#Best Home dialysis care

[cannot-copia]

Mental Health Check for the Ghesties! How we doin'?

uh

ive been better

ik i like never respond positively to these asks, I’m sorry whoever you are

but thank you for asking <3

also sorry to those who’ve tagged me in tag games the past while too, i do like them but between working for the past 14 days straight and some more not good things happening irl i have not had time to do them and now i probably won’t find them

[lizzy-bonnet]

Working in the yarn shop on Sundays, I have a group of regulars who come in specifically then for my advice on their knitting projects and over the years I've gotten to know a lot about them - their ailments and their spouses and their children and their careers and their mothers are all things they find themselves telling me about over the course of trying to bring forth a knitted piece. Most of them are women, most of them are over 50, and most of them have been through a lot and are trying to reclaim something for themselves through the act of creation. A while back, one of these older women opened up to me about how when she first came to this country it was just her and her daughter and they were so happy until her husband joined them, when he promptly began making her miserable. Now, decades later, all her children live far away, she spends all her time taking the husband to dialysis, her sciatic is bad and she may need heart surgery (who will take care of her, I find myself wondering), and she comes to see me once a month or so to talk about a new project and tells me it is the only thing she does for herself.

Today she came in with a smile on her face and delightedly introduced me to her son, who will soon move closer to home with his family. Then she says, as if commenting on the weather, that on Friday her husband died, and tomorrow they will hold the funeral. For a second I had tonal whiplash from the conversation and then I realized, oh, you're unburdened now. Like the relief in her face and her body were palpable. The son shows a picture of a cardigan to me and asks if it can be knitted, and we pick out yarn and a pattern. She's so excited to make it for him. She beams when she looks at him; he is tall and handsome and polite, and wants to wear something she made for him. She is proud of this man she raised.

It just made me think of the many, many women who come from cultures where leaving a crappy spouse isn't an option so they shuttle along doing their best and trying to find some beauty and joy in whatever way they can. Kids may not visit often because their spouse isn't welcoming or there is bad blood, so they are lonely. I remind her, we have our social group. She hasn't come to it much before because she is always taking him to dialysis, but now she says she will come often and meet the other women. Many of them are like her, but in the craft they find companionship that has been absent for so much of their lives. I hope there will be renewal for this dear lady and that she can learn more about herself and what brings her joy.

[andhumanslovedstories]

I’m looking for a second career after working corporate. I’d like something away from a computer, workin with people, in demand, and more flexible. I do have some autistic traits though (one therapist floated it but never officially diagnosed). Do you think nursing would be a bad choice?

Here's a useless answer: it depends! I'll also give my usual caveat that nursing is a very broad field and a school nurse versus a dialysis nurse versus an ICU nurse versus a home health nurse vs a community health nurse are all going to have different experiences. You'll probably spend more time at a computer than you might like (documenting......), but if you get efficient at it, you can blast through it alright. Except when you can't.

And you will work with people! In any part of nursing, you'll be working with people, often in intimate and vulnerable ways. You meet a lot of cool people and get to be there for a lot of cool moments, cool and funny and profound moments. Working with people when they aren't at their best can be exhausting. Working with people when they aren't at their best and also you're understaffed and also someone is complaining of new onset chest pain at the same time someone else is calling to be cleaned up because they've been incontinent--it's really easy to exhaust yourself out of compassion. You have to care and actively engage with people's often tragic situations, but you also have to protect yourself from secondhand trauma. It's okay if this is not something you're comfortable or good with, but if so, you should probably think critically about whether nursing is for you.

And flexible--maybe??? Again, different jobs will have different perks. A lot of nurses work prn which means they have to pick up a certain number of shifts a month, but they aren't on the schedule normally. You just pick up as you want. Very flexible! But also a lot of these nurses are getting their healthcare elsewhere, usually a partner. Like any shift work, you can always swap shifts with a coworker if you can find one who'll do it. When I worked in home health, it was very hard to adjust my schedule because there wasn't necessarily another nurse that could fill in. And often units in the hospital will have various schedule stipulations--work every other weekend, work a certain amount of holidays, work night shift until you get the seniority to go to days or become a nocturnal little freak (me). I currently work in float pool, which makes it way easier to call out and adjust schedules because I'm not assigned anywhere specific until like ten minutes before the shift starts.

And with regards to the last bit, the autistic traits, I don't know exactly which ones you mean, but none of them are an inherent obstacle to being a nurse. We need neurodiversity in nursing. Some patients might find you cold or awkward or weird or whatever way you worry you might come across. Other patients will resonate with those exact same traits. No one's the perfect nurse for all people. Some people want to that extra care, some people want competent work and then to have space for themselves, some patients want to learn everything about their situation, some patients don't even want to know what pills they're taking. Think of yourself as a specialty nurse. An oncology nurse can take care of a variety of patients, but they're most well suited and situated to take care of cancer patients. There's a patient type that is a perfect fit for you. And the same way cardiac nurses deal with strokes, and orthopedic nurses deal with respiratory infections, you work competently outside your specialty because you have a good base for your practice, but you also know that you have specialties that you are uniquely equipped to handle. Specialties like cheerleading through physical therapy, calming down dementia patients, knowing the shit out of telemetry, making sure patients get a bed bath and clean sheets, using a machine to pump a patient's blood outside your body--whatever you most like, you're most good at, what gives you energy to work. I think mine are working well with "difficult" patients, managing pain, and stealing cranberry juice from the patient fridge. for me.

I'll say too if you're worried like a lack of empathy or easy understanding of other people will be an impediment to care--I'm not saying I'm autistic, but I don't think I'm particularly empathetic. I NEVER know what people are thinking or feeling. I struggle to tell when patients are like "talk to me more!" versus "I am being polite to you, but please leave." I have never once been comforting a crying person and thought, "I am NAILING this. I am making them feel better." But I don't think I'm a bad nurse. I reverse engineer empathy by finding a situation that I was in that's similar to the situation a patient is in, and I think about what I would have wanted and appreciated in that situation. I think about what evidence says is a good thing to do in this situation. I think about what experience tells me has worked in this situation in the pas. I also just ask patients what they're feeling and what they want and why they do what they do instead of assuming I know. (That last one is so choice, we should all do it more.)

The job puts you in a lot of Situations that are hard for anyone to manage. So you can study up for a lot of Situations. I read conflict resolution books and writing by sick people, I think about how adherent I am to my own treatment plan when I get judgy, I ask patients a lot of questions in part so I can understand them but also so I can understand the next patient like them, I practice difficult conversations I can predict before I go into rooms, and I make sure I have certain phrases and reactions in my back pocket in case I'm caught by surprise. I've figured out my safe topics of conversations that I can chat about with patients that are personable but not intimate (cats, how long you've been in the area, how hard it is to sleep in the hospital at night). I periodically try out new conversation styles and topics to see how those work. I find people I admire and I try consciously to emulate them.

I make a shitload of rules too that help me structure my behavior so I can act like a person I'm proud of. If I can't get something for a patient, I have to go back and tell them that instead of just never returning to the room. Whenever I leave a room, before I go, I make sure the call light is within reach and I ask if there's anything I can do before I go. If someone is sad, ask if they want hot chocolate, and if they say yes, ask if they want it with hot water or milk. If I have a patient that is very chatty and always on the call light, allot conversation time with them like I'm scheduling wound care in case they're lonely. Whenever I tell a patient that they can't do something, I explain the clinical reasoning for that. If the only reason I can think of to tell a patient why they can't do something except "it's against hospital rules", I reconsider the refusal. I've got so many rules and guidelines I've developed for myself so I can best act in a way that I think a good nurse should act.

(usual disclaimer that this does not mean I always accomplish this or that I always behave in a way I'm proud of. but I do think developing these rules and following them makes behaving like I want to more habitual.)

