|Linda giving a bookstore talk, with |
Steve's image on the PowerPoint slide
After my talk, the four nephrology fellows (specialists-in-training) shown at left took me to the golden Kinkajui Temple shown behind us. We had a remarkable dinner - with me eating my first-ever raw fish.
|Dr. Sakai tells of having a patient|
on dialysis for 40 years!
My observation is that when dialysis is what you do for ESRD, you have to do it very, very well!
For example, the blood flow rate in Japanese hemodialysis is much slower than in the United States. Surely, this must be more gentle on the dialysis access fistula!
In Dr. Sakai's clinic, patients have the option to do hemodialysis every other day: not the Monday, Wednesday, Friday regimen we do in in-Center dialysis. The three-day U.S. routine leaves patients with a long weekend to allow a patient to become volume overloaded, thereby increasing their risk of cardiac events during the break!
Above, Dr. Aya Kita explains another feature of the Sakai Rumi Clinic. Each numbered cubicle allows a patient to dialyze in private overnight! They are monitored by video cameras, blood pressure recordings, and moisture detectors - in the event of an accidental disconnection. Patients are able to shower after their dialysis and go right on to work. To me, this seems like a great solution for people who do NOT wish to dialyze at home. Plus, it would allow for maximal facility utilization!
I am a staunch advocate for the use of home dialysis. But the more options we have, the better!
We're in this together, and we can make it better!
Linda Gromko, MD