Check out the Series from Jane McClure and me on Home Dialysis!

Check out the series Jane McClure and I have written for Dialysis Patient Citizens. This is Part II of our four-part post on "How to Set Up Your Home Dialysis Unit Without Feeling Like You're Living in an ICU!"  http://ow.ly/slBbF

It's good, practical information to help you make your home dialysis as easy and as comfortable as possible.

Take care,
Linda Gromko, MD

Home Dialysis was the Best Gift I Could Have Given to My Husband!

In looking back over my late husband's multiple health problems, e.g., diabetes, cardiovascular disease, renal failure, peripheral vascular disease, etc., it's clear that quality of life was the thing that ultimately mattered most.

Steve Williams in 2009, on home
hemodialysis at the time

Home dialysis - first hemodialysis, and later peritoneal - offered Steve the best possible mobility, flexibility, and access to some semblance of normalcy. It gave him more time with his daughter, Brita, and more time with his many friends.

As strong advocates for home dialysis, Interior Designer Jane C. McClure and I have written the first of a four-part series on "Setting Up Your Home Dialysis Unit - Without Feeling Like You're Living in an ICU!" Check it out in the Patient's Voice Blog: http://bit.ly/1gv3Uuo

Remember, home dialysis can be an enormous gift. Learn to do it!

Linda Gromko, MD

Mid-Columbia Nephrology Seminar: Plenty of Content, an Abundance of Heart

In a well-orchestrated program led by Lyle Smith, MN, nephrology nurses and dialysis technicians from all over Washington and Oregon shared common - but challenging - concerns.

Held in Richland, Washington on October 20, 2013, issues covered included:

• What's the most effective way to dialyze? How do you discharge an in-Center patient who is violent or otherwise inappropriate? What do the lab reports mean to our patients?

Dori Schatell, Director of the Medical Education Institute and co-author of the exceptional resource, "Help! I Need Dialysis!" spoke on issues of sexuality and fertility in the kidney patient. How much dialysis is necessary for a pregnant patient? How can we help our patients talk about sexuality concerns? How can we address self-image matters that impact relationships in all areas of life?

Jane McClure and I spoke about "How to Set Up Your Home Dialysis Center (Without Feeling Like You're Living in an ICU)." As the advantages of Home Dialysis become ever more clear, our patients need help in setting up their Home Centers in ways that are life-affirming!

Nancy Spaeth, RN - always inspiring after four kidney transplants - spoke about her experiences as one of the first Home Dialysis patients. She focused on the very real need for post-transplant patients to receive Physical Therapy and Physical Medicine care as part of their recovery.

It was a full and varied conference - plenty of content, and an abundance of heart.

Take care,
Linda Gromko MD

Medical Writing Seminar Participants to Get a Glimpse of Home Dialysis

At my September 22nd Field's End Writing Seminar "Just What the Doctor Ordered," participants will get an upfront look at many things medical.  We'll cover medical terminology, basic disease processes, medical slang, "who's who on the medical food chain," and a range of other topics.

We'll have a number of writing exercises, of course. Like this one:

"Compare and/or contrast the following photos of individuals undergoing kidney dialysis treatments."

This photo of Bill Peckham dialyzing on a rafting trip - while drinking champagne from a can(!) - begs for comment, in contrast with the photo below it! The lower photo was lifted from the Internet: some unidentified woman tolerating her in-center treatment.

 

 

 

 What a difference!

 

A photo contrast like this reaffirms my confidence in the superiority of Home Dialysis!

 

For more information on the Writing Seminar, visit www.FieldsEnd.org.

 

Take care,

Linda Gromko, MD

Field's End Medical Writing Workshop September 22, 2013

Join me for a Sunday writing workshop on Bainbridge Island:
Sunday, September 22nd, 1-4 pm, Bainbridge Island Library!

 



This workshop is intended to help participants incorporate credible medical content into their fiction and non-fiction writing.

 

 

Through writing exercises and discussion,we'll review

• Important medical terminology
• Who's who on the medical "food chain?"
• Medical dialogue and idioms
• The "flow" of an ER visit, delivery, surgery
• Basic disease processes
• Resources that can help you fact-check your own information.