All this to say--I care tremendously about my patients when they're my patients, but I don't take most of them home with me. I feel often feel very distant from the emotions of the situation. I used to feel like I was watching the world through glass. Now I still feel like that, but not in a bad way. I don't get mad when patients yell at me. I can view their problems as quests to solve. I'm engaged but I'm not flustered by distress.

look alllllllllllllllllll that to say is have you considered making nursing a special interest? works for me. oh and YEAH. The job security is AMAZING. It's such a weight off my mind to know that if I don't like my current job, it's so easy to get another somewhere else.

[yyxandere]

And more images about Yakuza men, but in this time it's a liiiittle dark (be careful 😶‍🌫️):

You must be one of the lucky people, or vice versa, if you were able to attract the attention of the most faithful servant of the chairman of the Tojo Clan - Mine. Most likely, you both met either by chance on the street or while working as his secretary. If you both was meet accidentally at street, he most likely didn’t even pay attention, but later he involuntarily began to remember, involuntarily grumbling, why a civilian like you got him hooked. This went from trying to get you out of his head to now actively pursuing you. Due to his important work, Yoshitaka is not able to monitor you around the clock, so he quietly asks for help from his master with the appearance that you are “suspicious” in the city and voila! It has access to all points wherever you are, and it always felt someone's else looks even in your home. But if you were his secretary, things would get more interesting. Under the guise of “work,” he obsessively bores you with his meticulous attention to detail and always finds something to complain about, still not understanding why he thinks about strange sensations from your presence, mistakenly considering you for rejection. Over time, Mine becomes more and more tolerable to you, afraid that his assertiveness will make you force fired from job, and immediately begins to make pleasant remarks here and there, thereby confusing you. As soon as you lower your guard, you will be completely in his hands with no way to escape. It is impossible to call for help or fight with him, this will not help anything, and will only anger your captor. Of course, he will not knock out every living thing from your body, but he can give a pacifying slap in the face if you try to attack him or express disrespect for his master. If you are initially calm and do not express negativity towards him, Mine will be pleased, and will even allow you to be among civilization again, but under close supervision. If someone dares to encroach on you, then this fool will face the most painful days of his life and may even would force you to watch all this if you were too close to this stranger in his opinion. He is not too cruel, but not too kind yandere.

Tachibana, as a businessman, is an extremely gallant and delicate man. This person is ready to literally spoil you with anything: high-quality food, expensive jewelry, clothes or even weapons; his power has no limits. If you had experience in the field of management, then he could attach you to one position in his real estate agency, which would make you as close as possible to him if by that time you still do not know him better. This gives him a chance, as in the case of Mine, under the guise of "performance monitoring", to literally breathe down your neck while you nervously fill out the paperwork. Tetsu has the most tolerance and best understanding of your situation if you are very unhappy with it, but the longer the negativity lasts, the more bitter it becomes. At one point, he will be able to punish you with isolation so that you “calm down”, after which he will try to make amends by feeling guilty. There is a real chance that he will kidnap you safely, he has many enemies, and he does not want to risk your safety for him. Due to kidney problems, he cannot be with you as often as he would like, leaving you in the care of his guards, or you go to him for dialysis, if you don't mind being with him during this procedure, which can It will comfort him a little. Tachibana is the man who smiles sweetly at you, talks about his day, and discreetly adjusts his prosthetic, which he used last night against the villains who were planning to kidnap you to blackmail him. But you don’t need to know this, the main thing is that you are safe, his and only his.

Oda is not as nice to you like his master. Using his experience with human trafficking, he can put as much pressure on you to stay with him, which makes him a very skilled manipulator. From sweet words to direct threatenings, he threat you with the most frightening things, using anything to break your revolution to resistance. Oda is even ready to use his people, where they “kidnap” you, and he, as a real “savior,” helps you in this situation, hoping for the development of Stockholm syndrome in you. But even if this does not help and by some miracle you are still able to fight it, then it is useless. Wherever you go, he can easily call for help from the Tachibana, for whom it is not difficult to find someone, especially civil. After this, you will have a stick instead of a cookie, where you will be isolated from the outside world and limited in food. No matter how long it lasts, Oda is very patient when it comes to your obedience, he has no morals unless it concerns his master. Of course, he is not completely heartless and can behave normally, but once you express your dissatisfaction at least once again, you will start all over. He is a ruthless demon with a cute mask instead of a face, be careful.

Saejima, after a long imprisonment, has become very restrained in terms of showing too strong emotions, and you can help him with this. Once he warms up to you, he will be able to trust you enough to talk about himself and his main trauma. You'll have to hold Saejima while he clings to you, crying fitfully, burying his face in your shoulder, after every nightmare in which he had dreams of the people he killed that fateful day. This incident has affected him greatly and he is grateful that you always console him after every breakdown by gently stroking his head in soothing movements. Saejima may seem very rude at times, but don't jump to conclusions! He is a very straightforward person and the combination of his Kansai accent can be a little confusing, but you will get used to it over time. You will also have to introduce Sejima to modern technology, patiently explaining everything, understanding that during his stay in prison he was literally completely cut off from the outside world. He takes advantage of this, pretending to be even more ignorant for your attention and enjoying the feeling of your presence, leaning against him from behind for a painstaking explanation of how to use certain gadgets! He's too obsessed with you to let you go, and he's so apologetic about it, trying to flatter you with every desire. Well, you still don't want to leave him, do you…?

-ˋˏSINCERELY YOURS. . . ->

ANON.

WHY ARE YOU ALWAYS COOKING???!!!! YOU'RE ALWAYS MAKING A WHOLE-COURSE BUFFET!! AND WE GET FED EVERSINGLE TIME!!! I GOT SO CARRIED AWAY THAT I MADE SO MANY SCENARIOS, ARGGG

Mine is so fine please help me, esply in isshin 🤤🤤

Mine, an obsessor by nature, we might never know if fate was trying to be cruel to your life, but it seems like your luck finally ran out when you met him. If you're just a normal civilian who manages to capture his interest, at the beginning he will hate you better yet despise you. you're just a normal person who has no place in this world he works yet why did you manage to keep him awake? always occupying his mind, it was a nuisance he couldn't be thinking of you, a lowly person when he could be at his boss's side. Yet here he was hiring one of his men to put CCTV in your own apartment, but it wasn't enough for him he wanted to see wherever you go, a decision that felt like he NEEDED to make. So talking to the clan head Daigo, he wanted to track down wherever you went saying that "you were very suspicious" or "she might be working with the other yakuza, and we might get information about them through her." such excuses made Daigo reluctant, I mean, spying a "normal" woman's life is very much mess up and he hasn't even heard about you but Daigo trusted his right-hand man, how can he not? He has done many things that improve the clan. So in the end Daigo agrees to track and keep an eye on you by Mine, and so with that, you were being watched over Mine, everywhere, he now has all the cameras in all of Kaumuroscho even in the most darkes alley, and he has it. Maybe he was trying to find out something suspicious or maybe just to feed this growling dog inside of him, asking, and yearning to see more of you. Yet this begins a story of a man falling in love, a man who wants to control you.

Mine would show himself but he would be planning your downfall, making you lose your job, turning your friends against you, and making you unable to pay for rent, causing you to be kicked out, you have nowhere to go until Mine saw you on the street and gave you a very manipulative smile, taking you away and asking you to be his secretary and this could have been an angel send but little did you know that you were just about to walk to the devils palm (if you know the devils palm reference ily and we should kiss)

As his secretary, you are more tense than ever. Mine giving you many strict rules and many more, make sure that you keep a list of his next meeting and all, even though he told you he was in the yakuza which is a MAJOR red flag, you agreed cuz hey, beggars vant be choosers so you decided that if you have food in the table a roof in your head and security from all the dark business that he's doing then you would be good, Mine did tell you that hell makes sure that you won't be involved in any kind of yakuza business where you need to spill blood, no only some shady ones.

