So, the pandemic hits. This was not fun for anyone. Where were you when you first heard about COVID-19? I don’t remember where I was, but when I heard about COVID, I thought that it was just one of those viruses that wouldn’t make it to the United States. Even if it made it here, it would be contained and eradicated, and that’s that. Boy, were we shocked.
I was sort of used to my solitude. Staying home and not having much of a social life were part of my daily routine. So when the world had to be quarantined, it was no big deal for me. Because dialysis treatments are essential for CKD patients to survive, the dialysis centers continue to run.
I don’t really like change (I’m sure I’m not the only one), and lately, there had been a lot of changes going on in my life. So because of the pandemic, a lot of changes started happening at the dialysis center that stressed me out. First, we had to start wearing masks (this was also going to be the new norm when at the dialysis center). I didn’t mind it too much, but because of the masks, we could barely communicate with each other. Then we couldn’t even bring our snacks anymore. So when they removed the ice machine from the room, that was the last straw! (Eating ice was my thing at the time.)
For some reason and for some time now, they had been pushing for me to do peritoneal dialysis (PD). PD is a type of dialysis you can do from the comfort of your own home. We were in the early stages of the pandemic, so I decided that there was no better time than the present. I asked to speak to the PD nurse to make sure this was right for me. We considered the pros and cons of how the change will or will not affect my daily life. After our discussion, I decided that the pros definitely outweighed the cons.
I set up an appointment to have a PD catheter placed in my abdomen. So, here we go, another surgery. When I arrived at the hospital, I got all checked in, and then I was left with my thoughts. You guess it, my anxiety jumped up again. I’m glad I have my helpful tips to relieve my stress and anxiety to fall back on. I prayed, did some deep breathing to calm down, and then I played games on my phone to keep my mind off what was coming. Playing games is my way to relieve stress, but sometimes I meditate or even do crossword puzzles (I bought a big book of them just for situations like this).
Before going under the knife (ok, that wasn’t a nice way to say that), your surgical team comes around and introduces themselves to you. The team consists of the nurses, the anesthesiologist, the surgeon, and any other staff members who will be working on you in the operating room. They want to let you know what their job is and what they will be doing to you during your surgery. Having them explain everything can sometimes help ease your mind concerning the operation you are about to go through.
After the surgery, I was given special instructions in taking care of the catheter to keep it working properly and free of infections.
- Wash your hands before and after touching the catheter.
- Clean and dry the catheter and access area immediately after getting wet.
- Change the dressing at each dialysis session, or daily to keep the exit site clean and dry.
- No baths, hot tub, or swimming pools (although you can swim, if you use an activity pouch.
- Always check for any redness, swelling, warmth, or tenderness around the catheter insertion site to report the nurse if need be.
- While healing avoid exercise and heavy lifting.
- Prevent constipation to decrease chance for a hernia
My next dialysis treatment was learning how to use the catheter when doing PD, so when I started it at home, I would be comfortable doing so. I also got plenty of practice on how to keep the PD site clean. I had to learn how to keep good records of my treatments. I made my own worksheet because I had to weigh myself and take my vitals daily.
We started with manual dialysis which is called continuous ambulatory peritoneal dialysis (CAPD). CAPD is done several times a day. The steps were pretty easy:
- Fill – Use the catheter to fill the abdomen with the dialysis solution.
- Make sure you warm the solution before fills.
- Hang the solution bag on the pole
- Connect your catheter to the tubing.
- Dwell – You leave the solution inside you. How long you leave it in depends on your prescription.
- You unhook yourself from the bags.
- Exchange the empty bag for a new one.
- Go about your day.
- When your dwell time is done, connect yourself back to the bags.
- Drain – Use the same catheter to drain the the solution from your abdomen.
- With the drain bag on the floor, the fluid is removed by gravity.
- Refill your abdomen with the new solution to start the process over again.
I continued to do the manual PD at home. The nurse came to my house to make sure I had everything that I needed for PD at home :
- A set up place for the dialysis exchange
- The water was working properly
- A clean close bathroom
- Storage room for my solutions (Believe me, there was a lot of it)
I also had to learn how to order my supplies. Not only do you have to know what to order, but you also have to know how much to order. It was a tedious job, but after a while, you do get used to it.
After doing this at home for about six weeks, we then moved on to training on the machine. It wasn’t as daunting as I thought it was going to be once I got the hang of hooking myself up to the machine. I was now able to have my dialysis treatments run at night. This gave me more freedom during the day.
Disposing of the used bags and other medical treatment material safely was another tedious job. The nurse said that the treatment bags and hoses were recyclable, but since waste management didn’t see it that way, I was told to just throw them in the trash. Learning how to troubleshoot issues that may come up was a little challenging, but if I got in a jam, there was always a nurse on call 24/7. There was also a toll-free number to call if an error message set any alarms on the machine.
My treatment time was 10 hours a night (I tried to convince my nephrologist that 8 hours was enough, but he wasn’t going for it). Yes, that’s a long time to be confined to one area, but it allowed me to get plenty of rest, catch up on some shows, or read a good book.
To get ready for each treatment, here are a list of things I had to do:
- Set up my station.
- Wash my hands sterilely.
- Put on my mask.
- Clean and dry my catheter.
- Connect myself to the solution bag.
Because I could only go around the perimeter of my bedroom, I had to make sure I had everything for the night. After you hook yourself up to the machine, you are advised to stay connected for the duration of your treatment. Disconnecting and then reconnecting yourself can cause bacteria and germs to infiltrate your site and cause complications and infections.
At times, peritoneal dialysis can get lonely. That’s why it is always important to stay in touch with family and friends to have someone to talk to when things start to get a little tough. If you are a praying person, talking to God helps too.
#peritonealdialysis #pandemicdialysis #PDdialysis
