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1 | mobile-kidney-web-2.0.0.zip\mobile-kidney-web\acceptance_test\watir\datasheet | Treatment_Text_Content.xls | Wed Apr 4 20:16:46 2018 UTC |
2 | mobile-kidney-web-2.0.0.zip\mobile-kidney-web\acceptance_test\watir\datasheet | Treatment_Text_Content.xls | Wed May 23 14:43:11 2018 UTC |
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1 | SHEET: kid neysFail | |
2 | ||
3 | Section, N avigatitio n, Section Image, Im age Alt Te xt, Sectio n Header, Content Se gment 1, S egment 2, Segment 3, Segment 4 , Segment 5, Segment 6, Segmen t 7, Segme nt 8, Segm ent 9, Seg ment 10 | |
4 | 1, learnMo re>Treatme nt>1, fail -1.jpg, gr andpa with granddaug hter sitti ng on gras s, Taking an Active Role, It c an be a hu ge shock t o learn th at your ki dneys are failing—ev en if you knew it wa s coming. Kidney fai lure may s ound like the end of the world . It’s not . You CAN have a goo d life and keep doin g many of the things you enjoy . The keys are:, Kee p a positi ve attitud e, Learn a ll you can , Take an active rol e in your treatment, You’re ge tting a go od start r ight now b y visiting this site ., Do you know someo ne who did not do we ll on dial ysis? Plea se keep in mind that a poor ou tcome on d ialysis ma y be due t o the dise ase that c aused the kidneys to fail—not the dialys is treatme nts. And, today, the re are mor e options for dialys is than ev er before, so you ca n choose a treatment plan that is a good fit for y our life. | |
5 | 2, learnMo re>Treatme nt>1, man- thinking.j pg, older man thinki ng, An Emo tional Tim e, It’s no rmal to ha ve strong emotions w hen your d octor tell s you that your kidn eys are fa iling. You may be af raid, worr ied, depre ssed, or a ngry. You might even have all of these f eelings at the same time. If y our feelin gs are get ting the b est of you , you are not alone. You would n’t be hum an if you weren’t sc ared and u pset! Talk to someon e about ho w you feel —a loved o ne, your c are team, a clergy p erson, or a counselo r., When y ou believe that you can have a good life , it will help you t o get a gr ip on your feelings so you can move forw ard and ma ke decisio ns—like wh at treatme nt to choo se. For ti ps on copi ng with ki dney disea se, visit the Social Services Room. | |
6 | 3, learnMo re>Treatme nt>1, fami ly-beach.j pg, Nancy, person wi th kidney failure, w ith her ch ildren at the beach, You CAN H ave a Futu re, The mo st importa nt thing f or you to know is, y ou CAN hav e a future with kidn ey failure . Your kid neys aren’ t working right. But , you are still you. You can c hoose to k eep follow ing your d reams—or f ind new on es. This i s a photo of a perso n with kid ney failur e who has had a good life for decades af ter her ki dneys fail ed. Does e veryone ma nage this? No. But i t is possi ble, and t hat means you can tr y. | |
7 | 4, learnMo re>Treatme nt>1, exer cise.jpg, people exe rcising wi th hand we ights, Kee p Your Hea rt Healthy , Health p roblems th at cause k idney fail ure can al so harm yo ur heart. So, if you want to k eep doing the things you love, it’s impo rtant to t ake care o f your hea rt. How ca n you keep your hear t healthy? Here are a few idea s:, Exerci se! Talk t o your car e team if you are ou t of shape . Just wal king can h elp your h eart. Star t slow and build up as you get stronger. , Quit smo king. If y ou smoke, stopping i s one of t he best th ings you c an do for your heart . Talk to your care team if yo u need hel p., Keep y our blood pressure i n the targ et range y our care t eam sets. This may m ean that y ou need to take bloo d pressure pills., K eep your c holesterol in the ta rget range your care team sets . This may mean that you need to take pi lls to low er your ch olesterol. , Eat a he althy diet , with veg etables an d fruits. Lose weigh t if you a re overwei ght. Talk to the die titian to learn more ., Drink o nly modera te amounts of alcoho l. How muc h is moder ate? Ask y our care t eam. | |
8 | 5, learnMo re>Treatme nt>1, bala nced.jpg, balance ba r, Balanci ng Water a nd Mineral s, The mai n job of h ealthy kid neys is to keep wate r and key minerals i n your bod y in balan ce. To kee p the bala nce, kidne ys measure levels of water and electroly tes in you r blood. T hey send w astes and extra wate r to the “ trash can” —your blad der. Your body remov es them as urine. If blood lev els of a s ubstance a re low, he althy kidn eys keep i t in the b lood and s end messag es to the rest of yo ur body to get more. These mes sages are called hor mones. | |
9 | 6, learnMo re>Treatme nt>1, fail -6.jpg, di agram of t he kidneys , Replacin g Kidney F unction, I f your kid neys fail, you will need treat ment to ta ke over th e work of the kidney s. Your tr eatment ne eds to rem ove waste, excess wa ter and so dium from your blood and help control bl ood pressu re. And, y ou may nee d to take medication s to repla ce the hor mones your body need s. | |
10 | 7, learnMo re>Treatme nt>1, fail -7.jpg, gr een button with a pl us sign in dicating t reatment, Choosing a Treatment , There ar e three ma in treatme nt options for kidne y failure. The first two optio ns—a kidne y transpla nt or dial ysis—may h elp you li ve. Some p eople choo se the thi rd option— medical ca re without dialysis— which allo ws a natur al death., There are two main types of d ialysis: p eritoneal dialysis a nd hemodia lysis. Per itoneal di alysis is most often done at h ome. Hemod ialysis ca n be done at home or in a clin ic. Visit all the to pics in th is room to learn mor e about tr eatment op tions for kidney fai lure. | |
11 | 8, learnMo re>Treatme nt>1, fail -8.jpg, wi nding road , Treatmen t Options and Your L ife, Life is a journ ey. You ca n go to on e place or many plac es on a jo urney, and get where you are g oing in a number of ways. You’ ll need to think abo ut what yo u want you r life jou rney with kidney fai lure to be . The choi ce you mak e about ho w to treat your kidn ey failure will have an impact on your l ifestyle. This inclu des:, What you can e at and dri nk, How ma ny medicat ions you m ay need to take each day, How much energ y you may have, Whet her you fe el well en ough to wo rk, How ea sy it is t o travel, How well y ou sleep, Your sex l ife and ab ility to c arry or fa ther child ren, How l ong you ma y live, Ch oosing a t reatment t hat is a g ood fit fo r you can help you t o have a g ood life. If you hav e other he alth probl ems, they may play a role in t he treatme nt choice you make. | |
12 | 9, learnMo re>Treatme nt>1, gold fish-jumpi ng.jpg, tw o goldfish bowls wit h one gold fish jumpi ng to a di fferent bo wl, You Ca n Change Y our Treatm ent Choice Any Time, The VA of fers every treatment option fo r kidney f ailure. Wh en you cho ose a trea tment, it doesn’t ha ve to be a permanent choice. I f you try a treatmen t and it d oesn’t wor k out the way you ho ped, you c an change. Please gi ve your tr eatment a good try f irst, thou gh. For me dical reas ons, some treatments may be a better fit for you t han others . Your doc tor can ad vise you a bout any m edical rea sons why y ou can’t d o a certai n treatmen t, and can help guid e your cho ices. | |
13 | ||
14 | SHEET: per itonealDia lysis | |
15 | ||
16 | Section, N avigatitio n, Section Image, Im age Alt Te xt, Sectio n Header, Content Se gment 1, S egment 2, Segment 3, Segment 4 , Segment 5, Segment 6, Segmen t 7 | |
17 | 1, learnMo re>Treatme nt>2, dial ysis-1.jpg , African American c ouple look ing at a m agazine wi th a pd cy cler in th e backgrou nd, The PD Option, P eritoneal dialysis, or “PD,” i s one way to replace some of t he functio n of kidne ys that do n’t work. It is a ge ntle treat ment and i s easy to learn and do by your self at ho me. Good h ygiene is very impor tant for P D success. , You don’ t need a p artner to do PD. Ass ist device s can help you to do PD if you don’t see or hear w ell, or ca n only use one hand. If you ha ve had maj or surgery to your b elly, PD m ay not wor k for you. | |
