Saturday, June 16, 2018

The importance of strength training on dialysis

I have been on dialysis for almost 21 years now. One thing I have noticed is that my limbs have begun to get a little weak. For example, I am unable to get up without taking support of my hands on the chair. I am also unable to sit without some support. This is more so for chairs and sofas that are low. I am completely unable to sit on the floor.

Kidney failure, especially when present for more than a few years can cause such issues. Fortunately, there are ways to avoid this and even correct it to some extent if it has already happened.

The best thing to do, obviously, is to prevent it from happening. For this, do some kind of exercise that keeps your joints supple and limbs strong. This link from Life Options has an excellent guide on the different kinds of exercise that can be done by those on dialysis. Try to get started on some kind of exercise that suits you. Include some options from all the three kinds of exercise covered in the link - flexibility, muscle strength and endurance. As with anything in Kidney Disease, check with your doctor before beginning anything new.

To me, muscle strength is very important as losing this can cause a lot of problems in doing basic stuff like sitting and standing up. If you don’t take enough care to maintain good muscle strength, you could end up losing it over a period of time.

However, I recently figured by posting a question on the Facebook group of Home Dialysis Central about the loss of muscle strength and I got some very useful responses and help on what could be done to correct it. An old friend and an old hand at home hemo gave me some very pertinent advice. He said that he had had similar problems and he invested in a good Physiotherapist who came home and spent a few months working on him getting him to exercise so that he could achieve his goals which were pretty straightforward - to be able to sit on and and get up from the floor without support. He has apparently made some very good progress over the past few months.





After reading that, I have engaged with a Physiotherapist and am undergoing training under him for my weak muscles. I have completed two weeks and have already begun to see early results.

Many of us assume, wrongly, that these things cannot be resolved. The beauty is that in today’s world, there is hardly any problem which is being experienced for the first time. People before you have definitely had the same problem. So, ask around to check if they’ve found a solution. In this case, people had found a solution and it will help me as well.

So, try to prevent muscles from becoming weak by undergoing some kind of regular exercise and if they’ve already become weak, take action to regain some of the lost strength.

Saturday, June 9, 2018

Going on international holidays while on dialysis

I often get asked how to go for international holidays while on dialysis. It is not as difficult as you might think. The key is to plan early. Few months in advance is always a good idea.

To begin with, once you’ve decided where to go and the rough dates, the next thing to do is to figure out a dialysis centre. I usually use Global Dialysis to do this. Type your destination in the search field and it will show you dialysis centres close to that location. It will also give you a clickable list of centres with distance from your location.

Spend some time on this list and click on each centre that is at a reasonable distance from your location and read the information about the centre like timings, facilities offered, reviews (very important to see if people liked the services) and so on.

Once you have picked a centre, send them an email with your dates and ask if they will be able to accommodate you. Typically most places are accommodating of holiday dialysis patients. Each centre has its own set of documents needed for dialysis. They will usually be a range of blood tests and prescriptions that would be needed. You can email or fax them to the centre depending on the mode they prefer. I find email the easiest way to communicate. Sometimes you would need to send another set of blood test reports a few days before your travel dates. Always carry a printed copy of all these tests, prescriptions, everything you’ve sent along with you.


After a dialysis session at a centre in Seattle, USA

Remember that not all dialysis centres will have English speaking staff so if you need to call for whatever reason, be very patient. Keep a record of the contact numbers with you and the name of the person you’ve been in touch with. Call a day before your session to confirm your slot.

Every centre has their own protocol for dialysis which may be different from yours. So if you need anything apart from the ordinary, take it with you. For example, I am used to buttonhole needles. I took them with me. I also asked to allow to self-cannulate and all places agreed. Some people are used to lignocaine. If so, take a vial with you. 

In the US, the dialysis centres do not provide blankets and pillows. You have to take them with you as the centres can be cold. 

There are several very good destinations around the world which you can explore even if you’re on dialysis. 

Dialysis Cruises

I love the idea of going on a cruise. There are several cruises that have a dialysis facility on board. They have dialysis staff and even a nephrologist on board. You can check out www.dialysisatsea.com and www.cruisedialysis.co.uk for options.


Aboard a cruise ship in Alaska

Cost

The cost of dialysis in most international locations is much more than a session in India. So, remember to find out upfront about the cost and also find out the payment options - whether they accept credit cards or need cash etc. and be prepared with this. Most insurance companies will not reimburse the cost of dialysis abroad.

Session timings

Many centres (especially in the US) will confirm dates but not let you know the time of your session until the week before your session. So, better to avoid travel on the dialysis days.

International travel is very exciting for those who can afford it. It not only gives you a chance to see lovely places, it also gives you an insight into dialysis services in other countries.

Do try out a trip if you are able to and let me know how it went. All the best!

P.S. Thanks Ms. Astha Tandon, a guest from NephroPlus who urged me to blog about this.