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Author Topic: Questions to Ask When Choosing an In-Center Dialysis Provider  (Read 10144 times)
okarol
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Photo is Jenna - after Disneyland - 1988

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« on: April 23, 2011, 10:48:40 AM »

Questions to Ask When Choosing an In-Center Dialysis Provider

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By Karol Franks                          (From Karol's Blog: http://okarol.blogspot.com/)
 
Not all dialysis centers are the same and their rules and procedures can vary. The willingness of the dialysis center staff to address these questions will give you a good idea of the level of customer service you can expect to get.
 
1.      Can I visit the center before beginning dialysis?
2.      What is the process for the first treatments?
3.      How many stations (chairs) are there and how many shifts?
4.      What shift can I expect to get? What if I have school or a job?
5.      Can patients eat or drink while being treated?
6.      Are TV's shared or individual?
7.      Is there free wifi?
8.      Are visitors allowed during treatment?
9.      How do you handle holiday scheduling?
10. What if I need to modify my schedule? How do I arrange this and who do I contact?
11. Who is the operating manager? What is their backround? Are they a caregiver, RN, RD, MSW, etc. or a corporation?
12. What precautions are taken to make sure I don't get someone elses disease or an infection?
13. How many RN's are there per shift?
14. How many techs? What is their training/certification?
15. Who will be cannulating (nurse or techs?)
16. Do you have trainees cannulating patients? Are patients informed of this and given a choice?
17. Do you encourage and teach self-cannulation?
18. Are patients taught how the dialysis machines work?
19. Can I get a copy of my monthly lab slips?
20. How often can I expect to see the nephrologist?
21. Is there a support group? For patient and family?
22. Do you offer help with pain? Lidocaine injections? EMLA cream? Benadryl?
23. Do you offer Peritoneal Dialysis (PD)? If not, do you know of any centers that do?
24. When are PD nurses here at the dialysis center? If I need help after hours, who do I call?
25. Do you offer home hemo training?
26. Is nocturnal dialysis available!? Can I come in to observe?
27. Is a social worker able to assist with Medicare and kidney transplant questions?
28. Is renal diet and nutrition counseling given?
29. What lab levels are used before giving epogen/iron?
30. Do you help arrange transportation to the dialysis center?
31. Can you assist me with scheduling if I want to travel while on dialysis?
32. What is the complaint or grievance procedure?
 
When you're new to dialysis it can be overwhelming, so not all these issues will make sense at first. But knowledge is power and having information up front can help you have a better experience.

About the Author
Karol Franks lives in Southern California. She is married and a mother of 4. Her 24 year old daughter received a kidney from an altruistic donor in Jan. 2007, and as a result Karol became an advocate for patients and living donors. She serves as an administrator for www.livingdonorsonline.org - an online community for living organ donors, potential donors, their families, and medical professionals. She also volunteers as an administrator for ihatedialysis.com, a patient support forum for patients and their families as they cope with living with kidney disease.
 
Last Updated April 2011
   


The information on KidneyTimes.com is provided for general information purposes only.
Always consult with your healthcare team before making any changes to your healthcare or nutrition regime.

KidneyTimes.com is a program of Renal Suppot Network.
For more information about RSN go to RSNhope.org.

http://www.kidneytimes.com/article.php?id=20110421165503
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Admin for IHateDialysis 2008 - 2014, retired.
Jenna is our daughter, bad bladder damaged her kidneys.
Was on in-center hemodialysis 2003-2007.
7 yr transplant lost due to rejection.
She did PD Sept. 2013 - July 2017
Found a swap living donor using social media, friends, family.
New kidney in a paired donation swap July 26, 2017.
Her story ---> https://www.facebook.com/WantedKidneyDonor
Please watch her video: http://youtu.be/D9ZuVJ_s80Y
Living Donors Rock! http://www.livingdonorsonline.org -
News video: http://www.youtube.com/watch?v=J-7KvgQDWpU
Zach
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"Still crazy after all these years."