18 | 2, learnMo re>Treatme nt>2, dial ysis-2.gif , animatio n of manua l PD excha nge using a catheter , Needle-f ree Treatm ent Using Your Own B ody, Perit oneal dial ysis uses your perit oneum as a filter fo r your blo od. Your p eritoneum is a thin layer of t issue that lines the inside of your bell y and cove rs your or gans. This tissue is rich in t iny blood vessels, a nd the blo od vessels filter yo ur blood f or you whe n you do P D. A PD ca theter—a s oft, plast ic tube ab out as thi ck as a dr inking str aw, but lo nger—is pl aced in yo ur belly b y a doctor . A nurse will teach you how t o use this tube to f ill your b elly with sterile fl uid., PD g oes on all the time. Wastes an d water in your bloo d flow out of the bl ood vessel s in your peritoneum and into the fluid in your be lly. After a few hou rs, you dr ain out th e used flu id and put fresh flu id in. Dra ining out used fluid and putti ng in fres h fluid is called an “exchange .” Each ex change tak es about 2 0 minutes. The rest of the tim e when you are not d oing an ex change, yo u are free to do oth er things. | |
19 | 3, learnMo re>Treatme nt>2, dial ysis-3.jpg , PD cycle r machine, Manual or Automated Exchanges , PD excha nges can b e done a f ew times a day, by h and. Or, p eople can use a mach ine called a cycler at night w hile they sleep. The cycler do es the exc hanges for you. If y ou are a l arger pers on, you ma y need one daytime e xchange, t oo. | |
20 | 4, learnMo re>Treatme nt>2, dial ysis-4.jpg , nurse on phone, Tr aining for PD, PD is quick to learn—it t akes a wee k or two t o learn ho w to do PD . A nurse will visit your home to help y ou get rea dy. Each s tep of the exchange must be do ne with gr eat care, JUST as yo u are taug ht, to avo id infecti on inside the belly (called pe ritonitis) . You won’ t start PD at home u ntil you a nd your nu rse are bo th confide nt that yo u can succ eed., Once you go ho me with PD , a nurse is on call 24/7 if y ou have qu estions. P D fluid ha s sugar in it, so yo u may need to limit starchy fo ods to avo id weight gain. If y ou are not which foo ds are sta rchy, you should tal k to your dietitian. If you ha ve diabete s, you may be able t o add regu lar insuli n to the P D bags. | |
21 | 5, learnMo re>Treatme nt>2, bala nced.jpg, two equal weighted b alls balan ced on a b ar, Keepin g Your Bod y in Balan ce, The jo b of healt hy kidneys is to kee p substanc es in your blood in balance. T he closer to balance a treatme nt for kid ney failur e brings y ou, the be tter you m ay feel. W hen you fe el better, you can d o more of what matte rs to you. | |
22 | 6, learnMo re>Treatme nt>2, bloo d-cells.jp g, red blo od cells i n the bloo d stream, Continuous Treatment with Fewe r Ups & Do wns, Dialy sis remove s water an d wastes f rom your b lood. PD i s a way to do dialys is every d ay. It’s a continuou s treatmen t that hel ps keep yo ur blood i n balance all the ti me. There are no ups and downs in how pe ople feel from one d ay to the next on PD . | |
23 | 7, learnMo re>Treatme nt>2, dial ysis-7.jpg , Man read ing to boy , PD and Y our Lifest yle, Now t hat you un derstand t he basics of how PD works, let ’s look at how it mi ght affect your life in the ar eas of:, W hat you ca n eat and drink, How many medi cations yo u might ne ed to take each day, How much control yo u would ha ve over yo ur time, H ow work-fr iendly PD is, How tr avel-frien dly PD is, How PD ma y affect y our sex li fe and abi lity to ca rry or fat her childr en | |
24 | 8, learnMo re>Treatme nt>2, keba b.jpg, gri lled chick en and veg etables on a skewer, PD and Wh at You Eat , When you do PD, yo u may need to make s ome change s to what you can ea t and drin k. Most pe ople who d o PD need to eat mor e protein, because a little bi t of prote in is lost each time you drain out the u sed PD flu id. Protei n is a bui lding bloc k for musc les that i s found mo stly in me ats. To le arn more a bout prote in in your diet, vis it the Nut rition Roo m., Since PD fluid h as sugar i n it, you can gain w eight if y ou don’t l imit starc hy foods., Your diet itian will go over y our lab te st results with you each month . If your levels of potassium or phospho rus are to o high, yo u may need to limit foods that have thes e minerals . | |
25 | 9, learnMo re>Treatme nt>2, pill -box.jpg, pill box, PD and Med ications, If you cho ose PD, yo u will nee d to take some medic ines each day. Most people on PD need at least som e phosphat e binders. Phosphate binders a ct like a magnet to pull exces s phosphat e out of y our gut so you don’t absorb it . You may need to ta ke blood p ressure pi lls. You m ay also ne ed EPO (er ythropoiet in) to you r body mak e its own red blood cells to t reat anemi a. To lear n more abo ut anemia treatment, visit the Pharmacy. , If you h ave diabet es or othe r health p roblems, y ou will st ill need t o take pre scribed me dicines fo r them, th ough the d ose may ch ange if yo ur kidneys stop work ing. | |
26 | 10, learnM ore>Treatm ent>2, ala rm-clock.j pg, alarm clock, PD and Your S chedule, A treatment for kidne y failure that you c an do at h ome, like PD, gives you more c ontrol of your sched ule. You D O have to fit in all of your e xchanges e ach day to get enoug h treatmen t. But, yo u can shif t the time a bit whe n you need to. | |
27 | 11, learnM ore>Treatm ent>2, mee ting.jpg, co-workers in a meet ing room, PD and You r Job, Do you want t o be able to work? A work-frie ndly treat ment:, Is not schedu led during the work day—or can be done a t work, Do es not cau se symptom s that mig ht make yo u miss wor k, Reduces the chanc e that you might nee d to go to the hospi tal—and mi ss work, H elps you t o have eno ugh energy to work, PD is work -friendly for all of these rea sons. Most people us e a cycler to do PD at night, but a dayt ime exchan ge can be done in a clean room at work. Since PD i s gentle a nd continu ous, it do es not ten d to cause symptoms that bothe r you. It is vital t o do all o f your exc hange step s as you a re taught to avoid i nfection. Most peopl e who do P D do not n eed to be in the hos pital ofte n. | |
28 | 12, learnM ore>Treatm ent>2, str eet-signs. jpg, stree t signs po inted in v arious dir ections, P D and Trav el, When y ou do PD, you can br ing your t reatment w ith you wh en you tra vel. A cyc ler can go in a car, on a crui se, or on an airplan e. With ad vance noti ce, the co mpanies th at make PD supplies will ship them to yo u in the c ontinental U.S. If y ou want to travel ou tside of t he U.S., t alk to you r VA care team to le arn how. | |
29 | 13, learnM ore>Treatm ent>2, fam ily.jpg, f amily phot o, PD, Fer tility, an d Your Sex Life, Peo ple who ch oose PD re port a bit less erec tile dysfu nction and fewer oth er sexual problems t han those who do sta ndard in-c enter hemo dialysis. Women of c hildbearin g age who do PD tend to have a hard time getting p regnant, b ut some ha ve. To car ry a child to term, more dialy sis may be needed th an the sta ndard PD p rescriptio n. | |
30 | 14, learnM ore>Treatm ent>2, dia lysis-14.j pg, stacke d storage boxes, Wha t You Need to Do PD, You don’t need to l ive in a c astle to d o PD. Peop le who liv e in small apartment s or mobil e homes ha ve done PD . You do n eed space to store a bout 40 cu bic feet o f supplies . The supp ly company will brin g new boxe s once or twice a mo nth. They will unloa d the boxe s and put them where you want them—even upstairs. The first batch of s upplies wi ll be the biggest to be sure y ou have al l that you need—late r ones won ’t be quit e as big., If you ar e homeless , there is a Nationa l VA call center to help you: 1-877-4AID -VET (1-87 7-424-3838 )., You do n’t need t o have a p artner at home to do PD., Mult iple or co mplex abdo minal surg eries can prevent PD success. But, a c-s ection, he rnia repai r, or prio r transpla nt should not be a p roblem if you want t o do PD. T alk with y our care t eam if you want to d o PD but d on’t know if you can . | |
31 | 15, learnM ore>Treatm ent>2, dia lysis-15.j pg, swimme rs in a po ol, PD Lim its, If yo u like bat hs and not showers, PD may not be a good fit for y ou. Gettin g your PD catheter w et could c ause an in fection. S o, if you like to sw im for exe rcise, PD may not be the best treatment for you. T alk to you r care tea m about wh ether you can swim a nd how to care for y our cathet er if you get it wet . | |
32 | ||
33 | SHEET: hem odialysisI nAClinic | |
34 | ||
35 | Section, N avigatitio n, Section Image, Im age Alt Te xt, Sectio n Header, Content Se gment 1, S egment 2, Segment 3, Segment 4 , Segment 5, Segment 6, Segmen t 7 | |
