Wednesday, July 22, 2009

An enterprise of honorable, dangerous consequence

I can't get over Shakespeare, can I?

Well, the title is only partly true. It is more an enterprise of healthy or dangerous consequence! Only one of the two really. Let me explain.

As you probably know, I undergo daily nocturnal dialysis. Which means that I get considerably more dialysis than your average Joe who usually gets about 12 hours a week. I get around 42. There is a downside to this.

For most dialyzors, Phosphorus is not adequately removed during dialysis due to the infrequent and relatively short sessions they get. They need to take Phosphate binders that remove the excess Phosphorus from their blood.

I get so much dialysis that excess Phosphorus is actually removed from my blood. So much that my Phosphorus is - hold your breath - below normal!

I have been taking Neutraphos, a Phosphorus supplement. This is one of the ways to treat this but not ideal. My Phosphorus probably goes below normal towards the last 2-3 hours of my dialysis. Then I take the supplement after a couple of hours of this. So, for a long time, my Phosphorus is below normal.

The amazing Dr. John Agar suggested in a webinar on Home Dialysis Central that a phosphate additive be added to the dialysate so that too much phosphorus is not removed in the first place. They add a phosphate solution (I am leaving out more details on purpose. You don't want to know. Trust me) to the dialysate for most nocturnal dialysis patients in Australia.

A similar solution is available in India too but the composition is slightly different. So, though the dosage is standardized in Australia, I am going to have to do a little bit of trial and error to arrive at what will work for me.

The consequences can't be too bad however, given that I am going to start with a low dose, measure my post-dialysis Phosphorus and then keep tweaking it till I get a good post-dialysis Phosphorus.

My Class 12 Chemistry has really helped me in this endeavor!

I start trials today. Wish me luck!


Miri said...

Good luck, Kamal. Report back soon, so we don't worry.

Miriam Lippel Blum said...

Oops, Kamal, that last note was from me.