« Reply #1 on: April 24, 2011, 05:41:50 AM »

Do you have a bowling team?
 :waving;
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Uninterrupted in-center (self-care) hemodialysis since 1982 -- 34 YEARS on March 3, 2016 !!
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
No transplant.  Not yet, anyway.  Only decided to be listed on 11/9/06. Inactive at the moment.  ;)
I make films.

Just the facts: 70.0 kgs. (about 154 lbs.)
Treatment: Tue-Thur-Sat   5.5 hours, 2x/wk, 6 hours, 1x/wk
Dialysate flow (Qd)=600;  Blood pump speed(Qb)=315
Fresenius Optiflux-180 filter--without reuse
Fresenius 2008T dialysis machine
My KDOQI Nutrition (+/ -):  2,450 Calories, 84 grams Protein/day.

"Living a life, not an apology."
okarol
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« Reply #2 on: April 24, 2011, 10:37:08 AM »

Do you have a bowling team?
 :waving;

Dang it! I knew I should have had you review this!!  :banghead;
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Admin for IHateDialysis 2008 - 2014, retired.
Jenna is our daughter, bad bladder damaged her kidneys.
Was on in-center hemodialysis 2003-2007.
7 yr transplant lost due to rejection.
She did PD Sept. 2013 - July 2017
Found a swap living donor using social media, friends, family.
New kidney in a paired donation swap July 26, 2017.
Her story ---> https://www.facebook.com/WantedKidneyDonor
Please watch her video: http://youtu.be/D9ZuVJ_s80Y
Living Donors Rock! http://www.livingdonorsonline.org -
News video: http://www.youtube.com/watch?v=J-7KvgQDWpU
Rerun
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Going through life tied to a chair!

« Reply #3 on: April 24, 2011, 01:16:51 PM »

Do you have an ice machine?    :rofl;

Does the Doctor come talk to you (in clinic) so everyone in the whole unit knows about your depression and wanting to kill yourself and the one humming and making odd noises beside you? 

Good job Karol.  Was this published??
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okarol
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Photo is Jenna - after Disneyland - 1988

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« Reply #4 on: April 24, 2011, 07:34:15 PM »

LOL Rerun, I should have included a short questionnaire about the other patients, "Is there anyone who rants, hums, belches, sings, farts or screams during their treatment?"
It was published in Renal Support Network's Kidney Times.
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Admin for IHateDialysis 2008 - 2014, retired.
Jenna is our daughter, bad bladder damaged her kidneys.
Was on in-center hemodialysis 2003-2007.
7 yr transplant lost due to rejection.
She did PD Sept. 2013 - July 2017
Found a swap living donor using social media, friends, family.
New kidney in a paired donation swap July 26, 2017.
Her story ---> https://www.facebook.com/WantedKidneyDonor
Please watch her video: http://youtu.be/D9ZuVJ_s80Y
Living Donors Rock! http://www.livingdonorsonline.org -
News video: http://www.youtube.com/watch?v=J-7KvgQDWpU
KarenInWA
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« Reply #5 on: April 24, 2011, 08:18:09 PM »

Mine has an ice machine, and a microwave! And, they encourage you to eat during treatment! (no vending machines, though...  :rofl; )

Mine also welcomes visitors, as long as they're not unruly and nasty.  I so far consider myself lucky when it comes to clinics.  Now if only something could be done about that "clinic smell"...

KarenInWA
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1996 - Diagnosed with Proteinuria
2000 - Started seeing nephrologist on regular basis
Mar 2010 - Started Aranesp shots - well into CKD4
Dec 1, 2010 - Transplant Eval Appt - Listed on Feb 10, 2012
Apr 18, 2011 - Had fistula placed at GFR 8
April 20, 2011 - Had chest cath placed, GFR 6
April 22, 2011 - Started in-center HD. Continued to work FT and still went out and did things: live theater, concerts, spend time with friends, dine out, etc
May 2011 - My Wonderful Donor offered to get tested!
Oct 2011  - My Wonderful Donor was approved for surgery!
November 23, 2011 - Live-Donor Transplant (Lynette the Kidney gets a new home!)
April 3, 2012 - Routine Post-Tx Biopsy (creatinine went up just a little, from 1.4 to 1.7)
April 7, 2012 - ER admit to hospital, emergency surgery to remove large hematoma caused by biopsy
April 8, 2012 - In hospital dialysis with 2 units of blood
Now: On the mend, getting better! New Goal: No more in-patient hospital stays! More travel and life adventures!
Hazmat35
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« Reply #6 on: April 25, 2011, 09:22:11 AM »

We have Wi-Fi, Tv's, Ice Machines, and Microwaves.  Ocassionally, someone brings in a new DVD that we can all watch if we choose to. 