36 | 1, learnMo re>Treatme nt>3, hemo dialysis-c linic-1.jp g, a chair in a dial ysis clini c, The In- Center Hem odialysis Option, He modialysis (HD) is o ne way to replace th e function of kidney s that don ’t work. H D is most often done in a clin ic in one of two way s:, Three days a wee k (standar d in-cente r HD), Thr ee nights a week whi le you sle ep (noctur nal in-cen ter HD), I t is somet imes calle d “in-cent er” HD. | |
37 | 2, learnMo re>Treatme nt>3, hemo dialysis-a ccess.jpg, hemodialy sis access in patien t's left a rm, Hemodi alysis Acc ess, All H D requires a way to take blood out of th e body to be cleaned , and then put it ba ck in. Thi s is calle d a vascul ar access, or just a ccess. The re are thr ee types o f access:, A fistula , which is your arte ry + your vein, A gr aft, which is your a rtery + yo ur vein + a piece of man-made vein, A ca theter, wh ich is a p lastic tub e placed i nto a larg e vein tha t ends in your heart , A fistul a is the s afest type , if you c an have on e. | |
38 | 3, learnMo re>Treatme nt>3, graf t-fistula- diagram.jp g, graft a nd fistula diagrams, HD Access : Fistulas , Dialysis needs the strong bl ood flow o f an arter y (the blo od vessels that carr y blood aw ay from th e heart). But veins (the blood vessels t hat carry blood to t he heart) are closer to the su rface of y our skin a nd easier to reach. Linking an artery to a vein gi ves you th e best of both: stro ng blood f low that i s easy to reach., So me ways of linking t he artery and vein t o make an access for HD are be tter than others. A fistula co nnects you r artery d irectly to your vein . A graft connects a n artery t o a vein w ith a piec e of man-m ade vein., Fistulas can last t he longest (sometime s decades) and they have the l east chanc e of devel oping bloo d clots or infection s that cou ld put you in the ho spital. If you want to do HD, a fistula is ideal. Plan ahead ! A fistul a needs to be made a t least a few months before di alysis sta rts, so it has time to “mature ” and be r eady to us e. It is w ise to get a fistula made abou t 6 months before yo u need to start HD. | |
39 | 4, learnMo re>Treatme nt>3, cath eter-anim. gif, diagr am of cath eter and a nimation o f germs en tering the bloodstre am through the cathe ter, HD Ac cess: Cath eters, HD catheters are plasti c tubes th at are pla ced in a l arge vein in the nec k, chest, or groin. They are u sed if som eone needs dialysis right away , or has n o other ch oice. A ca theter is partly out of your b ody and pa rtly insid e your blo od vessels . The tip is in your heart., C atheters h ave severa l problems :, Germs c an climb u p the tubi ng and get into your bloodstre am. If thi s happens, a serious blood inf ection, ca lled sepsi s can occu r. Sepsis can land y ou in the hospital o r be fatal . In fact, infection and sepsi s are amon g the lead ing causes of death in people on dialysi s. It’s a good reaso n not to g et a cathe ter, or to get one o ut as quic kly as you can., Cat heters are linked to a risk of death tha t is many times high er than ot her types of HD acce ss., Cathe ters can’t get wet. So, you ma y not be a ble to sho wer with a n HD cathe ter., Ther e may be a scar wher e the cath eter enter s your bod y. | |
40 | 5, learnMo re>Treatme nt>3, dial ysis-machi ne.jpg, di alysis mac hine, HD C leans Your Blood Out side Your Body, When you do HD , two need les are pl aced in yo ur access. A nurse o r technici an connect s the need les to tub ing that c arries you r blood to a dialyze r, or arti ficial kid ney. The d ialyzer ha s filters inside to clean your blood. Wa stes and e xtra water are remov ed, and th en your cl eaned bloo d comes ba ck to you. A blood p ump pushes your bloo d through the tubing at a rate that your doctor pr escribes. | |
41 | 6, learnMo re>Treatme nt>3, hemo dialysis-c linic-6.jp g, hemodia lysis acce ss, 3 Days or 3 Nigh ts a Week, HD in a c enter can be done in two ways: , Standard HD is don e in a cli nic three days a wee k for abou t 4 hours at a time. You would get a tim e slot on a Monday, Wednesday, and Frida y, or a Tu esday, Thu rsday, and Saturday. A nurse o r technici an sets up the treat ments, or you may be able to l earn to do the set-u p yourself . (This is called in -center se lf-care.) Standard H D is done in the mor ning or af ternoon, a nd some cl inics have evening h ours, too. Treatment s are done at the sa me time ea ch day. Th e clinic w ill work w ith you to assign a time slot. If that s lot doesn’ t fit your life, you can ask t o see if t here is a time that would work better., Nocturnal HD can be done in a clinic thr ee nights a week, fo r about 8 hours whil e you slee p. These t reatments are most o ften done on Mondays , Wednesda ys, and Fr idays. As with stand ard HD, a nurse or t echnician most often sets up t he treatme nts, or th ey can tea ch you to do it your self. Sinc e nighttim e treatmen ts are twi ce as long as standa rd ones, t hey are ve ry gentle. And, nigh ttime trea tments don ’t take ti me out of your day. | |
42 | 7, learnMo re>Treatme nt>3, bala nced.jpg, two equal weighted b alls balan ced on a b ar, Keepin g Your Bod y in Balan ce, The jo b of healt hy kidneys is to kee p substanc es in your blood in balance. T he closer to balance a treatme nt for kid ney failur e brings y ou, the be tter you m ay feel. W hen you fe el better, you can d o more of what matte rs to you. Nocturnal HD in a c enter give s you abou t twice as much trea tment as s tandard HD | |
43 | 8, learnMo re>Treatme nt>3, stan dard-hd-gr aph.jpg, g raph showi ng the ups and downs of fluid and waste in the bod y when doi ng 3x/week dialysis, Standard HD: Big Up s & Downs, Between d ialysis tr eatments, wastes and excess wa ter build up in your blood. If you have a 4-hour t reatment o n Mondays, Wednesday s, and Fri days, you have no tr eatment on Tuesdays, Thursdays , Saturday s, or Sund ays. The u ps and dow ns when wa stes and w ater build up are bi g with sta ndard in-c enter HD—a nd they ar e hard on the heart. Heart pro blems are the leadin g cause of death in people on dialysis. High blood pressure or diabete s, the two main caus es of kidn ey failure , also aff ect the he art. Most sudden dea th on dial ysis happe ns after a 2-day wee kend with no treatme nt. Forms of dialysi s that are done more often are more gent le on your heart. | |
44 | 9, learnMo re>Treatme nt>3, noct urnal-hd-g raph.jpg, graph show ing the mu ch smaller ups and d owns fluid and waste in the bo dy when do ing noctur nal dialys is, Noctur nal HD: Ve ry Small U ps & Downs , Nocturna l HD in a center rem oves much more water and waste s from you r blood th an standar d HD. And, since the treatment s are twic e as long, it is muc h more gen tle, as yo u can see from the v ery small spikes in water and wastes (gr een) in th e picture on the rig ht., This means that even with three tre atments pe r week, yo u may feel good from day to da y, with fe wer sympto ms from ki dney failu re. In fac t, most pe ople feel like thems elves agai n about 10 minutes a fter doing a nocturn al HD trea tment. | |
45 | 10, learnM ore>Treatm ent>3, hem odialysis- clinic-10. jpg, famil y portrait on front steps of h ome, In-ce nter HD an d Your Lif estyle, No w that we’ ve seen th e basics o f how in-c enter HD w orks, let’ s look at how it mig ht affect your life in the are as of:, Wh at you can eat and d rink, How many medic ations you might nee d to take each day, How much c ontrol you would hav e over you r time, Ho w work-fri endly it i s, How tra vel-friend ly it is, How it may affect yo ur sex lif e and abil ity to car ry or fath er childre n | |
46 | 11, learnM ore>Treatm ent>3, keb ab.jpg, gr illed chic ken and ve getables o n a skewer , Standard HD and Wh at You Eat , Since st andard HD is done 3 times a we ek for onl y 4 hours, it requir es more st rict diet and fluid limits tha n any othe r option. Your dieti tian will go over yo ur lab tes t results with you e ach month and help y ou come up with a pl an that in cludes as many of yo ur favorit e foods as possible. To learn more about lab tests , visit th e Laborato ry., Noctu rnal HD in a clinic is done 3 times a we ek for abo ut 8 hours . More tre atment mea ns you hav e fewer di et and flu id limits. You can e at more of what you like best with this treatment option. | |
