Thursday, January 29, 2009

Dialysis in Goa

During my recent trip to Goa, I was planning on being there for three nights. I would need to do one dialysis session there. I was leaving on Friday afternoon which meant I would have dialysed Thursday night. I was returning on Monday evening which meant I would get dialysis on Monday night. That meant I would be away from my machine for three nights - Friday, Saturday and Sunday. So, it made the most sense to dialyse in Goa on Saturday.

Last time, we were staying in North Goa so it made sense to dialyze in the Vrundavan Hospital which is in that part of the city. This time around, however, we were planning to stay in South Goa. Apollo Victor Hospital in Margao would be the most ideal.

I got the telephone number of the hospital from the internet and called them up about 10 days in advance. I spoke to one of the senior technicians there. I requested an appointment for the 24th of January, Saturday evening. He checked his charts and told me that a slot was available for 8 p.m. that day. I confirmed that he should book it for me.

8 p.m. made sense since I could enjoy myself the whole day and then get to dialysis late in the evening and get back late in the night. I called the Monday of that week too to confirm. Everything was fine.

Once I got to Goa too, I called to confirm my appointment.

Dialysis facilities are quite different in India from the US and other countries (from what I read on the internet). Most facilities, here, are part of a full fledged hospital. Male technicians trained in the various aspects of dialysis mostly do the entire treatment. There are female nurses too but it is the male techs who are responsible. In the US, a majority of dialysis centers are independent units and it is mostly female nurses who do everything.

The Apollo Victor Hospital was a typical Indian hospital with a dialysis unit and male techs doing the job.

I went and met the tech there. He asked me to go and pay the dialysis charges at the cash counter on another floor and also buy the dialyser and the tubing set from the pharmacy. I did this and then came back to the unit.

I had got my buttonhole needles with me. I then talked to the tech and requested him to allow me to cannulate myself. He was hesitant at first. He had never come across anyone who could cannulate himself. I explained that I dialyzed every night at home and did the entire procedure myself. I explained about the buttonhole method and about the tunnels that form. He reluctantly agreed.

I then asked him how many hours did they usually dialyse people for. "Four hours", he said. I asked if I could do it for five. He said no. He then asked me how much fluid I needed to pull off. "Three liters", I told him. He then checked my blood pressure. It was 90/60 which was my normal pressure. He was worried. He thought that was quite low and he decided to check with the nephrologist attached to the hospital. He called him and gave him a little background. The neph asked him to remove 3 liters over a dialysis session of 6 hours. I was glad.

The rest of the session was quite uneventful. I had taken a sedative and so, slept through the treatment which was quite a relief because staying up six hours can be both butt-numbing and nerve-racking at the same time!

The weight loss however was only 2.2 kgs. This is one piece I can never reconcile with. Some machines are so unreliable in removing fluid. Imagine going through a six hour session and getting only 2.2 off! What a royal waste of dialysis hours! My Fresenius at home is perfect. 3 liters is 3 liters no matter what.

My dear brother Karan had dropped me off around 8:30. He returned at about 3 in the morning to pick me up. But it felt good to get a good session of dialysis. This would pep me up for the rest of the trip.

When I got back home on Monday, I checked my weight. I was about 5 kgs above my normal dry weight. Add the 2.2 that I lost during dialysis and I deduced that my net fluid consumption during the trip was about 7.2 liters. Over 4 days and 3 nights. Which is not bad at all!

7 comments: said...

Very interesting report Kamal. It's nice to hear a story of a unit that works to meet your needs. How much was the treatment?

Kamal Shah said...

The total cost was Rupees 2850 ($ 60) of which the actual treatment costed me Rupees 1000 ($ 21), the dialyser and the tubings, Rupees 1400 ($ 30) and Rupees 450 ($ 9.5) for the rest of the consumables (all billed separately).

Donster said...

Kamal, Thanks for all the info you post. We're still somewhat new at living with CKD and dialysis. It's good to gain wisdom and knowledge from those of you who have lived on the receiving end. The hospitals in my region of the US generally do not even have a dialysis unit. From what we've seen they have 1-4 portable machines (Fresenius 2008 w/ water purifier on wheels) and contract dialysis from a provider like Fresenius who provide traveling nurses who then come to the patient's rooms and dialyze them. The nurse may have to cover 4 hospitals each day. They do not provide any outpatient dialysis services from what we have seen :( Please keep up the good posts.

Payal Verma said...

Would it be apt to call you on thus Kamal, if so could you share the number

Kamal Shah said...

Sure. 9000202185. Leave a text message in case I don't take the call. Thanks!

Srinivas Tallavarjula said...

Hi Kamal
Thanks a lot for the complete details.
I myself am planning a trip to Goa, i stay in Ahmedabad,so was worried whether i should consider a dialysis there or not
Now after reading your blog am much relieved

coolmil123 said...