Mine as your boss, is very much restricted, he would be so close to you that he's practically breathing your scent, to see "your progress" and he would make sure that you have more work than assigned no matter how much you want to pull your hairs out you can't really complain to your boss, the same boss that is giving you money to live a stable life. Mine would give you mixed signs, just a moment he was charming and was buttering you up now he's staring at you with some sort of cold expression in his eyes, he doesn't show any emotion, only that look in his eyes gives you shivers.

Now if he were to kidnap you, he knows that you would throw a "childish" tantrum so, of course, he has tricks up his sleeve after many months of planning to kidnap you, one of them is using your family or friends as blackmail material, he wouldn't kill them (for now) but he will use them as his pawns to keep you from staying away from him, every failed attempt to escape or even bad manners like spitting on his face, he would give you a satisfying slap and as for your escape he would make your close one's life like hell, they will lose their job and their house by some unknown organization. Don't you even dare disrespect Daigo in any kind of way, he will drag you from your hair and hold your face and bind your wrist together as he gives you one of the most furious looks ever, your wrist too would be bruised, he would tie you up in his basement and leave you there for many days, until you apologize from disrespecting Daigo he would then let you go and soothe your wounds.

If you actually behave yourself then be prepared to be spoiled by Mine, he will give you many luxurious clothes, fancy restaurants, or even raise one of your siblings to have a higher position in the company they are working at, see, not a bad deal right? Just behave and deal with the bruises that he gives you while kissing you so harshly.

TACHIBANA AAAAA EXPLODES

Our beloved Tachibana, his sophisticated yet intelligent demeanor had lured you in like a siren's voice, a siren that will lure you by her voice and her beauty is the only thing shinning beside the mast of gold she has beside her (yandere siren tachibana au?). Tachibana like Mine will plan your downfall and come to your life like a savior, and we all know what happens next, you have nothing else but despair and disappointment in your heart. The one who will bring you into the light is none other than Tachibana our beloved Tachibana who will take care of you. He will make you work close to him, you won't even have to know any kind of experience in the area, he just wants you to be near him, but if you really want to learn how to manage the business then he would be happy to teach you, while you sit on your chair he is behind, so close that you can practically smell what kind of colne his wearing and his shampoo smells like your favorite brand too. He would place his non-prosthetic hand on top of yours so he can feel your skin and body heat while he tells you basic instructions, yet how can you focus when you are out here being a blushing mess, Tachibana knows that and makes himself closer to you. Your heart beats faster and faster, and your breath gets heavier as you try to concentrate on his words. It's not just the fact that he is hot, it's his charisma, his smile, his eyes, his body, and his personality, he is someone you can't seem to get enough, he is alluring. You know how he makes you blush and you can't stop it. His presence, his warmth, the way he smiles gently at you, the way you melt every time he whispers sweet words to you, the way he holds you so carefully and tenderly in his arms, the way he caresses your skin whenever he touches it.

Offending is pretty much impossible since his lapdog I mean- Oda is already near him, (pretty much giving you a stink eye). If Tachiaban manages to kidnap you, he will spoil you but if you keep on screaming and crying he will gently hush you like how a mother comforts her baby, bite him, kick him, even spit on his face he won't get angry, no, him showing you that his calm shows you how much he is in control, like you said anon, he would leave you at his basement so you can calm down. But unlike Mine, Tachibana would slowly creep into your family or friend's life, so if you even manage to escape (how tf is that possible, he has cameras everywhere) you would seem like the ungrateful one. How can a nice and soft-spoken man, ever do such things, they're gonna look at you like you're insane!!

Actually, while we are on the topic of family, Tachibana would actually want a child himself, yes, he knows that he needs an heir but he deeply wants a child of his own. Most of all Tachiaban wants to live a good life even if it is a short one, he wants you to talk about your day as you carry his child while he fixes his prosthetic arm after giving the person who was planning to kidnap you a good punch.

I DESPISE this bastard Oda, after what he has done to my beloved queen Makoto.

The glorious asshole himself Oda, as you said aint a savior unlike his boss, he is willing to hurt you so you can learn how to love him. It doesn't matter if it's physical or psychological he will hurt you no matter what. He has no problem pulling some strings to get you kidnaped by his old pals and letting them play with you for a bit, and then he will come and save you like some kind of superhero, he would make sure after what happened to you, you will cling unto him like a leech and never let him go and he sucks ever affection and attention you give him, he speaks like feathers are roaming around you yet, in reality, are insects ready to eat you whole. Escaping him would be impossible, being the right hand of the most powerful estate agent in Kamurocho, leaving him won't be easy. He will use your family as blackmail but, if you push his buttons hard he will not hesitate to kill your family in front of you, their waling screams pierce your ears, a night to remember. He has no morals and would not even stop until you behave.

Even though you will have the luxury of living a good life with Oda, his kindness and gentle manner are only a facade to his demonic self, act out of line again then you wouldn't mind being thrown in his basement with no food or water as you makes you forcefully watch a video of your father getting tortured. He will leave you there for days and come back to you in your disheveled state, he will make you take a bath and feed you, he's going to break you and rebuild you as many times as he wants until you behave.

SAEJIMA MY FAVOURITE YAKUZA CHARACTER OMFG AON IM SQUEELING, I HAD TO REFRAIN FROM RANTING IN HIS PART IJOIDCDIOKVGS

Ah yes, Saejima the man with blood in his hands, his hands are rough and big, and calloused yet here he is the same man that has a hand that can grip a man's head with one arm while being wounded not knowing how to send a text to someone, and of coarse you never blame him he spend many years in the gutter and missed out of all human technologies, you are more then happy to explain the basics!! He listens attentively, absorbing the information and memorizing it all the best he can, he tries his best but most of the time he has a hard time concentrating when your body is touching him, he likes it when you in his side while you tap on the "cellphone" but please do be patient with him, he is learning! Even though he is acting aloof he can spend more time with you and listen to your voice. Also, Saejima asked about your favorite music which you happily agreed to give recommendations about, you happily listen to your music taste and make Saejima listen to any kind of genre you listen to, it's just an excuse for Saejima to be close to you and see your smile as you hum the lyrics, he has to stop himself from trying to hug you and kiss you afraid that he will make you uncomfortable.

Saejima is vulnerable to you, he trusts you that he is willing to cry on your shoulder as he clings to you when he has suddenly memories of what happened, many years in the gutter deprived him of any kind of affection hell, and even humans touch, so he CRAVES your touch, he wants your touch, your hugs, anything that will give him any kind of comfort. When he hugs you he can smell your scent, he loves the way your fingers feel between his hair (IF HE HAD HIS HAIR B4), how warm you feel, how soft and pliant you are, the way you make his heartbeat quicker than normal, the way you make him feel special and important. He can't explain the feelings he has in his heart whenever you do, but deep inside him there is a fear that it will change someday, he is scared that someday your view of him will change and you will realize that he is nothing more than a monster.

Saejima is also scared that you might see him as a rude individual plus his resting bitch face doesn't help either yet if you manage to see through him and see that he's just being honest and straightforwards and he's also, in fact, a soft man at heart, he is really just a traumatized guy who needs all the support he needs, you would just leave him in the dust wouldn't you?

[sirfrogsworth]

I'm home. It was a long day. The night nurse asked me to stay a little longer to keep an eye on my dad because of his confusion. (Last night Dad tried to make an escape and they had to use soft restraints.) I told him I was tired and if I felt my dad was going to be a spaz and cause trouble again, I would stay. But if he seemed calm and sleepy with the new sedative they are trying, I would need to get home to rest. The nurse was cool with that, and my dad looked sleepy as heck, so I left.