47 | 12, learnM ore>Treatm ent>3, hem odialysis- clinic-12. gif, foods that migh t be off l imits for dialysis p atients, w ith flashi ng warning symbol, S tandard HD Means Lim its on Som e Foods & Fluids, Mo st people who do HD must limit their int ake of:, S alty foods , like fre nch fries, High pota ssium food s, like fr uits, High phosphoru s foods li ke beans, nuts, and dairy, Flu ids—to abo ut 1 quart per day, If you hav e diabetes , you stil l need to limit star chy foods. , If you c hoose stan dard in-ce nter treat ment, you MUST follo w the stri ct limits to feel yo ur best. I f an unres tricted di et is impo rtant to y ou, talk w ith your c are team a bout other dialysis options th at have fe wer limits . | |
48 | 13, learnM ore>Treatm ent>3, pil l-box.jpg, pill box, Standard HD and Med ications, If you cho ose standa rd HD, you may need to take as many as 1 9 pills ea ch day. Mo st people on standar d in-cente r need pho sphate bin ders and b lood press ure pills. You may a lso need e rythropoie tin EPO to help trea t anemia. Anemia is a shortage of oxygen -carrying red blood cells. It can leave you feelin g tired, w eak, and c old. If yo u have dia betes or o ther healt h problems , you will still nee d to take prescribed drugs for them, tho ugh the do se may cha nge when y our kidney s don’t wo rk., If yo u do noctu rnal HD in a clinic, you may n eed fewer— or no—phos phate bind ers or blo od pressur e pills. Y ou may nee d EPO to h elp treat anemia, bu t may be a ble to use a lower d ose. If yo u have dia betes or o ther healt h problems , you will still nee d to take prescribed drugs for them, tho ugh the do se may cha nge when y our kidney s don’t wo rk | |
49 | 14, learnM ore>Treatm ent>3, ala rm-clock.j pg, alarm clock, Sta ndard HD a nd Your Sc hedule, If you do st andard in- center HD, the clini c will wor k with you to assign a time sl ot. Your t reatments will be do ne at the same time on Mondays , Wednesda ys, and Fr idays or T uesdays, T hursdays, and Saturd ays. If th e time slo t you are given is n ot a good fit for yo ur life, y our job, y our childc are, or yo ur ride to the clini c, talk to your care team. | |
50 | 15, learnM ore>Treatm ent>3, mee ting.jpg, co-workers in a meet ing room, Standard H D and Your Job, Do y ou want to be able t o work? A work-frien dly treatm ent:, Is n ot done du ring the w ork day—or can be do ne at work , Does not cause sym ptoms that might mak e you miss work, Red uces the c hance that you might need to g o to the h ospital—an d miss wor k, Helps y ou to have enough en ergy to wo rk, Standa rd in-cent er HD is n ot very wo rk-friendl y for all of these r easons. It takes tim e out of t he day, wh en most pe ople need to be at w ork. It ca n cause sy mptoms tha t make it hard to wo rk, and ca n lead to more hospi tal stays than other treatment options. People DO work on st andard in- center HD— but it is more of a challenge than it wo uld be wit h other tr eatment op tions | |
51 | 16, learnM ore>Treatm ent>3, str eet-signs. jpg, stree t signs po inted in v arious dir ections, S tandard HD and Trave l, When yo u do HD in a center— during the day or at night—you can trave l by findi ng a clini c at your destinatio n that has a time sl ot open an d can take you. This is best d one a few months bef ore you wa nt to trav el. Your s ocial work er can hel p you plan and send the clinic your medi cal record s. You wil l need to be up-to-d ate with y our vaccin es, too. | |
52 | 17, learnM ore>Treatm ent>3, fam ily.jpg, h appy famil y photo of mom, dad, and young son, Stan dard HD, F ertility, and Your S ex Life, S tandard HD , Fertilit y, and You r Sex Life , People w ho do stan dard in-ce nter HD re port more problems w ith sexual ity and fe rtility th an those w ho do any other trea tment opti on. For me n, about h alf who do this trea tment repo rt problem s with ere ctions. It is also m ore diffic ult to fat her a chil d., Women have probl ems, too. It is hard er to carr y a child using this treatment option. W omen who b ecome preg nant on st andard in- center HD may have a chance of carrying a baby to term if th ey do long er and/or more frequ ent treatm ents., The re are few studies o n the sexu ality of p eople who do nocturn al HD trea tments. Pe ople who d o dialysis this way say they f eel better , and ther e are some reports o f women be ing able t o carry ba bies to te rm. | |
53 | 18, learnM ore>Treatm ent>3, dia lysis-mach ine2.jpg, dialysis m achine, St andard HD: Facts to Consider, There are things to think abou t when you do HD in a clinic—d uring the day or at night. You r risk of infection is very hi gh if you start trea tment with a cathete r. If you know you w ant to do HD, get a fistula or graft wel l ahead of time., Yo u need to be at the clinic for each trea tment at t he time th at is set for you. I f this tim e is not a good fit for your l ife, talk to your ca re team. Y ou may be able to sw itch to a time that fits bette r, or to a clinic th at has a b etter time for you. You may ha ve to wait until the time slot you want opens up. Don’t miss any dialy sis! Misse d treatmen t time can cost you your life when you a re on dial ysis., Som e people h ave a hard time slee ping in a clinic at night. Wea ring earpl ugs and a sleep mask may help. Some even bring in a foam pad for the c hair to ma ke it easi er to slee p. | |
54 | 19, learnM ore>Treatm ent>3, por cupine.jpg , porcupin e, Dealing with HD N eedles, Fi stulas and grafts fo r HD use n eedles. If needles b other you, there are lots of t hings you can do to help:, You can put a numbing c ream on yo ur skin 1– 2 hours be fore treat ment. Some numbing c reams are prescripti on and som e are not. Talk to y our care t eam., A fr eezing spr ay can num b just the top of yo ur skin ve ry quickly ., You can try to re lax and ta ke deep br eaths., Pu tting in y our own ne edles puts you in ch arge and d istracts y ou, so the needles h urt much l ess. No on e else can put in yo ur needles as well a s you can— you are th e only per son who ca n feel bot h ends of the needle . The clin ic staff c an teach y ou how if you want t o learn., The “Butto nhole tech nique” is a way of p utting dia lysis need les into t he exact s ame spots every time to form t unnel trac ts (like p ierced ear ring holes ). Once Bu ttonholes form, you can use bl unt needle s for dial ysis, for less pain. | |
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56 | SHEET: hem odialysisA tHome | |
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58 | Section, N avigatitio n, Section Image, Im age Alt Te xt, Sectio n Header, Content Se gment 1, S egment 2, Segment 3, Segment 4 , Segment 5, Segment 6, Segmen t 7 | |
59 | 1, learnMo re>Treatme nt>4, hemo dialysis-h ome-1.jpg, photo of a house, T he Home HD Option, H ome hemodi alysis (HD ) is a way to replac e the func tion of ki dneys that don’t wor k. HD can be done at home in o ne of thre e ways:, T hree days a week for about 4 h ours (stan dard home HD), Five to six day s a week f or 2.5 to 4 hours (s hort daily HD), Thre e to six n ights a we ek for abo ut 8 hours (nocturna l home HD) , HD at ho me is flex ible. You can do it on your ow n schedule with your loved one s around y ou. Someon e from you r clinic w ill do a h ome visit to help yo u get set up., You w ill need a partner w ho can be there whil e you do y our treatm ents. The VA offers support fo r care par tners. A n urse train s you and your partn er until y ou are con fident tha t you know what to d o. A home HD machine can be a large mach ine like t he ones us ed in cent ers. Or, t here is a small mach ine (about the size of a micro wave oven) that was built for home use. Talk with your care team about which mac hine you m ight be ab le to use. And, watc h the news —a number of compani es are wor king on sm all, porta ble dialys is machine s. And, yo u don’t ne ed to buy the machin e or your supplies. The VA wil l supply t hem for yo u. After t raining, i nstead of going to t he clinic three time s a week, you will c ome in onc e a month or so to m eet with y our kidney care team . The VA p ays for ho me health care. | |
60 | 2, learnMo re>Treatme nt>4, graf t-fistula- diagram.jp g, graft a nd fistula diagrams, Hemodialy sis Access , All HD r equires a way to tak e blood ou t of the b ody to be cleaned, a nd then pu t it back in. This i s called a vascular access, or just acce ss. There are three types of a ccess:, A fistula, w hich is yo ur artery + your vei n, A graft , which is your arte ry + your vein + a p iece of ma n-made vei n, A cathe ter, which is a plas tic tube p laced into a large v ein that e nds in you r heart, A fistula i s the safe st type, i f you can have one. | |