Bring your questions and writing projects for a painless afternoon of medical attention. For further info, go to www.FieldsEnd.org.

 

Linda Gromko MD

New CDC Recommendations Show Reduction in Bloodstream Infections by Half!

Bloodstream infections are among the most common - and most deadly - complications for dialysis patients. A recent CDC report discusses dialysis protocols that were shown to reduce infections by about half. http://dialysispatients.wordpress.com/2013/07/02/fistula-first-keeps-life-saving-options-open/

Many of the CDC protocol recommendations were simple: just common sense. How often we appreciate just how rare "common" sense really is!
Here are some of the main points:

• When possible, start initial dialysis treatments via a fistula or graft - rather than a central IV line in the internal jugular vein (neck) or subclavian vein (chest).
• Follow a checklist for dialysis procedures. The CDC gives examples of these tools.
• Wash your hands (!).
• Use clean gloves.
• Use an appropriate antiseptic for cleansing the access site, e.g., chlorhexidine.
• Apply a recommended anntimicrobial ointment to dialysis access sites.

The first point, i.e., "Fistula First!" is probably the most important.

This is because central line infections are more serious - often involving resistant bacteria such as MRSA. Central line infections are costly - and potentially deadly. Plus, they can lead to complications like infections of the heart valves (endocarditis) or the bones (osteomyelitis).

And nobody needs such complications less than a dialysis patient!

Yet, roughly 80% of dialysis patients begin their initial treatments via a central line!

In the case of my late husband, Steve, there was no other option. When first diagnosed with Chronic Kidney Disease Stage 4 (CKD-4), we thought dialysis would be years to at least months down the road.

Then a perfect storm of three calamities (dental abscess, sinus infection, and bronchitis) precipitated a free-fall into CKD-5 - over a period of only two weeks. This was way too fast for a fistula or peritoneal dialysis catheter.

But most patients don't fall into "kidney hell" as quickly as Steve did; there really can be time to plan ahead!

Please take a look at my Dialysis Patient Citizens blog, "The Patient's Voice," for more information.

If you're heading towards dialysis, give yourself every advantage. And make sure you and your dialysis center are following the CDC guidelines.

Take care,
Linda Gromko MD

Mark Bittman Offers a Rational "Part-time Vegan" Solution at the Northwest Kidney Centers 2013 Breakfast of Hope

If eating healthfully and maintaining a normal weight were, well, a piece of cake, we'd see less End Stage Renal Failure - fewer people on dialysis!

Why? Because the two leading causes of CKD-Stage 5 (End Stage Renal Failure) are Type 2 Diabetes and Hypertension (high blood pressure). And there's no question that both of these conditions are linked to overweight and obesity.

Mark Bittman, well-known author of many cookbooks and a NY Times columnist, presented his practical solutions at the NW Kidney Centers Breakfast of Hope on May 14, 2013.

Bittman, author of "How to Cook Everything," faced his own dilemma several years ago when his doctor pointed out that his weight was climbing and his cholesterol numbers needed improvement. His doctor suggested, "Become a vegan." (Vegans are a strict group of vegetarians who won't eat "anything with a face.") There go Ben & Jerry.

Taken aback, Bittman came up with an alternative: become a part-time vegan - or more specifically, "Be Vegan Until Six."

VB6 means that you eat vegan until 6:00 pm everyday - and then relax a bit.

It worked for Mark Bittman, as he watched his weight normalize and his laboratory values improve.

Is it the only way? Of course not! But Bittman presents a reasonable view: it's not "all or none." It is likely sustainable over the long term.

There are many ways to lose weight, but keeping it off is trickier. Google up the National Weight Control Registry, or read Ann Fletcher's masterful "Thin for Life" for more advice.

Remember, this is a marathon - not a sprint.

Thanks to Mark Bittman for his outstanding presentation and contribution to the Northwest Kidney Centers Breakfast of Hope.

Take care,
Linda Gromko MD
www.LindaGromkoMD.com