The hospital is a bit frustrating with their closure procedures. They let visitors stay until 9pm. However, they close the main doors right at 9 and make you walk to the other side of the building to the secure exit. They also close off all the parking lot exits, minus the emergency one, directly at 9. Wouldn't it make sense to wait until 9:15 so people have time to get to their cars? And when they close off all the exits, you end up having to take this maze-like circuitous route to exit the parking lot. It literally takes more time to drive around that maze than it takes me to drive home.

My dad is really out of it. I am trying to be the best advocate possible and communicate to the staff how to help him become more lucid. HE NEEDS SLEEP. Like, long, restful, deep sleep. There hasn't been one time that has not fixed his confusion. But they are all trying to solve a bigger puzzle. They are like, "Maybe it is excess CO2 in his lungs. Maybe it is a new infection. Maybe he got COVID."

And I'm just like, "He needs sleep. Give him something to sleep."

And they are like, "Mayyyybe."

But I think that answer is too simple when they are in puzzle solving mode. So I broke it down...

"He had dialysis yesterday which wipes him out every time. Usually requires a 3 hour nap afterwards. But instead of napping, he had a catheter procedure with anesthesia. Then his foot hurt so bad he couldn't fall asleep all night. Plus they are giving him pain meds which always make him drowsy and loopy. HE'S EXHAUSTED."

And they were like, "Could be. We'll run some tests though."

I do think I convinced them to try and help him sleep with whatever options are safe right now. But I don't know if this sedative they are trying will end up having drowsy side effects which will cancel out the benefits of sleeping. I guess we'll see in the morning.

It really sucks that he choked on that food. He really didn't need this setback in his healing. It seems like the hospital always makes him sicker before they finally get around to helping him.

And lastly, podiatrists don't do weekends.

Apparently.

So it will be Monday until I know if my dad has a chance at standing and walking again. Why is a damned podiatrist the only one qualified at determining what to amputate?

I've been trying to brainstorm ways I could take care of him if he is unable to stand up on his own and transfer to a wheelchair or rolling walker. I know they have lifty things you can put over the bed. But I'm not sure that is a good solution for our house. I just wish I was strong enough to lift him on my own. He is just a tad heavier than I can manage. Maybe I need a mech suit.

There must be a solution though. Lots of people are without limbs. Hopefully I am just unaware of how caretakers deal with this issue.

[blurglesmurfklaine]

Okay Life As We Know It Javey AU here we GO:

Katherine and Sarah have been together for a few months. They conspire to get Sarah’s brother—who is sort of a recluse and doesn’t date much—and Katherine’s ex-turned-best friend—who is kind of a wildcard and needs to settle down—together on a date. They both think it’s a great idea because despite their different personalities and flaws, they’re both the best people Katherine and Sarah know, respectively.

The boys agree and naturally, the date is an absolute fucking disaster.

Jack is about 20 minutes late to pick up Davey, Davey can’t stop making snide remarks—whatever it is, they run each other the wrong way, much to the disappointment of Kath and Sarah.

“I hope I never have to see him again,” says Davey to Sarah and Jack to Katherine.

Sarah and Katherine are engaged within the year and Jack and Davey are their best men.

Flash forward through the years: Kath and Sarah’s engagement party, their wedding, and—holy shit Kath is pregnant??? They’re having a whole ass baby???—the baby’s first birthday party.

Jack and Davey keep it civil at all these events, as much as they can. For Katherine and Sarah’s and now the baby’s sake. But they still don’t get along.

Which is all fine and well because it’s not like they see each other that often. It’s not like they have to.

Until tragedy strikes and Katherine and Sarah leave behind a house and a one year old baby. In Jack and Davey’s name.

Surely, this must be some sort of mistake? Surely, there must have been at least one person they trusted more that Jack and Davey to raise their kid? Davey suggests Kath’s dad, but Jack knows they haven’t spoken since she quote unquote “married beneath her”. Jack asks about Esther and Mayer, but they’re still putting Les through high school and between Mayer’s dialysis—

So. It has to be them.

Amidst navigating their grief and the logistics of… everything, they agree that they shouldn’t move Kath and Sarah’s daughter. She should stay in the house, in a familiar environment. She’s lost enough. But it also means Jack and Davey have to move in.

The way Jack constantly rearranges Davey’s calendar drives him up the wall, and the way Davey is constantly micromanaging this kid’s life makes Jack pull a face but… they also see how much the other cares about her, so much love for what’s left of Davey’s sister, of Jack’s best friend, that it’s almost tangible and slowly but surely they learn to appreciate one another and all their quirks and flaws.

It’s a lot; managing a house, juggling appointments with the social worker, and not to mention raising a literal fucking child, but they make it work, surprisingly enough. In fact, they make it work really well. And one day, after Jack has rocked the baby to sleep and Davey has finished prepping her food for the next day, they sit on the couch and get to talking about just how well it’s working and have Davey’s eyes always been this captivating? Has Jack always been this sensitive and caring? And one thing leass to another and YOU GET THE GIST PEOPLE

But then Jack gets a job offer in Santa Fe. One he’s waited for all his life. So he’s got to decide whether to follow his lifelong dream or stay with Davey and raise their—Sarah and Kath’s baby. Well, Davey makes that choice for him. Of course Jack would even consider it. Davey’s managed most of his life alone, he can manage their… his—Kath and Sarah’s baby’s on his own, too.

Until Race talks some fucking sense into him and they’re loading up the car and “I don’t have a car seat! It’s in the garage!” “I’ll stay with her just GO YOU FUCKING IDIOT”

But Davey’s too late, the plane Jack was scheduled to be on has taken off and he returns home, sullen, but at least he has his daughter to come home to. Who is laughing, bright and delighted, in Jack’s lap when Davey walks through the door.

“I couldn’t just leave her. I couldn’t leave you. Us.”

And Davey runs into the arms of his happy little family

Aaaaand they live happily ever after because angsty endings?? In THIS economy?

[mowerewolf1550]

Mornings

As I sit in the bathroom, I find my eyes have fallen on a very old steel step. It folds out into 3 steps, and has a handy seat on the top step. The seat is fake leather, and I know it over 35 years old. It was my wife's when we started living together. I see splashes of paint, and I remember each one, the color, the room, and yes even the house. It takes me back a bitter road of love. The first color come from our first house. I can't say it where we fell in love, because we leaped into love. We were perfect together.I learned when people say a relationship takes a lot of work, they have no idea what they are talking about. We were married 29 years, and never had one major fight. We were like 2 perfect gears together. Another color is from our second house in Colorado. We moved there because she missed her mother. We found that even though she lived across the alley from her son, she was unable to take care of herself. She was messing up her meds and had fallen and broken her collarbone. We decided to find a house to suit both mom and us. We found a home that we loved. It was quite a drive from where I worked, about 120 miles round trip, but it wasn't about me. We moved mom with us, and my new barn became a home for a lot of junk, and my 1968 Chevelle convertible. I didn't drive it much, because it sucked gas like a vacuum cleaner. I drove back and forth to work everyday, until she was diagnosed with cancer. She had been feeling run down for almost a year. Finally her doctor had a bone marrow test, and a pet scan. It was non-Hodgkin's lymphoma, and it was stage 4. I turned in for retirement to take care of her. We could not make the mortgage payment, and decided to move. Mom had passed in 2013, her last years in a home for people with dementia. Enough said. We put the home on the market. It took almost a year to sell it. I had researched other places to live. She had live in Colorado all her life except the time she lived with me in California. She told me that she wanted to move out of Colorado, because this wasn't her Colorado anymore. We ended up selling and buying very quickly. One home that I had looked at was the one I am sitting in right now, although not in the bathroom anymore. We got moved and she found a fantastic doctor. He said she needed another round of chemo, and we had a meager Christmas that year, facing another round of sickness, loss of hair, well, you get the idea. She went through 4 treatments. She wasn't that sick, and lost little hair. After the treatments she was declared cancer free. We celebrated, but I had reservations. I knew this type of cancer comes back from experience.