61 | 3, learnMo re>Treatme nt>4, hemo dialysis-a ccess.jpg, hemodialy sis access in patien t's left a rm, HD Acc ess: Fistu las, Dialy sis needs the strong blood flo w of an ar tery (the blood vess els that c arry blood away from the heart ). But vei ns (the bl ood vessel s that car ry blood t o the hear t) are clo ser to the surface o f your ski n and easi er to reac h. Linking an artery to a vein gives you the best of both: s trong bloo d flow tha t is easy to reach., Some ways of linkin g the arte ry and vei n to make an access for HD are better th an others. A fistula connects your arter y directly to your v ein. A gra ft connect s an arter y to a vei n with a p iece of ma n-made vei n., Fistul as can las t the long est (somet imes decad es) and th ey have th e least ch ance of de veloping b lood clots or infect ions that could put you in the hospital. If you wa nt to do H D, a fistu la is idea l. Plan ah ead! A fis tula needs to be mad e at least a few mon ths before dialysis starts, so it has ti me to “mat ure” and b e ready to use. It i s wise to get a fist ula made a bout 6 mon ths before you need to start H D. | |
62 | 4, learnMo re>Treatme nt>4, cath eter-anim. gif, diagr am of cath eter and a nimation o f germs en tering the bloodstre am through the cathe ter, HD Ac cess: Cath eters, HD catheters are plasti c tubes th at are pla ced in a l arge vein in the nec k, chest, or groin. They are u sed if som eone needs dialysis right away , or has n o other ch oice. A ca theter is partly out of your b ody & part ly inside your blood vessels. The tip is in your h eart., Cat heters hav e several problems:, Germs can climb up the tubing and get i nto your b loodstream . If this happens, a serious b lood infec tion, call ed sepsis can occur. Sepsis ca n land you in the ho spital or be fatal. In fact, i nfection a nd sepsis are among the leadin g causes o f death in people on dialysis. It’s a go od reason not to get a cathete r, or to g et one out as quickl y as you c an., Cathe ters are l inked to a risk of d eath that is many ti mes higher than othe r types of HD access ., Cathete rs can’t g et wet. So , you may not be abl e to showe r with an HD cathete r., There may be a s car where the cathet er enters your body. | |
63 | 5, learnMo re>Treatme nt>4, dial ysis-machi ne.jpg, di alysis mac hine, HD C leans Your Blood Out side Your Body, When you do HD , two need les are pl aced in yo ur access. A nurse o r technici an connect s the need les to tub ing that c arries you r blood to a dialyze r, or arti ficial kid ney. The d ialyzer ha s filters inside to clean your blood. Wa stes and e xtra water are remov ed, and th en your cl eaned bloo d comes ba ck to you. A blood p ump pushes your bloo d through the tubing at a rate that your doctor pr escribes. | |
64 | 6, learnMo re>Treatme nt>4, hous e-in-hands .jpg, hand s holding a wooden m odel house , Three Wa ys to Dial yze at Hom e, “Standa rd” home H D is done three time s a week, or every o ther day t o get rid of the 2-d ay gap wit h no treat ment. Each treatment lasts abo ut 4 hours , but some people ch oose to do longer tr eatments a t home (wi th their d octor’s pr escription )., Short daily home HD is don e 5 or 6 d ays a week for about 2.5–4 hou rs at a ti me. Water and wastes are remov ed nearly every day. Most peop le who do short dail y treatmen ts say the y feel bet ter than t hey did on standard treatments ., Nocturn al home HD is done a t night wh ile you sl eep, for a bout 8 hou rs. This m eans that your days are free t o do other things. P eople who use this t reatment s ay they ha ve more en ergy and t hey feel g ood. Some do nightti me treatme nts three nights a w eek or eve ry other n ight. Some do four o r five or six nights a week if their doc tor prescr ibes it. | |
65 | 7, learnMo re>Treatme nt>4, bala nced.jpg, balance ba r, Keeping Your Body in Balanc e, The job of health y kidneys is to keep substance s in your blood in b alance. Th e closer t o balance a treatmen t for kidn ey failure brings yo u, the bet ter you ma y feel. Wh en you fee l better, you can do more of w hat matter s to you. | |
66 | 8, learnMo re>Treatme nt>4, stan dard-hd-gr aph.jpg, g raph showi ng the ups and downs of fluid and waste when on 3x /week dial ysis, Stan dard HD: B ig Ups & D owns, Betw een dialys is treatme nts, waste s build up in your b lood. If y ou have a 4-hour tre atment on Mondays, W ednesdays, and Frida ys, you ha ve no trea tment on T uesdays, T hursdays, Saturdays, or Sunday s. This sc hedule lea ds to wast e and wate r build-up between t reatments. The ups a nd downs w hen wastes and water build up are bigges t when tre atments ar e only thr ee times a week. Whe n treatmen ts are lon ger and/or more freq uent, ther e is less time for w ater and w astes to b uild up. T his is eas ier on you r heart an d means th at you may feel bett er, too., If you do standard t reatments at home, y ou can tal k to your care team about doin g longer t reatments or doing t hem every other day to reduce the ups an d downs. | |
67 | 9, learnMo re>Treatme nt>4, hemo dialysis-h ome-9.jpg, graph sho wing the s maller ups of fluid and wastes when on s hort daily dialysis, Short Dai ly HD: Sma ll Ups & D owns, If y ou do shor t daily HD , the leve ls of wate r and wast es in your blood are kept in b etter bala nce. This means you may feel b etter from day to da y, with fe w symptoms from kidn ey failure . | |
68 | 10, learnM ore>Treatm ent>4, noc turnal-hd- graph.jpg, graph sho wing the m uch smalle r ups and downs of w astes and fluids. K eeping clo ser to the normal ra nge when o n nocturna l hemodial ysis., Noc turnal HD at Home: V ery Small Ups & Down s, Since n octurnal t reatments are longer than stan dard ones, they can remove muc h more wat er and was tes from t he blood. In fact, t he treatme nts are ab out twice as long. T his means that fluid removal i s very gen tle, as yo u can see from the v ery small spikes in water and wastes (gr een) in th e picture. So, even with three treatment s per week , you may feel bette r from day to day, w ith few sy mptoms fro m kidney f ailure. Wi th their d octor’s pr escription , some peo ple who do nocturnal HD at hom e do treat ments ever y other ni ght, or ev en 4, 5, o r 6 nights a week. T his is the most dial ysis you c an get. | |
69 | 11, learnM ore>Treatm ent>4, hem odialysis- home-11.jp g, man and boy by ca mpfire, Ho me HD and Your Lifes tyle, Now that we’ve seen the basics of the three ways home HD works, let’s look at how ho me HD migh t affect y our life i n the area s of:, Wha t you can eat and dr ink, How m any medica tions you might need to take e ach day, H ow much co ntrol you would have over your time, How work-frie ndly home HD is, How travel-fr iendly hom e HD is, H ow home HD may affec t your sex life and ability to carry or father chi ldren | |
70 | 12, learnM ore>Treatm ent>4, chi cken-sandw ich.jpg, c hicken san dwich, Hom e HD: Few Limits on Diet or Fl uids, The more dialy sis you ge t, the clo ser to nor mal your d iet and fl uids can b e. So, of the three ways to do home HD:, Standard home HD wi ll have th e most die t limits, because th e treatmen ts are jus t done 3 d ays per we ek or ever y other da y., Short daily and nocturnal HD have fe wer limits , because treatments are longe r or done more often ., Your di etitian wi ll go over your lab test resul ts with yo u each mon th. If you r levels o f potassiu m or phosp horus are too high, you may ne ed to limi t foods th at have th ese minera ls—like ch ocolate. T o learn mo re about l ab tests, visit the Laboratory . | |
71 | 13, learnM ore>Treatm ent>4, pil l-box.jpg, pill box, Home HD: Fewer Medi cations?, The more d ialysis yo u get, the fewer med icines you may need to take. S o, of the three ways to do hom e HD:, Sta ndard home HD requir es the mos t medicine s—half of the people who do it need to t ake 19 pil ls a day, and about one in fou r need eve n more., S hort daily HD means fewer bloo d pressure pills and phosphate binders f or most pe ople who d o it. This can cut y our pill c ount by qu ite a bit. , Nocturna l HD may m ean that y ou don’t n eed blood pressure p ills or ph osphate bi nders. In fact, some people wh o do noctu rnal HD ne ed to take phosphate supplemen ts because the long treatments remove so much phos phate., On any form of HD, you may need erythropoi etin (EPO) to help t reat anemi a. Anemia is a short age of oxy gen-carryi ng red blo od cells. It can lea ve you fee ling tired , weak, an d cold. If you have diabetes o r other he alth probl ems, you w ill still need to ta ke prescri bed drugs for them, though the dose may change whe n your kid neys don’t work. | |
