So you want to live? Yes, a tough opening line, but every dialysis patient needs to understand the facts. Your doctor, rightly, will tell you that dialysis is not a cure, it’s a treatment. And, they should tell you that a transplant is not a guarantee.

It’s a fact that the life expectancy of dialysis patients, on average in years, is measured on the fingers of two hands. And, it is fair to say that if you stick with the absolute minimum of dialysis YOU think you can get away with, then start cutting the number.

The key to a much improved life expectancy is to improve your treatment. You need to get beyond the the 3 days a week for four hours mentality and consider daily dialysis, which can be for 3 or 4 hours a day, or nocturnal. To do this though, unless you are in an area that has a dialysis unit that offers nocturnal options, then the solution lies in dialysing at home.

I’ve banged on a bit about home dialysis before, but the real benefits are that you can take real control of your treatment and have a major impact on your long term health. Unless something quite radical happens in UK dialysis centres, the cost constraints that govern provision of facilities, nursing and supplies will continue to restrain centres to the standard 3 days x 4 hours routine as that ensures a reasonably controlled shift process, and moves through the maximum number of patients. When you see patients on dialysis with low pump speeds, clammering to come off early because they are bored or have something more important to do, you realise that many just do not get sufficient treatment to maintain good health. (and, to be frank, what can be more important than extending your life for as long as possible?)

A concerted effort to move all able bodied and those with the facilities to accommodate dialysis equipment should be trained to go on home hemo, this reduces costs to the NHS after the 16-18 month payback period, so freeing cash, and space to offer those that cannot go home a more considered dialysis regime at hospital so that they achieve better clearances because they are no longer ‘rushed’ to get off in 4 hours. The money saved through the home hemo route can then be ploughed back into the development of bigger and better facilities for those needing hospital treatment and may even offer the option to start nocturnal units, as is becoming increasingly ‘popular’ in the States.

All round, the average life expectancy of ALL dialysis patients will be enhanced.

And…. given the earlier blog post from me on finding an intelligent solution to the stalled donor situation, is this not one area for strong consideration. A case of changing the way we do things to achieve better results rather than trying to change the world on donor organs where half that world wants no change.

Tags: daily dialysis, dialysis, Home Dialysis, life, life expectancy, mind set, nocturnal, planning, self-care, training

So, you’re on dialysis, and with that, and age, the combination has led to embarrasing difficulties. If you are in a relationship from before you started dialysis, then your partner has shared things with you and may well be more understanding, but what if you are single, not only do you have the big D to overcome as a conversation stopper, but if things turn out great, the time will come when you go to bed and another embarrassment could result!

The good news is, so long as your blood pressure is fine, and you are generally well in your treatment, consult your GP about Viagra. Amazingly it’s not a big deal to talk about with your GP, and they will be able, in most cases, to prescribe Viagra. You may be started on a lower dose to check you can cope with the changes this causes. Viagra does have the effect of lowering blood pressure, so if your pressure is low to start then not a good idea to take it.

Also note that you are likely to experience elevated heart rate, so if this causes you problems, don’t take it and consult your GP.

The weird and almost beneficial effect is that if you have no renal function at all, the effects last longer!

But! Always consult your GP, and if they are not certain on the answers for you, they must consult your nephrologist or consultant.

The main thing is, don’t hold back, every day solutions can work for many on dialysis.

Tags: dialysis, viagra

There are so many ways that dialysis can be improved and I will focus on a number of good practices and new ‘stuff’ over the coming blog posts. But for this post, I was drawn by this article on saving the huge amounts of water used in dialysis and recycling, something they have been doing in Canterbury for 10 years now. The excess water from the reverse osmosis process is saved and pumped to a special tank in the roof set aside for this purpose and the water is then used to flush toilets in the unit. The process can save 800 litres of water per hour, and although the cost of installation was £15,000, the savings in ten years have been in excess of £75,000. One for the NHS bean counters to ponder – bit of a no brainer I suggest, especially as they installed the same process in the new Ashford dialysis unit from new, so being cheaper to instal, and savings achieved much sooner. I wonder if they thought to do that in the new Peterborough City Hospital we are moving to in November this year? Hmmmm! I’ll ponder that for a moment, and ask the question and update this blog post when I find out – think I know the answer though! http://greenerhealthcare.org/nephrology-resources/conserving-water

Tags: green conservation, innovation

Having dialysed on the island of Crete for two holidays now, I stayed in a great find in the hills above Hersonnisos. Creta Blue Suitesin Koutouloufari is a family run business, with a range of suites set around the pool and bar/restaurant. The Roussakis family is Eleni (mum), Vangelis (dad) and George (son and General Manager, and everything else, it seems!).
You are made to feel so very welcome, and it feels like the family are sharing their home with you. The rooms are excellent, clean and well furnished and 90% have great views out to sea.
From breakfast in the morning in the sun, through lunch and dinner, the food, the brainchild of Eleni, is perfect. The dishes are varied, and generous, as well as excellently prepared and cooked. And nothing is too much trouble, just ask, and George will sort it! So even if you want veggie options, or want one of the dishes prepared a bit differently, the result is always excellent.
During the day, if you don’t want to stray far, you can laze around the infinity pool and enjoy drinks and snacks to your heart’s content. If you venture into the pool, prepare for hypothermia! It’s cold! But in the heat of summer, very welcome.
If you do get out and about there are numerous tours you can take, either by dropping down the steep hill into Hersonninsos and trying out one of the many travel agents. or hire a car. The freedom to explore the island by car is by far the best way. You can take your time, and if you find somewhere you like, you can stay for longer. You can head south into the mountains, east to Agios Nikolaos, or head west to Chania, although I found Rethymnon a pleasant stop. Coffee shops every 2 paces so be prepared to be pounced on for coffee or food by eager waiters telling you they are the best award winning restaurant on the island!! To be honest, most look fine, so just take your pick – but it is interesting to notice the ones that are wall to wall busy, while their neighbour is empty – go with the crowd is my best tip!.

So, all in all, a great place to stay, central to all the good stuff to see and do, and a really friendly feel that makes you feel welcome, especially when you go back and get greeted like long lost friends by Vangelis – lovely bloke! And for dialysis, just 30-35 minutes away, and Mesogeios will send a taxi to pick you up, but I drove to dialysis, as I’m independent and stubborn and want to do things my way! Go and enjoy! This is a real 5 star break!

Tags: crete, holiday dialysis, international dialysis, travelling