It did. It came back 4 times. She went through chemo, having her spleen out, septic shock from an UTI, and the death of her best friend. The 4th time she had started chemo, and got infections through her PICC line, put in for the chemo. She went into the hospital again with infections. She had done this 3 times already. I didn't know this was the last. I watch as she had ups and downs, 18 days in ICU. About 5 days before she lost the fight, she told me she was so tired of fighting. I knew in my gut I was going to lose my bride. She rallied about 3 days before the end, but I knew this happens sometimes. The doctors tried one last treatment to fight the bacterial, fungal, and yeast infections in her blood and lungs. I agreed, but the drug killed her already weak kidneys. The last 2 days I told her she could go. I prayed for her to go, as terrible as that sounds. I knew she had a fear of dialysis, and told me many times she wasn't going to live like that, having watched her first husband died from kidney failure. Everyday I go up and sit by her bed, once she was sitting up, but had to have help even to stand. The last few days as she went in and out of reality, I'd sit and quietly sing to her. When I sang "Nights in White Satin", she'd smile, except the last 2 days, but I sang to her anyway. I was called to the hospital because they said she was going. I cried all the way there. I sat until 3 am on 5/5/2022. I had to go home and take care of our animals. I intended to come right back, but like an idiot, I sat down. I woke at 8:30 am, and got in the truck. At 8:45, the nurse called and said she had passed at 8:40 am. She had told me many times she didn't want me to sit and watch her die. Well Angel, I never denied you anything. Rest in Peace my Love.

[leontyne]

I lost my mother last week. You know this kind of thing happens.. it's almost guaranteed to lose your parents, unless something terrible happens and your parents lose you first. I know it could.. but nothing can prepare you for it.

My mother had 5 children. I was her 3rd and only girl. When I was younger I remember getting upset about not getting a sister. My brothers had a sister and 3 brothers. I had 4 brothers and no sister.

My mum handled it like a champ of course. She wanted more girls but 5 was her limit of tries. So her solution was to step in for anything I might need a sister for. Helping me pick clothes, doing my hair, helping with makeup, explaining puberty, answering embarrassing questions, hyping me up when I needed, befriending my friends, pushing me when I needed it, giving me the tough talks.

My mother became my best friend and I never once got embarrassed by her despite her worrying qbout that. Alot. She'd ask if I'd rather go to this movie with friends or hang out with someone else for the day instead of her. No. Of course not. I was so proud to have such a wonderful mum. She was fun, smart, hilarious, caring, brave, protective, beautiful, kind and so incredibly good. How could I ever not want to spend time with her?

Some of my friends had different relationships with their mums, ranging from the typical "That's my mum, she buys me stuff and cooks for us and helps me when I get hurt. I love her" to the "She's so annoying, why can't she just leave me alone" relationships. If I had to hang out with friends that treated their mums like c**p for no reason I'd go home and immediately crawl into my mums arm and hug her (even as an adult) and tell her about how horrid they were to their mum and how I could never do that. She always hugged me tighter at those times.

She got sick 3 years ago, and after months of blood tests and iron infusions she ended up in the ER and was admitted and kept for 18 months. Eventually she was diagnosed with Refactory Celiacs and they started trial drugs and treatment. After her bone marrow transplant and chemo she stabilized enough to come home, not because she was better but because her mental health was so low from being away from home for so long that the doctors and nurses insisted she should be allowed home.

Home helped her happiness but the pain never left, the symptoms never left, the disadvantages and restrictions never left. She persisted though. She had to go back sometimes when an infection came up or she lost too much blood or, as her last admittance, she had difficulty breathing.

Her last stay was 2 months long. She couldn't breathe easy which they'd found shadows on her lungs but biopsies showed nothing. Her right arm was no longer responsive, she'd be lucky to move her fingers. Doctors did a few lumbar punctures but only found 2 types of t-cells present. Her last operation was to get more punctures but they took too few so they were rescheduling. Her liver and kidneys were failing because of her TPN but she was dependent on that so she was told she'd be eligible for organ transplants as she didn't drink or smoke.

She also developed an infection they diagnosed as staff a week before her passing before changing that to sepsis as her oxygen got so low they had to keep uping her delivery of such (nose hoses, then mask, then hood, then eventually the throat tube). She was moved to ICU, put on every antibiotic they can physically put in her body, put her in an induced coma and hooked her up to the oxygen tube and dialysis. 6 hours later we got a call from ICU saying she had took a turn and another 6 hours of sitting by her side holding her hand, still in her coma, they had to start turning the machines off.

My world narrowed at that point, and we hyper focused on mums funeral which we had yesterday. It's been a complete blur and I'm still struggling to understand that she's not here. I reach for my phone to call her. I push share on a cute puppy video. I order her lollies and get excited to surprise her. I hear something funny and have it half typed out before I stop. I look towards her chair to smile at her. I sit in her seat in the car and plan to move when we pick her up despite that not being the meaning of the trip. I write another chapter but I can't get her to read it. I push my anxiety limits and fears and beat them but I can't tell her or see her massive grin and hear her tell me how so very proud she is and plan with her what we'll do when we're both better. I cry from my thoughts and heart. In public. In private. I cry hard, loud and I can't stop until I'm exhausted. I can't look at my ceiling because she covered it with glow in the dark stars when I was 20 while I was at work. Half my books she bought me. Half my plushies she bought me. Half my clothes she bought me. Half my room is her and memories of her. Her dogs, her cat, her photos, her seat, her trinkets, her renovations, her art, her tissues, her lollies, her hoodie, her shoes, her spare room/clean room, her blankets, her pillows, her everything is everywhere..

My mother was my biggest fan, my rock, my best friend and the bravest person I knew and I can't wrap my head around not being able to speak to her again.. she is everywhere but nowhere to be found. I catch myself talking aloud to her. I talk to her in my mind and memos and I say our catch phrases and my laugh is hers and my smile is hers and my face is hers and I'm so so.. numb.. empty.. lost.. broken. I'm 32, my mother was 53. I thought I'd have so many more years with her.. but now she won't see my wedding, or any of the boys. She wont meet any of my kids or any more added by the boys. She wont help me move or drive or write or pick me up after a break up or help me with advice for wooing a pretty girl or picking my next pair of converse or drag me to watch ANOTHER Fast and Furious movie or get to watch the 2nd season of Wednesday or go camping again.. she had so many plans.. and I don't like knowing how quickly all of that.. life.. is gone. I'm terrified and heartbroken and angry qnd I can't even go to the one person who could help me sort through it.

My mother was the biggest part of my life and now that part is gone and I have no idea what to do.. I'm eating because she'd want me to. I'm sleeping because she'd want me to. I'm going outside and talking because she'd want me to. I'm keeping in contact with the boys because she'd want me to. I'm keeping dad grounded because she'd want me to. But I don't want anything.. I don't know how to deal with that.. so instead I'm here writing a long a** post that will not be read and hoping it helps my heart feel a little less like a broken mess.

[dreaminginthedeepsouth]

A Hotter Planet Takes Another Toll on Human Health

A new hypothesis about heat waves, redlining, and kidney stones.

By Bill McKibben

January 19, 2023

Shortly after the New Year, the Washington Post ran a story with a headline that would have seemed inexplicable, even runic, to most readers just a few years ago: “The world’s torrid future is etched in the crippled kidneys of Nepali workers.” But we’re growing used to the idea that the climate crisis, in Naomi Klein’s phrase, “changes everything,” so why not the internal organs of Nepalis? Remarkable reporting by Gerry Shih tells a series of unbearably poignant tales: young Nepali men, struggling to earn a living in their impoverished homeland, head to the Gulf states to do construction work in the searing heat, some without access to sufficient water, some until they collapse. (Other reporting also shows that some Nepalis who work abroad resort to the black market for a transplant that might keep them—and the families that depend on the money they earn—alive.) The piece ends with a man coming back to the care of his sister, who donates her own kidney to save him. The costs of the medical procedures require that he sell his half-built house, and that he give up his life’s dream, which was to get married.

