Per her kidney doctor yesterday, Mom will probably need to start dialysis in the near future. He mentioned that most dialysis patients are younger than she is, and after thinking about that I have a couple of questions I hope someone can answer.
First ... he wants a 24-hr urine collection done for further diagnostic tests. Mom is incontinent and wears Depends. She *usually* makes it to the bathroom on time but not always, and overnight she definitely uses the Depends (goes in her sleep). Should I be concerned that not ALL of her urine will be caught during the 24-hr timeframe?
Second ... when she's been hospitalized, the nurses have had problems finding a good vein for IV and blood draws. In addition, her skin is very thin and needles/tubes meant to stay in place have torn the skin and had to be moved. I'm wondering how much of a problem this may cause for dialysis 3 times a week?
Talked to Dr.s office yesterday, and regarding the urine collection he wants it done with the "hat" for the toilet. Get as much as possible caught in the "hat" over the 24 hr period, then catch the "first urine" of the next morning plus one additional urine catch that next day, and that will suffice. He said he just needs a "ball park" to see about creatinine and potassium levels.
There is a dialysis clinic right here in town. Her doctor is not associated with this clinic and would not be able to continue to be her doctor -- she'd need to transfer her case to the doctor who handles the clinic here. Problem is, Mom had some consult with this local doctor (nephrologist) several years ago over something, and did not LIKE this doctor. I don't know whether or not this local doctor is a good nephrologist.
What I'm hoping is the dialysis is not necessary.
As to the reallocation of time, try to find a way to get something done that you wouldn't do otherwise - read a book, magazine, take a nap while dialysis is taking place or dash out to get some shopping done. Otherwise it will seem like a lot of time lost.
And it's very likely that you'll both be exhausted the following day, so plan on just resting up. Weekends can be for shopping, etc. so you have the week free to focus on making the dialysis as minimally unpleasant as possible.
As far as whether or not she wants dialysis ... she's of sound mind, so she is capable of making the decision. As her hearing is not great, she didn't catch everything the doctor said, but I explained to her during the drive home and she was accepting of the idea.
What I think she may not grasp -- in fact, this just hit "me" today -- is how much of our daily lives dialysis will eat up if in fact it's what the doctor wants her to do. Assuming she is scheduled in the afternoons, that will be 3 days a week that will include rushed mornings to make sure she's up on time to eat breakfast and be ready to go to the treatment so we can get there on time. By the time we get back home it will be nearly time for dinner, so no nap time for me even though hopefully she'd nap during treatment. Our dog will need to be crated while we are gone, so that's about 5 hours of crating a day for her ...
Just things I'm thinking about.
If Mom wants to keep him as her kidney doctor -- which she does and I agree, as we have a good rapport with him and his staff and have been very pleased with her care -- he is only affiliated with one dialysis clinic, and that is nearly an hour's drive from Mom's home. So we're talking 3 entire afternoons a week (hopefully she will be scheduled for afternoons). This would be easiest on her, as she normally naps in the afternoons, so she could nap during the treatment or maybe read if they can adjust lighting for her.
I'm afraid that the vein problems will be up to the medical staff. I've seen some very bad vein damage from dialysis. One of my friends had a vein made for her and permanently inserted. It made it easier.
I don't envy her the dialysis. It takes so much time I wish she didn't have to go through it. Maybe her tests will continue to be good enough.