will be here today, but it's a pleasure and an
honor to be interviewed by you and somewhat share some of my knowledge, some of my tips.
(36:06):
I wish you all the best and all the success to come.
And I hope this reaches to any part of the world because as I said,
this is a very informative and very useful podcast for kidney patients and for
also healthcare professionals.
I even told you before, you know, off the record that while listening to your
podcast, I'm learning new things. Thank you.
(36:29):
Thank you for listening to Diary of a Kidney Warrior podcast.
And don't forget that you can contact me on social media using the handle Diary of a Kidney Warrior.
Please do subscribe to the podcast and please do tell a friend.
New episodes of this podcast are released every other Monday.
(36:52):
Until next time, take care and choose to live. Diary of a Kidney Warrior.
Sharing faith, knowledge, hope, and love.
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