The Post was right: the world’s future is likely encapsulated in this story. The planet is getting steadily hotter, and large swaths of it are moving past the point at which it’s safe to do heavy outside labor in the middle of the day. A 2022 study estimated that six hundred and seventy-seven billion working hours a year were already being lost because it’s too hot to go outside and build things or farm. The researchers assessed the cost at more than two trillion dollars annually, but, of course, it could also be measured in other units—in vital organs, or dreams.

But it’s not just the future that’s illuminated by such studies; it’s the past as well. Unless you’ve been keeping up with your issues of Current Opinion in Nephrology and Hypertension, you may have missed a recent article titled “Redlining has led to increasing rates of nephrolithiasis in minoritized populations: a hypothesis.” I saw it only because one of the medical experts who wrote it—David Goldfarb, who runs the dialysis unit at New York’s V.A. hospital and teaches at New York University’s School of Medicine—is an old family friend. He forwarded it to me, and it fairly blew my mind.

“Nephrolithiasis” is the technical term for the development of kidney stones, those small formations that, as they pass, can cause excruciating pain. (I’ve never had them, but I know more than one man who has said he came away from the experience with a newfound appreciation for what his wife had undergone during labor.) Doctors have long known that higher temperatures lead to more sweat, which reduces urine volumes and thus increases “the saturation of the insoluble salts that cause kidney stones.” During heat waves in the U.S., it takes just three days before emergency-room visits for kidney stones begin to spike.

For reasons that remain unclear, kidney stones have traditionally been more common among white people, but, in recent years, doctors have noted huge increases among Black Americans and a significant rise in Latino communities. The authors of the new article looked to the past for a possible explanation—particularly to the nineteen-thirties, when a federal agency, the Home Owners’ Loan Corporation, graded all of America’s neighborhoods and deemed some of them “hazardous” for investment, essentially because they were home to large minority communities. This grading system (from A for “best” and B for “still desirable” to C for “declining” and D for “hazardous”) underlay what came to be known as redlining. The grading system led to “chronic disinvestment” in the lower-rated neighborhoods, resulting, over time, in less of everything from parks and green spaces to street trees and air-conditioning in homes.

Now the results can be measured with a thermometer: in Portland, Oregon, the authors report, neighborhoods that were graded A in the nineteen-thirties now “average 8 degrees Fahrenheit lower than the city’s mean temperature, while D-graded neighborhoods average 4.8 Fahrenheit degrees warmer.” Actually, you don’t need a thermometer—that’s a thirteen-degree gap that anyone can feel just by walking across town. No one has carefully studied the incidence of kidney stones among these different neighborhoods, but the authors, in their hypothesis, point to research now under way. Similar work on asthma, another heat-related disease, has shown emergency-room visits are 2.4 times higher in redlined tracts.

Indeed, Goldfarb’s son Ben—an environmental journalist who this year will publish a book called “Crossings,” on the environmental impact of roads—writes that the HOLC grading program produced all kinds of deleterious health effects. In Syracuse, Miami, Minneapolis, and other cities, large parts of neighborhoods that the agency had redlined—and whose residents were mostly Black—were bulldozed to make room for interstate highways. He told me, “Minorities today disproportionately live near the urban freeways that displaced them, and suffer as a result. Air pollution causes asthma and cancer; noise pollution increases the risk of heart disease and stroke; and the physical fragmentation wrought by highways shatters local economies. It’s heartbreaking, though hardly surprising, that disastrous policy decisions made decades ago continue to destroy bodies and communities today.”

It’s true that everyone is going to pay some price as the planet cooks. The authors of the nephrology study predict a likely additional cost to the U.S. health-care system of at least a billion dollars a year. But some people are going to be hit much harder than others because of history. Doing justice in the present requires taking that past seriously—understanding how we ended up where we are, and why we must put those with the least first, as we try to address the future. But we’re at a moment in this country when the idea of historical responsibility is increasingly seen not as logical and obvious but as some kind of invidious political correctness.

In April, 2022, Governor Ron DeSantis, of Florida, signed the Stop Wrongs to Our Kids and Employees Act, or the Stop WOKE Act. (In introducing the bill, he had said, “In Florida we are taking a stand against the state-sanctioned racism that is critical race theory,” adding that “we won’t allow Florida tax dollars to be spent teaching kids to hate our country or to hate each other.”) A preliminary injunction was issued against the act, which includes a dictum against any school teaching that “a person, by virtue of his or her race, color, sex, or national origin, bears personal responsibility for and must feel guilt, anguish or other forms of psychological distress because of actions, in which the person played no part, committed in the past by other members of the same race, color, national origin, or sex.” 

But, even if you can silence teachers, legislation can’t muffle the effects of history. On a hot summer’s day in Jacksonville, Florida, where DeSantis was born, the temperature in A neighborhoods is 5.5 degrees below the mean, and it’s 4.4 degrees above the mean in the D-rated communities.

[adhdedrn]

you just claimed getting rid of sanitation workers is the second fastest way to fuck up a hospital, i was wondering whats the #1 fastest way to fuck up a hospital? my best uneducated guess is dropping a bomb on it but i'm not sure thats what you were thinking of. cheerio

Fastest way to fuck up a hospital? Get rid of the nurses/midwives.

Aside from stuff like administering medications, doing basic patient care, and performing/assisting with procedures, the most important task a nurse does is patient monitoring - observing their patients, watching for any signs that their condition might be deteriorating in some way, and knowing how to appropriately respond if a patient does deteriorate.

Sure, the doctors know how to do some of that too (pretty sure they wouldn't know how to bathe a patient or use the standing machine), but there are a lot more nurses and midwives than doctors, and patient ratios mean the nurses and midwives will see you more frequently.

So if the nurses and midwives are gone, that means nobody's around to:

notice a ward patient might be getting sicker or having a medical emergency (e.g. heart attack, stroke)

look after patients undergoing surgical procedures

look after patients recovering from anaesthesia

look after patients undergoing lengthy or complex procedures (e.g. dialysis, chemotherapy, blood transfusion, childbirth)

look after patients that have one or more major systems compromised (e.g. intubated patients, babies in the special care nursery)

notice that a patient may have a concern about something that they haven't been able to tell the doctors (e.g. worried about being safe at home, don't quite understand something about their care)

notice that a patient may not be progressing as expected (e.g. a patient's mobility isn't improving)

triage patients that present to Emergency, which means nobody will reliably know how unwell a patient might be

You'll notice pretty fast if the cleaners are gone - but you'll notice the absence of nurses and midwives a lot faster.

[aasthadialysishospital]

Best Dialysis Hospital in Sri Ganganagar

Dialysis Hospital in Sri Ganganagar.

Aastha Hospital: Leading Dialysis and Nephrology Services in Sri Ganganagar’s

Introduction

Welcome to Aastha Hospital, Sri Ganganagar’s premier destination for comprehensive dialysis and nephrology services. With a dedicated team of healthcare professionals and state-of-the-art facilities, we are committed to providing exceptional care for patients with kidney-related conditions.

Our Dialysis Services

At Aastha Hospital, we understand the challenges that come with kidney disease. Our dialysis unit is equipped with the latest technology to ensure safe and effective treatment. We offer:

Hemodialysis: Our hemodialysis services are tailored to meet the individual needs of patients, providing treatment three times a week in a comfortable and supportive environment.

Peritoneal Dialysis: For patients who prefer home-based treatment, we provide comprehensive training and support for peritoneal dialysis.

Expert Nephrology Care

Our team of experienced nephrologists specializes in diagnosing and managing a wide range of kidney conditions, including:

Chronic Kidney Disease (CKD)

Acute Kidney Injury (AKI)

Kidney Stones

Hypertension related to kidney disease

We utilize advanced diagnostic tools to create personalized treatment plans, ensuring the best possible outcomes for our patients.

