Saturday, January 31, 2015

Visiting the Japanese Society of HHD Conference, Part 1

In February 2013, I gave two presentations at the Annual Dialysis Conference in Seattle, and sponsored by the University of Missouri.

After hearing my presentation on supporting the caregiver (care partner) in Home Hemodialysis, Dr. Ituko Masakane from Yamagata University asked me if I'd like to come to Japan.

Japan! A lifelong dream. With an invitation formalized by Dr. Noriko Mori of the Department of Nephrology of Shizuoka General Hospital, I left Seattle on April 17, 2014. My topic: "Home Hemodialysis: The Best Gift I Could Give My Husband."

Dr. Masakane, Dr. Gromko, and Dr. Mori after Linda's Talk

What's it like to give a talk in Japan? Considering I speak about three phrases in Japanese - and we weren't planning on formal translation, it could have been rugged! But Dr. Mori was kind enough to translate my slides into Japanese. My audience was very kind and respectful.

Here's the poster that advertised the conference I attended in Shizuoka.
We agreed that my late husband Steve, with his Metabolic Syndrome and Diabetic Renal Failure, would have been nicknamed, "Mr. Metabolic Syndrome." In Japanese, of course, that would have been "Metabol-San."

My guides, Keiko and Masaki
Japan's ESRD culture is quite different from what I know in the US. For example, kidney transplantation is extremely rare. With a philosophical stance that does not allow for brain death as a criterion for organ harvesting, transplants are essentially limited to related living donors, not cadaver donors.

For this reason, Japan leads the world in its proportion of hemodialysis. Home hemodialysis, however, occurs much less commonly than in America. There are approximately 400 patients on HHD in the entire country. This is where personal stories - like the story of helping Steve with dialysis at home - may be of help.

Models of sharp and blunt needles -
larger than life, but pretty much how Steve saw them!

It occurred to me that Steve had been told by a nephrologist, "Dialysis is what you do until you get a kidney."

In Japan, dialysis is most likely what you do with End Stage Real Failure, period. From what I saw, though, there are some innovative approaches with tremendous merit.

Check out the next blog post for my experience at the University of Kyoto, and - best of all - my visit to the Sakai Rumi Clinic in Kobe.

We're in this together - and we can make it better!
Linda Gromko, MD

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