Knockdown

Image courtesy of renalfellow.blogspot.com

It felt like it was a swing and a miss for me trying to hit that curved ball... No, more like a knockdown after that left hook. That’s what bad lab results can make you feel. That’s right bad lab results. 

At the NKTI Hemodialysis Center, we get free blood chem labs after every 20 sessions. I went to the laboratory this morning to have my blood extraction after 10 or so hours of fasting. I already had in inkling how the results would look like since just last week, similar tests were done when I had to undergo angioplasty. And my suspicion was confirmed when I received the results. And it floored me. I’m good in all departments except creatinine, phosphorus, potassium and hemoglobin. These areas are probably the most critical for persons in dialysis. My creatinine and potassium are still off the charts. 

I’m not sure how to react. Do I treat this as nonchalantly as I should because, anyway, I am not experiencing any of the uremic symptoms? Or should I be alarmed? I know that undergoing hemodialysis 8 hours a week is nothing compared to a normal person’s kidney functioning 168 hours a week. Am I under dialysed? Do I need to increase the frequency of my dialysis from 2 sessions to 3 sessions a week? I’ve gathered that in the US, hemodialysis frequency standard is 3 times a week. When I asked my nephrologist about this, he said it is because dialysis is for free in the US. But here in the Philippines, twice a week is more like it. He said that as long as I do not experience the ugly symptoms of always feeling cold, panting for breath after exerting some effort(symptoms I had before I started dialysis), then I am getting adequate dialysis. 

But still, a serum creatinine of 16 and a potassium of 6.2 despite all the effort of following the recommended diet. Will adjusting the diet again at this point help improve the result the next time around? I don’t think so. I believe I am eating properly, religiously following the nutritionist’s instructions. So what causes it to rise that high? I’m sure, if the blood serum extraction was done right after a dialysis session, the results would have looked better. So maybe this is the cycle that I have to accept: creatinine and all these other toxins build up to feverish levels until my next dialysis session. 

The thing is, I’m getting bouts of paranoia just after reading those results. What with imagining that I’m feeling the symptoms I had pre-dialysis. It’s making me listen more closely to what I am feeling now. The thing is, I’m justifying the results by conjuring up symptoms that I actually do not have. Haha! At least I know that they’re imagined.

From this (Image by cvcbundle.com)

This coming Monday, I’ll be having a Permcath inserted. It is an OR procedure that usually requires sedation. But I spoke with the vascular/transplant surgeon, Dr. Ben Purugganan, if it is possible to do it with local anesthesia(to keep the cost down) and he said yes. The only question he asked was, “Nerbyoso ka ba?” I have to to this to replace the IJ catheter that I currently have. Since the transplant has to wait for at least 3 months, I was advised to have a better/superior vascular access device than what I have now. The Permcath is supposed to be safer, more durable and is not as exposed than what I have currently sticking out of my neck. This is not for vanity. I have learned to live with the IJ catheter. If I had the choice, I will keep using the IJ. But I am a good patient. I follow what doctors advice me. Wish me luck. I hope it is not painful as it sounds/looks. 

Sorry for grossing you out. 

To this (Image by myspace.com/darkknight)