Tuesday
2014-07-08
The pace and amount of fluid removed from a patient is simple and yet risky.
On Thursday,
July 3th I went to the training centre and R was the only patient
there. The nurses had forgotten that it was my day of the week and were
surprised seeing me. As I only made the room half full, I was settled-in in no
time.
R (see myblog Monday, 2014-06-16 DialysisRisk—Fresenius 5008 ) told me he spent the last 10 days in hospital. It seems
that after months coming here strapped up with the flashy Fresenius 5008 to
reduce his weight, and after numerous times of fainting here and in the clinic
on and after dialysis, and a few times of strapping with oxygen masks, his formerly
by-passed heart could take it no more. One day while on dialysis here in this
centre his heart finally gave in and he was sent by ambulance to the mother
hospital M where he stayed for 10 days allegedly for heart trouble.
When asked
about his 12kg + excess weight he replied that it was all gone. He did dialysis
everyday for 5 hours for 10 day while in hospital.
Hospital M
doesn’t have F5008S, what they do have are the regular F4008S (BVM-lie detector) which is just one
scale better than the F4008B I have in my home. What they did there was very
simple. Some doctor ordered 2.6 litres was to be taken off from him each day.
My interpretation is this, R was allowed 800ml of fluid each day, on dialysis
he would take on 500ml which include 200ml drink, 300ml saline going on and off
the machine, together that make up to 1.3 litre, double that to 2.6 litres
which is the amount doctor prescribed.
10 days
later, bang, his fluid was all gone. R was a happy man again and out of the
hospital. The benefit of removing 2.6 litres a day is obvious, the speed of
fluid removal allowed ample time for the excess fluid to move from extracellular
into blood vessel without dehydrating the patient which causes unnecessary
fainting spells thus endangering the patient’s life. Gradually in a steady pace
the weight came down.
Everything
was so surgical, mathematical and yet so simple. Another contributor is that in
hospital a renal patient’s fluid movement is closely monitored, anyone who has
been to the renal ward knows how strict the nurses can be in handing out drinks
and recording the urine output, they follow instructions to the letter.
Now that
R is back, I saw on the F5008 the UF was
3.9 litres (RISKY) for 5 hours and he was due back again the next day on
Friday, Saturday and Sunday the centre closes, and his machine at home is been
checked out by our technician. R is back to his old routine including the help
he gets from the nurses at the training centre.
Again the
nurse was preaching to him about the benefit of longer hour dialysis and
enquired about the length of R’s sessions at home. His answer was evasive.
By the way,
R’s diet is mainly fruit than anything else except some noodle soup and ice. I
wonder how he can survive with such a diet, after all R is a guy of 88 kilos.
If both he and the nurses at the centre were back to their old way, I remember
at one cession that R wanted taking off 4 litre at one go and the nurse chose 3
litre over him, provided these continued I would imagine that his
next tune-up is either 6 months or 10kg whichever comes first. For now things
are looking up, I heard there’s a baby on the way. Until next service, so long
R.
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