72 | 14, learnM ore>Treatm ent>4, ala rm-clock.j pg, silver clock, Ho me HD and Your Sched ule, A tre atment for kidney fa ilure that you can d o at home, like any form of ho me HD, giv es you con trol of yo ur schedul e. You DO have to do all of yo ur treatme nts to fee l your bes t. But, yo u can choo se to do t hem in the morning, afternoon, or evenin g. You can shift the days of t he week to go to a s pecial eve nt, too. | |
73 | 15, learnM ore>Treatm ent>4, mee ting.jpg, co-workers sitting a round a ta ble workin g, Home HD and Your Job, Do yo u want to be able to work? A w ork-friend ly treatme nt:, Is no t schedule d during t he work da y—or can b e done at work, Does not cause symptoms that might make you miss work, Reduces t he chance that you w ill need t o go to th e hospital —and miss work, Help s you to h ave enough energy to work, Hom e HD can b e work-fri endly for all of the se reasons . You can schedule i t around y our work h ours, so i t doesn’t get in the way of wo rk. The mo re dialysi s you get, the less likely you are to ha ve symptom s from dia lysis that cause you to miss w ork. (You may still have sympt oms from t he illness that caus ed your ki dneys to f ail, thoug h.) People who do ho me HD say that they have more energy. St udies find that they tend to s leep and e at better, too. | |
74 | 16, learnM ore>Treatm ent>4, str eet-signs. jpg, multi ple street signs poi nting in d ifferent d irections, Home HD a nd Travel, When you do HD at h ome, one w ay to trav el is by f inding a c linic at y our destin ation that has a tim e slot ope n and can take you. This is do ne a few m onths ahea d of when you want t o travel, and your s ocial work er can hel p you. You will need to be up- to-date wi th your va ccines., I f you use a small, m ore portab le machine for home HD, you ma y be able to bring i t with you on a car trip, or o n a plane or boat. Y our suppli es can be shipped to you for f ree in the continent al U.S. | |
75 | 17, learnM ore>Treatm ent>4, fam ily.jpg, m an and wom an with ch ild - happ y family, Home HD, F ertility, and Your S ex Life, P eople who choose sho rt daily o r nocturna l home HD say that t heir sex l ives are b etter than they were with stan dard in-ce nter HD. S ome women of childbe aring age have been able to ca rry babies to term d oing short daily or nocturnal HD, though a pregnan cy with di alysis is always hig h risk. | |
76 | 18, learnM ore>Treatm ent>4, hem odialysis- home-18.jp g, grandpa with gran ddaughter sitting on grass, Mo re HD: Sur vival May Compare to Transplan t, Doing H D at home puts you i n charge. And, you a re not exp osed to so many othe rs who may be ill. O nly you or a partner put in yo ur dialysi s needles. These are pluses of home HD t hat may he lp improve your heal th., Studi es have fo und that p eople who do short d aily or no cturnal HD may do ev en better. They may live about as long a s those wh o get a de ceased don or kidney transplant ., Statist ics apply to groups, not to in dividuals. Some peop le have li ved for de cades on s tandard in -center HD and PD, t oo! But, i t makes se nse that m ore dialys is keeps y our body i n better b alance and protects your heart . | |
77 | 19, learnM ore>Treatm ent>4, hem odialysis- home-19.jp g, happy m ature coup le, Home H D: Things to Conside r, There a re things to think a bout when you do hom e HD. You’ ll need a partner wh o can be t here when you do you r treatmen ts. It’s b est if you can do as much of y our treatm ent as you can yours elf—especi ally putti ng in your own needl es. But a partner ca n help you with some of the ta sks of the treatment or suppli es, give y ou emotion al support , or both. In most c ases, a pa rtner for home HD is a family member. Th e VA offer s support for care p artners. I f you don’ t have a f amily memb er who can be a part ner and yo u want to do home HD , the VA m ay pay for a home di alysis hel per in som e cases. T alk to you r care tea m about ho me health care., You ’ll need t o set up a room in y our home t o do your treatments . Your car e team can do a home visit and help give you tips about what has worke d for othe rs. Your t reatment r oom may ne ed changes to the wi ring or pl umbing, an d the VA c an help yo u with the se. Ask yo ur VA soci al worker about home improveme nts and st ructural a lterations (HISA) gr ants to he lp with ho me changes needed fo r a dialys is machine . | |
78 | 20, learnM ore>Treatm ent>4, por cupine.jpg , porcupin e, Dealing with HD N eedles, Fi stulas and grafts fo r HD use n eedles. If needles b other you, there are lots of t hings that can be do ne to help :, You can put a num bing cream on your s kin 1–2 ho urs before treatment . Some num bing cream s are pres cription a nd some ar e not. Tal k to your care team. , A freezi ng spray c an numb ju st the top of your s kin very q uickly., Y ou can try to relax and take d eep breath s., Puttin g in your own needle s puts you in charge and distr acts you, so the nee dles hurt much less. No one el se can put in your n eedles as well as yo u can—you are the on ly person who can fe el both en ds of the needle. Wh en you do home HD, i t’s best i f you put in your ow n needles. The clini c staff wi ll teach y ou how, or will teac h your par tner if yo u can’t do it yourse lf., The “ Buttonhole technique ” is a way of puttin g dialysis needles i nto the ex act same s pots each time to fo rm tunnel tracts (li ke pierced earring h oles). Onc e Buttonho les form, you can us e blunt ne edles for dialysis, for less p ain. | |
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80 | SHEET: kid neyTranspl ant | |
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82 | Section, N avigatitio n, Section Image, Im age Alt Te xt, Sectio n Header, Content Se gment 1, S egment 2, Segment 3, Segment 4 , Segment 5, Segment 6, Segmen t 7, Segme nt 8, Segm ent 9, Seg ment 10, S egment 11 | |
83 | 1, learnMo re>Treatme nt>5, tran splant-1.j pg | |
84 | DoD photo by Senior Master Sgt . David H. Lipp, two men holdi ng a Donat e Life sig n, The Kid ney Transp lant Optio n, A kidne y transpla nt is one way to rep lace some of the fun ction of k idneys tha t don’t wo rk. Surviv al with a kidney tra nsplant is about thr ee times b etter, on average, t han it is with stand ard in-cen ter hemodi alysis., S ome people think tha t they can ’t have a transplant due to ag e or some other conc ern. If yo u are not sure if yo u can get a transpla nt, talk t o your doc tor and th e transpla nt center staff. Or, look onli ne to lear n more abo ut the VA Transplant Services. | |
85 | 2, learnMo re>Treatme nt>5, tran splant-2.j pg, diagra m to show where tran splanted k idneys are placed, A New Kidne y from a D onor, When you have a kidney t ransplant, a surgeon puts a ki dney from a donor in to your bo dy. Your o riginal ki dneys are above your waist, un der your r ibs. The n ew kidney is placed in your be lly, prote cted by yo ur hip. Th e scar may be long, or it may be shorter and in th e middle o f your bel ly., If yo u have typ e 1 diabet es, you co uld think about a ki dney-pancr eas transp lant. You’ d get a ki dney and a new pancr eas (on th e other si de). You m ight get b oth organs from one donor, or from two. There is a n excellen t chance ( 80–85%) th at you’d n eed no ins ulin or di alysis for at least 1 year. Th ere is a v ery good c hance (70% +) that a kidney-pan creas tran splant wil l still be working 5 years lat er. Wait t ime to get a transpl ant can be shorter w hen you ar e listed f or two org ans, too. | |
86 | 3, learnMo re>Treatme nt>5, tran splant-3.j pg, test t ubes, Tran splant: Do You Quali fy?, Befor e you can be cleared for trans plant, you need a lo t of medic al tests. The transp lant team needs to b e sure you are in go od health aside from kidney fa ilure. The se tests m ay include :, Blood t ests, X-ra ys of your chest, ki dneys, ure ters, and bladder, E KG/echocar diogram, A heart str ess test, Dental exa m, Colonos copy, Psyc hosocial e xam, Men m ay need a PSA test t o check pr ostate hea lth., Wome n may need a mammogr am and pap smear., T hese tests will need to be rep eated, dep ending on how long t he wait is . | |
