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Dialysis for FIL - what does it mean?

Doctors have been warning my FIL for years that he was headed for dialysis, and finally that day has arrived - they want him to start asap. He has type 2 diabetes and a host of related health problems.

I know what dialysis is in a technical sense, but what does this mean for my FIL? Is this an end stage treatment or something he could do for many years??How will this limit his mobility? - I think he has to go in to a clinic for it, rather than doing home dialysis.

He just found out yesterday, so I didn't want to drill him with all my questions yet.

Re: Dialysis for FIL - what does it mean?

  • I had a great-uncle who needed dialysis. He did it for years -- how many, I don't remember, but it was quite awhile. He also had to go to a clinic to do it.?

    As long as he had access to a dialysis clinic, he wasn't all that limited -- except in the other mental & physical problems he had that kept him from things like driving. (Of course, his mobility while hooked up to the machines wasn't much, and it did take up time.) But in the broader sense, my parents took him on trips to Florida -- they just made sure that there was a dialysis place nearby where they could take him when he needed it. I think he had to go once or twice a week? ?

    I have no idea how all that works with insurance. He was disabled and on medicaid, I believe. ?

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  • I had an employee that worked for me that was on dialysis, and as a matter of fact, he had a portable dialysis machine that he'd bring to work.  It was in a little brief case.  Twice per day he'd have to hook it up.  We set up a private office for him to go into and do it.  He actually felt so much better once he was treated, and it really wasn't an interuption with work.  He did it for a couple of years while he waited for a transplant.
  • Well, that's reassuring. I was afraid this was along the lines of end of life care or something.... I would be great if this would actually improve his quality of life. Right now he is always tired and can hardly even walk around anymore.

    My ILs are senior citizens and on Medicare, so I think this will be covered by their insurance.?

  • it also means his kidneys are not functioning properly and he will need it regularly for the rest of his life unless he gets a kidney transplant. It means (usually) surgery to place a graft for dialysis and a huge interruption to lifestyle.
  • I haven't heard anything about trying to get him a transplant... would they do that for someone who is generally in poor health? He is on a huge list of precription drugs, including a powerful blood thinner. He just had eye surgery, and that was hard enough to schedule around his blood thinner med issues.

    It has been frustrating to watch him go down this road. When we moved here two years ago his nephrologist started talking about dialysis with him. I love my FIL dearly, but he has made ZERO lifestyle changes to prevent this from happening to himself.

  • It is a big lifestlye change.  It will depend on the type of dialysis he will be on.  He will be on a more restrictive diet.  He can be on dialysis for years.  Some people get really tired after their treatments, some feel great.  Your ILs might not be able to answer all your questions until after the first couple of treatments.
  • image ibis:

    I haven't heard anything about trying to get him a transplant... would they do that for someone who is generally in poor health?

    Unfortunately, the answer to that is no.  And usually, they try to reserve organs for younger individuals, unless the older person is in excellent shape and has an excellent life span ahead of them.  The rigors of transplantation and the following immune system suppression are just not something that most older individuals can stand up to, and with your FIL's health conditions, it doesn't sound like something that he'll be able to have as an option for him.  

     There are two kinds of dialysis.  Peritoneal dialysis can eventually be done at home.  They can teach your FIL and MIL how to run a machine that instills fluid in the belly, then pulls it back out.  There's an implanted catheter placed in the stomach that allows the exchange of fluid.  Sometimes it can be done during sleeping hours.   This website has information on PD dialysis, as it's sometimes known.  (I can't get it to be clicky... sorry.)  http://kidney.niddk.nih.gov/kudiseases/pubs/peritoneal/

     Hemodialysis requires time at a hospital or community dialysis center.  A vascular catheter or a fistula made from a vein graft is accessed and the blood is cleaned through a machine.  They're also able to remove fluid from the body this way, if there's a problem such as fluid overload.  The amount of time that this requires depends on the person and the dialysis orders.  Info on hemodialysis can be found here:  http://kidney.niddk.nih.gov/Kudiseases/pubs/hemodialysis/.

    I'm a pediatric nurse, and I know several kids who lead mostly normal lives, except for the fact that they're dialyzed every few days.  I hope this helps.

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  • Thank you so much for all the info.

    It doesn't look likely that PD will be their route, because from reading that info it looks like the patient has a lot of responsibilities. My ILs (again, I love them, but) have really not been on the ball with their diabetes at all. Since we moved here they have both had to go to the hospital with their blood sugar practically off the charts, though they are supposed to monitor that at home and take insulin as needed, to say nothing of their poor eating habits.... I highly doubt that any doc who sees their medical records would trust them with the PD type of dialysis.

    It looks like we're going to have to set up some kind of family schedule to get them to the nephrologist's a few times a week for this. MIL does not drive and FIL cannot see (we're trying to get him to stop driving completely). I so desperately wish they would consider a retirement community, but they won't even think about it.

    I feel badly for FIL. I know that the breakdown of his body is really taking a toll on him emotionally. At the same time, he has been so careless... it's a tough road. :(?

  • I'm not sure where you live, but here in PA, there's a service called ACCESS run by public transportation that is designed for people (i.e.: the elderly, those in wheelchairs, etc.) who aren't able to use traditional public transportation.  They pick them up at their door, then transport them to their appointments/church/wherever, then return them home.  I don't know if there's something like that in your state, but the social worker at your FIL's doctor's office should be able to set you up with information on filing for eligibility for benefits with a program like that if your area does have one.  Any family member would be able to set up a trip for your FIL, so you won't have to leave the scheduling up to him... you'll know that they're coming on his scheduled day at the scheduled time.