Patient-Centered Approach

At Aastha Hospital, patient care is our top priority. We strive to create a welcoming environment where patients feel comfortable and supported throughout their treatment journey. Our services include:

24/7 Emergency Care: Immediate access to medical assistance for urgent kidney-related issues.

Nutritional Counseling: Our dietitians work with patients to develop kidney-friendly meal plans.

Support Groups: We offer resources and support for patients and their families to cope with the emotional aspects of kidney disease.

Why Choose Aastha Hospital?

Experienced Team: Our nephrologists and dialysis technicians are highly trained and experienced in managing kidney health.

State-of-the-Art Facilities: Our hospital is equipped with modern dialysis machines and advanced monitoring systems to ensure patient safety and comfort.

Comprehensive Care: We provide a full spectrum of kidney care, from diagnosis to treatment and ongoing management.

Conclusion

If you or a loved one is seeking reliable dialysis and nephrology services in Sri Ganganagar’s, Aastha Hospital is here to help. Our commitment to excellence in patient care and our expert medical team make us the trusted choice for kidney health.

For more information or to schedule a consultation, please contact us today. Your health is our priority!

 Directions

Phone: 096949 28920

Dialysis Hospital in Sri Ganganagar

Kidney Hospital in Sri Ganganagar

Kidney Stone Hospital in Sri Ganganagar

Hospital in Sri Ganganagar

[nishmahealthassist]

Top 10 Kidney Specialist in Delhi

Finding the Right Kidney Specialist in Delhi: A Comprehensive Guide

Introduction

Delhi, a bustling metropolis and the capital of India, is home to numerous healthcare facilities and specialists. Among the various medical specialties, nephrology—the branch focused on kidney health—plays a crucial role in managing renal diseases. With an increasing incidence of kidney-related issues, finding a qualified kidney specialist in Delhi is essential for effective treatment and management. This blog explores the importance of kidney specialists, common kidney diseases, and how to choose the right nephrologist in Delhi.

The Role of a Kidney Specialist

Kidney specialists, or nephrologists, are medical doctors trained to diagnose and treat diseases related to the kidneys. Their expertise encompasses a wide range of conditions, including chronic kidney disease, kidney stones, glomerulonephritis, and hypertension. Nephrologists also manage patients undergoing dialysis and those preparing for kidney transplants.

The role of a kidney specialist extends beyond treatment; they also educate patients about kidney health, dietary modifications, and lifestyle changes that can prevent further complications. Regular consultations with a nephrologist can help in the early detection of kidney issues, leading to timely intervention and improved outcomes.

Common Kidney Diseases

Understanding common kidney diseases can help patients recognize symptoms and seek timely medical assistance. Some prevalent kidney conditions include:

1. Chronic Kidney Disease (CKD): A progressive loss of kidney function over time, often caused by diabetes and hypertension. CKD can lead to kidney failure if not managed effectively.

2. Kidney Stones: Hard deposits made of minerals and salts that form inside the kidneys. Symptoms may include severe pain, blood in urine, and frequent urination.

3. Glomerulonephritis: Inflammation of the kidney’s filtering units (glomeruli) which can result from infections or autoimmune diseases.

4. Polycystic Kidney Disease (PKD): A genetic disorder characterized by the formation of fluid-filled cysts in the kidneys, leading to enlargement and reduced kidney function.

Recognizing these conditions and understanding their symptoms can motivate patients to consult a kidney specialist sooner rather than later.

Choosing the Right Kidney Specialist in Delhi

Finding the right kidney specialist in Delhi involves considering several factors to ensure you receive the best possible care. Here are some tips to help you make an informed decision:

1. Credentials and Experience

Look for nephrologists with the appropriate qualifications, board certifications, and extensive experience in treating kidney diseases. An experienced specialist is more likely to be familiar with the latest treatments and technologies.

2. Hospital Affiliation

Consider the hospitals or clinics where the nephrologist practices. Reputable healthcare facilities typically have better resources, advanced technology, and a multidisciplinary approach to patient care.

3. Patient Reviews and Recommendations

Reading patient reviews and testimonials can provide insight into the doctor’s approach and patient satisfaction. Additionally, seeking recommendations from family or friends who have had positive experiences can guide your choice.

4. Consultation and Communication

Schedule a consultation to gauge the nephrologist’s communication style and willingness to address your concerns. A good specialist should be approachable, patient, and able to explain complex medical terms in understandable language.

5. Accessibility and Location

Consider the location of the specialist’s office and their availability for appointments. Proximity can make it easier to attend regular check-ups and consultations, which are crucial for managing kidney health.

Conclusion Selecting a qualified kidney specialist in Delhi is essential for maintaining kidney health and addressing any potential issues. With the right expertise and guidance, patients can effectively manage kidney diseases, leading to improved quality of life. By understanding the role of nephrologists, recognizing common kidney conditions, and following the tips for choosing a specialist, individuals can take proactive steps toward their kidney health and overall well-being. Whether you are experiencing symptoms or simply seeking a consultation, investing time in finding the right kidney specialist can make a significant difference in your healthcare journey

[thedataproject]

Find a Dialysis Center Near You: Comprehensive Guide

Chronic kidney disease (CKD) is said to affect almost 37 million Americans, while approximately 786,000 are already at the point of end-stage renal disease - a condition wherein the kidneys have completely lost their ability to do their job efficiently, and when dialysis or a kidney transplant is essentially needed to sustain life. In replacing some functions of the kidneys, dialysis filters out waste and excess fluids from the blood when the kidneys can no longer do this. Because treatments can be several hours, repeated several times a week, the selection of a dialysis center is an important part of the management of the disease.

In this informative guide, we are going to take a closer look at the types of dialysis, how to choose a center, and provide practical steps in finding the best dialysis facility near you with resources from Find Dialysis Centers directory. We'll also provide crucial statistics, facts, and references so you can make an educated decision.

1. Understanding Dialysis: What Are Your Options?

Dialysis is a treatment for patients whose kidneys have lost most or all of their functional abilities. The two major forms of dialysis - hemodialysis (HD) and peritoneal dialysis (PD) - are suited for different types of patient needs.

Hemodialysis (HD)

How It Works: Hemodialysis cleans the waste and excess fluid from your blood with the aid of a machine known as a hemodialyzer. During treatment, blood will leave your body and then pass through this filtering machine, after which it will be returned to the body. One session of hemodialysis typically lasts from 3 to 5 hours and is done three times a week.

Patient Experience: HD can be performed either in a dialysis center, in a hospital, or at home-with proper training. In-center hemodialysis remains the most common modality, with supervision by trained healthcare professionals during treatment.

Who It’s For: Hemodialysis is best suited for individuals who need regular treatment professionally supervised or prefer structured schedules. As of 2016, the U.S. Renal Data System (USRDS) reported that 89% of dialysis patients in the United States use hemodialysis.

Peritoneal Dialysis (PD)

How It Works: In peritoneal dialysis, a catheter is inserted into the abdominal cavity, a sterile cleansing fluid called dialysate is infused into the abdomen. The peritoneum, which lines the abdomen, acts as a filter; after absorbing waste products, the fluid is drained. It can be done at home-typically several times a day-or by using a machine overnight.

Patient Experience: PD tends to be more flexible than many other treatment modalities, as patients can conduct treatments in the comfort of their own home or even while at work. That makes it a good fit for patients placing a premium on autonomy.

Who It’s For: PD is a popular alternative for patients who would wish to have more control over their treatment schedule. It is an operation with less invasion compared to hemodialysis and has no needles in many cases. According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), about 11% of dialysis patients go for peritoneal dialysis.

Key Statistics:

Average life expectancy on dialysis: 5-10 years, although some patients live 20 or more years with appropriate care.