87 | 4, learnMo re>Treatme nt>5, tran splant-4.j pg, green goldfish s wimming wi th orange goldfish, Transplant : A Foreig n Object Y our Body T ries to Fi ght, A tra nsplant is different from the rest of yo ur body—li ke the gre en fish is different from the orange fis h. Your im mune syste m will rea ct to it a s “foreign ” and atta ck it. Tra nsplant dr ugs partly suppress your immun e system. The goal i s to keep you health y, and tri ck your bo dy into ac cepting th e kidney. | |
88 | 5, learnMo re>Treatme nt>5, red- blood-cell s.jpg, red blood cel ls, Transp lant: Gett ing a Good Match, Be sides taki ng drugs t o suppress your immu ne system, another w ay to help your body accept a kidney tra nsplant is to choose one that is a good match for you. Three types of matches ar e looked a t:, First, the blood type of t he donated kidney. I s it compa tible with your bloo d type?, N ext, the t issue type . Like you r blood ty pe, your t issue type is a mark er of how unique you are. The transplant team will look at m arkers cal led human leukocyte antigens ( HLA). Thes e tell cel ls in your immune sy stem to at tack a for eign body— like a new kidney. I s it a goo d match wi th your ti ssue type? , Finally, blood is tested for a crossma tch to red uce the ch ance that your immun e system w ould attac k the new kidney. | |
89 | 6, learnMo re>Treatme nt>5, tran splant-6.j pg, diagra m of diffe rent blood types - T ype A, B, AB, and O, Matching Blood Type for a Tra nsplant, Y our blood type depen ds on anti gens that are on the surface o f each of your red b lood cells . You inhe rit your b lood type from your parents. T here are f our blood types:, A, B, AB, O, Type O bl ood is cal led the “u niversal d onor” beca use it has no antige ns! An ant igen is a substance that trigg ers a resp onse from your immun e system. Some antig ens, like blood type , are part of your b ody. Other antigens come from outside of your body —such as f rom a new kidney. Ty pe AB bloo d is calle d the “uni versal rec ipient,” b ecause it has ALL of the antig ens. So, s omeone wit h type AB blood can get a kidn ey from a donor with type A, A B, B, or O blood. Th is means t hat it can be faster to get a kidney. | |
90 | 7, learnMo re>Treatme nt>5, tran splant-7.j pg, tissue diagram, Matching T issue for a Transpla nt, HLA is a measure of your t issue type . HLA stan ds for hum an leukocy te (white blood cell ) antigen. We inheri t 3 HLA ty pes from e ach parent , for a to tal of 6. Identical twins matc h all 6. T his can al so happen in unrelat ed people. There is no minimum number of HLA types that must match for you to ge t a kidney . A zero H LA match k idney can work just as well as a 6 antig en match—b ut you may need to t ake more m edicines t o avoid re jection. | |
91 | 8, learnMo re>Treatme nt>5, tran splant-8.j pg, blood samples in tubes, Cr ossmatchin g for a Ki dney Trans plant, A c rossmatch looks for antibodies in your b lood that could reac t against a new kidn ey. It tes ts the ser um of your blood (pl asma) agai nst a dono r’s blood cells. A p ositive cr ossmatch m eans a hig h chance t hat your b ody would attack the kidney. A negative crossmatch means tha t a transp lant with that donor can go fo rward. | |
92 | 9, learnMo re>Treatme nt>5, tran splant-9.j pg, Using traffic li ghts as a concept - green ligh t showing 0%, yellow light sho wing 50%, red light showing 10 0%, Transp lant and P RA, Each m onth or so while you wait for a kidney, your blood will be t ested agai nst a pane l of 60 HL A markers. If your b lood react s to 30 of them, you r panel re active ant ibody (PRA ) is 50%. Some thing s that can cause a h igh PRA in clude bloo d transfus ions, preg nancy, and prior tra nsplant. T he lower y our PRA, t he better your chanc e of getti ng a kidne y transpla nt. A high PRA means that you are “sensi tized.” Fe w kidneys would be a good matc h for you. , Your PRA can chang e from one month to the next. Talk with your trans plant team about tre atments to reduce yo ur PRA if you are se nsitized. | |
93 | 10, learnM ore>Treatm ent>5, fam ily.jpg | |
94 | Photo Cred it: Spc. L aura Owen, family ph oto, Trans plantation and Your Lifestyle, Now that we’ve seen the basic s of how t ransplant works, let ’s look at how it mi ght affect your life in the ar eas of:, W hat you ca n eat and drink, How many medi cations yo u might ne ed to take each day, How much control yo u would ha ve over yo ur time, H ow work-fr iendly tra nsplant is , How trav el-friendl y transpla nt is, How a transpl ant may af fect your sex life a nd ability to carry or father children | |
95 | 11, learnM ore>Treatm ent>5, chi cken-sandw ich.jpg, c hicken san dwich, Tra nsplant: F ew or No L imits on D iet and Fl uids, A tr ansplant m ay require some limi ts on what you eat. You may ga in weight from the t ransplant drugs and need to li mit calori es. Your d octor may also want you to eat less salt than in t he standar d American diet. But , compared to standa rd in-cent er hemodia lysis, tra nsplant ha s far fewe r limits o n what you can eat a nd drink. | |
96 | 12, learnM ore>Treatm ent>5, pil l-box.jpg, pill box, Transplan t and Medi cations, A kidney tr ansplant w ill requir e you to t ake many m edications . You will need to t ake drugs to block y our immune system so it does n ot attack your new k idney. You may also need blood pressure pills. If you have d iabetes or other hea lth proble ms, you wi ll still n eed to tak e prescrib ed drugs f or them, t hough the dose may c hange when you have a transpla nt., When you get yo ur transpl ant at a V A transpla nt center or receive care at a VA clinic , your tra nsplant dr ugs will b e covered for as lon g as you h ave the tr ansplant. You may ha ve a small co-pay. | |
97 | 13, learnM ore>Treatm ent>5, ala rm-clock.j pg, alarm clock, Tra nsplant an d Your Sch edule, A t ransplant gives you control of your sche dule. You need to ta ke your me dications each day, and you wi ll have cl inic visit s, but you won’t nee d dialysis treatment s. | |
98 | 14, learnM ore>Treatm ent>5, tra nsplant-14 .jpg, work place envi ronment, T ransplant and Your J ob, Do you want to b e able to work? Gett ing a tran splant can be work-f riendly fo r many rea sons. With a transpl ant, treat ment:, Jus t means ta king pills every day , May incl ude some s ymptoms (f rom medica tions), bu t most peo ple feel w ell enough to work, Reduces th e chance y ou might n eed to go to the hos pital—and miss work, Helps you to have e nough ener gy to work , You will not need to miss wo rk to go t o a clinic for regul ar treatme nts. You a re likely to feel we ll and hav e enough e nergy to w ork becaus e a transp lant can r eplace up to 50% of lost kidne y function , which is more than most kind s of dialy sis. And, a transpla nt works 2 4 hours a day, just like healt hy kidneys . | |
99 | 15, learnM ore>Treatm ent>5, str eet-signs. jpg, stree t signs po inted in v arious dir ections, T ransplant and Travel , A transp lant is th e most tra vel-friend ly treatme nt option for kidney failure. Since you carry your treatment with you, it goes w here you d o and does n’t take t ime out of your day. Always ke ep your me dications with you w hen you tr avel. Don’ t leave th em in chec ked luggag e. | |
100 | 16, learnM ore>Treatm ent>5, tra nsplant-16 .jpg, coup le relaxin g in front of firepl ace, Trans plant, Fer tility and Your Sex Life, Both men and w omen who h ave had a kidney tra nsplant sa y that the ir sex liv es improve . Women ha ve safely carried ba bies to te rm after h aving a ki dney trans plant. (Do ctors sugg est waitin g about 2 years befo re trying to get pre gnant.) | |
101 | 17, learnM ore>Treatm ent>5, tra nsplant-op eration.jp g, surgeon s performi ng a kidne y transpla nt operati on, Kidney s from Liv ing Donors , Kidneys for transp lant come from eithe r living p eople or d eceased pe ople. Sinc e healthy people hav e two kidn eys, they can choose to donate one. All surgery ca rries some risk, tho ugh the ri sk of kidn ey donatio n is small . A donor must have most of th e same tes ts as you. Living do nors must be healthy , so they tend to re cover quic kly from t he surgery . A kidney is a gift —it is not something you can e xpect from someone e lse. A liv ing donor can be a r elative or friend., You can ge t a kidney before yo u start di alysis (pr eemptive t ransplant) . Preempti ve transpl ant can be done with living or deceased donor kidn eys. It is easier to schedule a transpla nt if you have a liv ing donor. Laparosco pic surger y can be d one to rem ove a kidn ey. To do laparoscop ic surgery , gas is u sed to inf late the b elly so th e doctor c an see and the kidne y is remov ed through a small i ncision in the belly button. H ealing is much faste r for the donor than with stan dard surge ry. | |