    Also, if the dialysis center will be in a hospital setting, the hospital may have a shuttle service for patients.  Again, another one of those things that a social worker or case manager should be able to set you up with.  That way, FIL will still be able to maintain a little independence and not be reliant on your family to get to and from required appointments, but will be able to do it safely.  

    I hope this helps a little bit.

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  • Hi,

    Kidney disease runs in my family, so I thought I'd add a bit of advice from someone who's been here several times (my dad is currently on dialysis).

    The best advice I can give you and your family is to make sure that ALL of you are educated on exactly what is hapening with your FIL.  Your MIL should go to nephrologist appointments with him, ask lots of questions and really try to understand how this impacts her and your whole family.  There's obvious ways, like making driving arrangements so he can get to the clinic, but it can also change the dynamic of your family.  Renal failure is tough.  The patient can have mood swings (which will be hard on your MIL) and it can be hard for your DH to see his dad go through this kind of treatment.  My own dad has aged about 15 years in the few years that he's been on dialysis (he also has other health problems, though).  Hemo is hard on the body.

    I'm basing this off of my experiences with my own family, so it's not to say that your family will necessarily have these problems, but I wish someone had prepared my family beforehand, which is why I'm bringing it up.

    I wish your family all the best in this tough time.

  • I can only speak from my own experience, so I am not sure how it will easily relate to you... but I can really only speak to the mobility piece.

    My great-grandfather has been on dialysis for about 3 years now, and it's given him a MUCH better quality of life now.   He has always been very active, and traveled here to the US from Sweden every other year for about 20 years to visit my mom, uncle and grandparents (they moved here when my mom was a teenager, rest of the extended family is still in Europe).   His actual mobility was never really affected by the dialysis, other than in the positive - it gave him much more energy.

    The downside is that because of the dialysis, he is no longer able to make those trips over here to see all of us.   He wasn't able to find options for his insurance to be able to continue care while overseas, and since he is much older (I think 86 now? maybe 87..) it could get bad if he discontinued.

    So as long as FIL doesn't have any overseas traveling plans - the dialysis should overall improve his quality of life, giving him more energy and making him feel healthier.

     

    GL!

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  • Lurker chiming in, hope you all don't mind...

    My FBIL had a kidney transplant a couple years ago (FI was the donor).  FBIL was on dialysis for renal (kidney) failure for a few months before the surgery.  He had dialysis twice a week & had to go to a clinic to have it done.  He said he could really tell when he was due to go, he'd get lethargic and just feel lousy.  I suppose we would too if our bodies were filling with toxins...but I digress. 

     Since he was getting it so regularly, they installed a port in his shoulder (near clavicle) to hook him up to the machine.  He'd sit there a couple hours I think while it did its magic.  He had lots of diet restrictions and had some major high blood pressure because of the kidney failure.  He was on lots of drugs for both.  Course he's on even more now as an organ recipient...

     My understanding is that dialysis can be done for years.  Not sure exactly how long.  It is a disruption in life though and getting to the clinics could be an issue as could the fact that, like a PP mentioned, even a long weekend would need to take the dialysis schedule into consideration. 

     

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  • I havent read any of the other replies but I will post from my experience...

    My dad has been on dialysis for just over 3 years... He was diagnosed with type 2 diabetes in the early 90s and was told in the early 2000's that he should start dialysis... he kept saying no no no and that he wasn't going to live out the rest of his life depending on some machine....fast forward to May 2005 and it;s only 3 months til my wedding.. well my dad was getting sicker and sicker and getting extremely bloated... his dr told him either get his a55 over to the hospital now to start dialysis or my mom would be calling the undertaker in a few days,,, Thankfully he went to the hospital... he spent a week there and with in the first 36 hours of being in the hospital and 4 dialysis treatments, they took almost 40 pounds of fluids out of my dad!!!!...

    Now my dad goes for treatments 3 days a week for 4 hours a visit...he has to follow a strict diet amd limit his fluid intake to no more than 32 oz of fluids a day... As long as your dad follows the drs orders hw will be fine... he should still be able to do most of the things he did before...

    For the last 3 years my dad has been in end stage renal failure and the only thing keeping him alive is dialysis.... we also know that when he does decide to stop going that it will only be a matter of a few days to a few weeks until he passes (more likely about a week).

    if you have any questions feel free to email me at cmw2 at hotmail dot com..  put the nest and dialysis in the subject line and I'll get back to you asap... i know you and your family will ave lots of questions and I can try to answer some of them as best as I can from my experiece....

     

     

  • I'm super late on this, but in case you are checking:

    If you or your DH go to an appt. ask to talk to a social worker.  Dialysis centers usually have at least one social worker or someone in "social services".  This person will be able to tell you what benefits your FIL will be eligible for (including transportation, Medicare-which covers kidney related care for people of all ages, and any SSI or SDI he may be eligible for).   They may also have other programs or resources that could help your In-laws.

    My brother was diagnosed with renal failure when he was 13.  Within 2 months he was on dialysis and within 5 months had a transplant (family donation).   I think everyone else has provided any dialysis information I could provide.

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