We can eat and drink while we are hooked up, as long as we take our BINDERS!  NO BINDERS no snacks!!!! 

Also, we have a coffee machine running.  Mostly for the Nurses and Techs, but when they make a fresh pot, someone always makes the rounds asking if anybody wants some. 
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Brother Passed away - 1990 - Liver Disease
Diagnosed w/ Polycystic Kidney Disease - 1998
Mother passed away - Feb. 1999 - PKD
Sister passed away - Feb. 2006 - PKD
AV Fistula / Upper Left Arm - September 2009
Father passed away - September 2009
In-Center Hemo Dialysis - April 2010
Broken Knee Cap - January 2015
Diagnosed w/ A-Fib October 2017
Surgery to repair Hiatal Hernia 2018
Multiple Fistula Grams / Angioplasty's since then!


Hating Dialysis since Day 1 and everyday since then!!!!  :)
greg10
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« Reply #7 on: April 25, 2011, 09:46:59 AM »

Questions to Ask When Choosing an In-Center Dialysis Provider
..  http://www.kidneytimes.com/article.php?id=20110421165503
There is a DaVita clinic just a mile away from my home, but I am at the non-profit Puget Sound Kidney Center. 
DaVita is only open during work hours, and I'd rather go to a non-profit, especially after all I've read here!
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Newbie caretaker, so I may not know what I am talking about :)
Caretaker for my elderly father who has his first and current graft in March, 2010.
Previously in-center hemodialysis in national chain, now doing NxStage home dialysis training.
End of September 2010: after twelve days of training, we were asked to start dialyzing on our own at home, reluctantly, we agreed.
If you are on HD, did you know that Rapid fluid removal (UF = ultrafiltration) during dialysis is associated with cardiovascular morbidity?  http://ihatedialysis.com/forum/index.php?topic=20596
We follow a modified version: UF limit = (weight in kg)  *  10 ml/kg/hr * (130 - age)/100

How do you know you are getting sufficient hemodialysis?  Know your HDP!  Scribner, B. H. and D. G. Oreopoulos (2002). "The Hemodialysis Product (HDP): A Better Index of Dialysis Adequacy than Kt/V." Dialysis & Transplantation 31(1).   http://www.therenalnetwork.org/qi/resources/HDP.pdf
okarol
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Photo is Jenna - after Disneyland - 1988

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« Reply #8 on: May 31, 2012, 10:26:46 PM »

 :bump;
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Admin for IHateDialysis 2008 - 2014, retired.
Jenna is our daughter, bad bladder damaged her kidneys.
Was on in-center hemodialysis 2003-2007.
7 yr transplant lost due to rejection.
She did PD Sept. 2013 - July 2017
Found a swap living donor using social media, friends, family.
New kidney in a paired donation swap July 26, 2017.
Her story ---> https://www.facebook.com/WantedKidneyDonor
Please watch her video: http://youtu.be/D9ZuVJ_s80Y
Living Donors Rock! http://www.livingdonorsonline.org -
News video: http://www.youtube.com/watch?v=J-7KvgQDWpU
Heisenburg
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« Reply #9 on: December 14, 2015, 04:29:29 PM »

When there is only one provider you ask if you can use the nearest centre.
My nearest unit is 12 kilometres away and I was there from the day it opened.
No WiFi but individual TVs and we are supplied a sandwich and can plug in
a computer etc. Internet is available via individual mobile phone services.
We can have visitors and we can eat and drink (and be merry?)
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You all know exactly who I am. :)
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