102 | 18, learnM ore>Treatm ent>5, tra nsplant-18 .jpg, ambu lance, Kid neys from Deceased D onors, Dec eased dono r kidneys come from people who are brain dead. The ir loved o nes donate their org ans. A non -profit gr oup called the Unite d Network for Organ Sharing (U NOS) keeps a nationa l transpla nt list of people wh o are wait ing for an organ. Th e VA is pa rt of the UNOS Syste m. You mus t have man y tests at a VA tran splant cen ter to be on the lis t—you do n ot get add ed to the list just because yo ur kidneys are faili ng., When your kidne y function drops to about 20%, you can b e put on t he transpl ant list. Most peopl e start di alysis bef ore they g et a trans plant, but some peop le get a t ransplant first., Mo st people have to wa it to get a deceased donor kid ney. The w ait time m ay be a ma tter of mo nths, or i t may be a s long as seven year s or more. The wait time depen ds, in par t, on your blood typ e. | |
103 | 19, learnM ore>Treatm ent>5, tra nsplant-19 .jpg, map of U.S. sh owing VA t ransplant centers in the vario us regions of the co untry, VA Transplant Centers, You may ha ve a choic e of one o r more tra nsplant ce nters. The VA has it s own netw ork of tra nsplant ce nters. Cur rent VA ki dney trans plant cent ers are: I owa City, IA; Nashvi lle, TN; P ittsburgh, PA; and P ortland, O R. Kidney transplant centers p ending act ivation ar e located in Birming ham, AL; H ouston, TX ; and Miam i, FL. For more info rmation ab out VA tra nsplant ce nters visi t the VA T ransplant Program we bsite., Th e VA will pay your t ravel cost s to and f rom a VA t ransplant center. Th e VA will also pay f or a donor ’s travel costs to b e seen at a VA trans plant cent er. Ask yo ur VA care team to p oint you t o the tran splant cen ter closes t to you., You can a lso choose to get a transplant at a non- VA center, but then you would need to us e Medicare and/or ot her insura nce to pay for your care., You may be ab le to get on the tra nsplant li st at more than one center (th is works b est if the y are in d ifferent a reas). | |
104 | 20, learnM ore>Treatm ent>5, tra nsplant-20 .jpg, pati ent in hos pital bed, Transplan t: What to Expect, T ransplant surgery it self takes only 2–3 hours. The kidney ma y kick in right away , or it ma y take tim e. Your ho spital sta y will usu ally be 5– 7 days. Be fore you l eave the h ospital to go home, you’ll get a lot of teaching. The medica tion regim en is comp lex and yo u’ll need to know it . You’ll a lso learn what sorts of compli cations to watch for and repor t to your care team. Total rec overy time is about 6–12 weeks . To learn more, con tact the V A Transpla nt Program . | |
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106 | SHEET: car eWithoutDi alysis | |
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108 | Section, N avigatitio n, Section Image, Im age Alt Te xt, Sectio n Header, Content Se gment 1, S egment 2, Segment 3, Segment 4 , Segment 5, Segment 6, Segmen t 7, Segme nt 8, Segm ent 9, Seg ment 10, S egment 11, Segment 1 2 | |
109 | 1, learnMo re>Treatme nt>6, no-d ialysis-1. jpg, flowe ring crab tree with a swing ne xt to a po nd, Choosi ng No Dial ysis, In s ome cases, when your kidneys f ail, you m ay choose not to hav e dialysis or a kidn ey transpl ant, but t o do medic al care wi thout dial ysis. This means tha t you will let natur e take its course. M ost religi ons do not think of this choic e as suici de, even i f you deci de to stop dialysis after you start trea tment., St udies find that for some older people wh o are quit e ill, dia lysis does not exten d life any more than good medi cal care w ithout dia lysis. Med ical care without di alysis for kidney fa ilure uses active pa lliative c are to hel p you feel your best until nat ural death occurs. P alliative means “to cloak with care.” Yo u will hav e clinic v isits, tak e medicati ons, and s ee a dieti tian and s ocial work er. The VA is a lead er in pall iative car e and has many suppo rt service s to help you. Palli ative care is open t o all vete rans who a re enrolle d at the V A. | |
110 | 2, learnMo re>Treatme nt>6, cat- in-lap.jpg , older ma n with a b lack cat i n his lap, Comfort c are and su pport, If you choose not to st art dialys is when yo ur kidneys fail, nat ural death will occu r in a few weeks or months. Me dical care without d ialysis ca n keep you comfortab le, treat your sympt oms, and g ive you em otional an d spiritua l support. It does n ot extend life., You might cho ose medica l care wit hout dialy sis if you have othe r serious health pro blems. Thi s is not t rue for ki dney failu re alone. Feeling he lpless or depressed alone is n ot a reaso n to turn down dialy sis—there are other ways to he lp you wit h these fe elings. | |
111 | 3, learnMo re>Treatme nt>6, vete ran-profil e.jpg, pro file photo of Navy v eteran wit h another veteran in backgroun d, Strong Emotions A re Normal, In fact, it is very normal to feel depr essed when you learn that your kidneys a re failing . Depressi on can mak e you feel hopeless— as if the best part of your li fe is over and you h ave nothin g to live for. Depre ssion is a mood diso rder. If y ou feel sa d, worthle ss, angry, or frustr ated for w eeks and t hese feeli ngs get in the way o f your nor mal life, you may be depressed . But many people ca n and do h ave good l ives with kidney fai lure and d ialysis or transplan t. Depress ion can be treated s o you feel better. T o learn mo re about h ow to cope with your emotions, visit the Social Se rvices Roo m., You mi ght also w ant to lea rn more ab out the VA mental he alth servi ces. | |
112 | 4, learnMo re>Treatme nt>6, no-d ialysis-4. jpg, holdi ng hands, Hospice fo r You and Your Loved Ones, Hos pice is a form of pa lliative c are for th ose with a dvanced il lness such as cancer or heart, liver, lu ng, or kid ney failur e. You can get hospi ce care at your VA m edical cen ter, in a hospice ce nter, or i n your own home. You r VA care team can h elp you fi nd hospice care., Ho spice serv ices may i nclude:, P ain contro l, Symptom relief, D iet help, Therapeuti c massage, Physical therapy, H ome health aides to help with bathing or other per sonal care , Inpatien t care, as needed, T rained vol unteer sup port, Emot ional and spiritual support fo r you and your famil y, Bereave ment suppo rt for you r family | |
113 | 5, learnMo re>Treatme nt>6, no-d ialysis-5. jpg, folde d US flag, Choosing Medical Ca re without Dialysis: What to E xpect, A n atural dea th from ki dney failu re should not hurt. Wastes wil l build up in your b lood until you slip into a com a. If you approve, d ialysis ma y be used just to re move water from your blood so it does no t build up in your l ungs. Wate r in your lungs woul d make it hard to br eathe. Eat ing less s alt and dr inking les s water ca n help, to o. You wou ld receive treatment for any p ain you ha ve., Be su re to fill out an Ad vance Dire ctive form and share it with y our care t eam and lo ved ones. You can pr int a copy of the VA advance d irective., All adult s should h ave an Adv ance Direc tive wheth er or not they have a kidney p roblem. To learn mor e about ad vance dire ctives, vi sit the So cial Servi ces Room. | |
114 | 6, learnMo re>Treatme nt>6, gold fish-jumpi ng.jpg, tw o goldfish bowls wit h one gold fish jumpi ng to a di fferent bo wl, You Ca n Change Y our Mind A bout Your Treatment Choice, If you have kidney fai lure, you can choose medical c are withou t dialysis at any ti me—even if you start dialysis. And, you can change your mind if you ch oose medic al care wi thout dial ysis, and decide to start dial ysis. | |
115 | 7, learnMo re>Treatme nt>6, no-d ialysis-7. jpg, young er man com forting ol der man, T alk to You r Loved On es, Talk w ith your f amily and friends ab out your c hoice. The y can supp ort you be tter if th ey underst and what y our goals and dreams are. |
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