Average dialysis cost: Hemodialysis costs approximately $89,000 per year while peritoneal dialysis costs about $71,000 annually.

2. How to Find a Dialysis Center Near You

Finding a dialysis center that best fits your medical needs, personal preferences, and lifestyle is essential in maintaining health. How to make this search effective:

Step 1: Use an Online Dialysis Center Directory

Some directories, such as Find Dialysis Centers, will allow a search based on location, services, and star ratings for dialysis centers. With over 7,600 listings of United States dialysis centers in their directory, this directory makes a comparison of dialysis centers in your area based on your zip code or city.

Why Location Matters: For most dialysis patients receiving three treatments a week, location is key. Ease of travel can make the difference between sticking to a schedule and either missing sessions or experiencing treatment fatigue. A number of studies have shown that patients residing closer to their dialysis centers have higher adherence with fewer complications.

Step 2: Check Medicare Star Ratings

For instance, dialysis centers in the United States maintain a star rating from 1 to 5 in various areas of concern, including infection rates, hospitalizations, and patient survival rates.

Why It Matters: Facilities with more stars have been associated with better outcomes, fewer hospitalizations, and better long-term survival. A superior quality of care is concentrated within facilities with 4 or 5 stars.

Step 3: Filter by Services Offered

Other than the generic in-center hemodialysis, the services provided by dialysis centers may include a multitude of different offerings, including:

Home dialysis training: Many of the facilities provide training for patients who are anxious to take care of home hemodialysis (HHD) or peritoneal dialysis themselves.

Nocturnal dialysis: For working patients, several centers may provide overnight dialysis treatment sessions, allowing a patient to dialyze while sleeping.

Vascular access care: Fistulas or catheters are often required to continue hemodialysis, and some centers have specialized care for this.

3. Key Factors in Evaluating Dialysis Centers

Choosing a dialysis center isn't just about location. The care is indicative of the quality, and the skill of those performing it, and so are the patient outcomes.

Staff-to-Patient Ratios

Centers with a lower ratio of staff to patients allow for more individualized care, which may improve patient outcomes. A center that has fewer patients assigned per staff member can monitor each patient more closely, which minimizes the chances of complications such as infection or low blood pressure during dialysis.

Infection Control

Infection is perhaps the most serious risk with dialysis, but especially with patients on hemodialysis through catheters or fistulas. Estimates by the Centers for Disease Control and Prevention (CDC) approximate that the death toll by bloodstream infections kills over 34,000 dialysis patients each year. Look for facilities that have low rates of infection and those that follow strict hygiene practices.

Patient Outcomes and Mortality Rates

Check the center's mortality rates and hospitalization rates compared to national averages. Generally, the higher quality the center is, the better the outcomes and most report these statistics on their websites.

Fact: Studies have shown that patients dialyzing in facilities with more nurses on staff have a 20 percent lower mortality rate compared to patients that are treated in understaffed centers.

4. Financial Considerations: Understanding Insurance and Costs

Dialysis is an expensive treatment, but for patients with end-stage renal disease (ESRD). Medicare pays 80% of dialysis costs regardless of age. The remaining costs are usually paid by Medicaid or private insurance.

Navigating Insurance Coverage

Medicare ESRD Program: Covers all ESRD patients in the United States and covers, after a three-month waiting period, the cost of hemodialysis and peritoneal dialysis. Once coverage kicks in, Medicare will cover 80% of treatment costs.

Out-of-Pocket Costs: Still, copays, deductibles, or the cost of medications are paid by the patients. At most centers there are financial counselors who will provide assistance to patients to review their insurance coverage and apply for additional financial assistance programs available such as the American Kidney Fund.

5. Specialized Care and Support Services

In addition to dialysis treatment, patients have many support services that facilitate quality of life and help achieve successful long-term outcomes.

Nutritional Counseling

The patients requiring dialysis must adhere to strict dietary styles that limit their fluid and food intake containing potassium, phosphorus, and sodium. A registered dietitian at the dialysis center will be in the position to offer specific nutrition counseling aimed at averting complications such as hyperkalemia (high potassium).

Mental Health and Emotional Support

It is burdensome to live with kidney failure; sometimes the physical and emotional stress is overwhelming for the patients, which may be helped by the availability of mental health counseling and social workers at dialysis centers to fight against depression, anxiety, and emotional burden of chronic illness.

Vascular Access Management

For a hemodialysis patient, a good vascular access site be it fistula, graft, or catheter is equal to life. Vascular access facilities stand by the patient in the prevention of complications of infection, clotting, or poor blood flow that might disrupt treatment.

Conclusion: Making the Right Choice for Your Health

It is life-supportive treatment, and success means finding a compatible dialysis center. Pay attention to location, expertise of staff members, patient outcomes, and additional support services to make a well-rounded decision that best fits your needs-medically and personally. Make use of various resources, like the Find Dialysis Centers directory, to compare centers based on location, ratings, and services provided.

While dialysis can be long-term, the right center will make treatment much easier and vastly improve your quality of life.

References:

National Kidney Foundation. Chronic Kidney Disease in the United States. https://www.kidney.org/kidney-topics/chronic-kidney-disease-ckd

U.S. Renal Data System. Annual Data Report: Epidemiology of Kidney Disease in the United States https://usrds-adr.niddk.nih.gov/2023

Centers for Disease Control and Prevention (CDC). Hemodialysis-associated Infections. https://www.cdc.gov/dialysis-safety/about/index.html

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Treatment Methods for Kidney Failure: Peritoneal Dialysis. https://www.niddk.nih.gov/health-information/kidney-disease/kidney-failure/choosing-treatment

American Kidney Fund. Financial Assistance for Dialysis Patients - https://www.kidneyfund.org/get-assistance

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Discover the Best Nephrologist in Delhi at Epitome Hospital for Comprehensive Kidney Care

When searching for the best nephrologist in Delhi, look no further than Epitome Hospital. Renowned for its state-of-the-art facilities and world-class medical expertise, Epitome Hospital is home to one of the leading nephrologists in the city. Specializing in diagnosing and treating a range of kidney-related diseases, including chronic kidney disease, kidney failure, and kidney transplants, the nephrologist at Epitome Hospital ensures personalized care and a patient-centric approach. Whether you're dealing with kidney stones, high blood pressure affecting kidney function, or seeking long-term dialysis support, the dedicated nephrology team at Epitome Hospital is committed to improving your kidney health with cutting-edge technology and compassionate care. For patients in Delhi and beyond, Epitome Hospital is a trusted destination for superior kidney treatment, offering not just medical expertise but also a holistic approach to wellness.

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Kidney Specialist in Greater Noida West

Introduction Kidneys play a crucial role in our overall health, filtering waste from our blood and maintaining a balance of fluids in the body. But what happens when these vital organs start to malfunction? This is where the expertise of a kidney specialist, also known as a nephrologist, becomes indispensable. Greater Noida West, a rapidly growing region, has seen an increasing demand for specialized kidney care. In this article, we’ll delve into why kidney health is so important, explore the types of kidney specialists available, and guide you on finding the best kidney care in Greater Noida West.

Understanding Kidney Health The kidneys are two bean-shaped organs located on either side of the spine, just below the ribcage. They perform the critical function of filtering out waste products and excess fluids from the blood, which are then excreted as urine. In addition to this, kidneys help regulate blood pressure, produce essential hormones, and maintain electrolyte balance.

However, like any other organ, kidneys are susceptible to various diseases and conditions. Chronic kidney disease (CKD), kidney stones, and acute kidney injury are just a few examples. Recognizing the symptoms and seeking timely medical attention from a kidney specialist is key to preventing further complications.

Why You Might Need a Kidney Specialist Early signs of kidney issues are often subtle, making them easy to overlook. These may include fatigue, swelling in the ankles and feet, changes in urination patterns, and high blood pressure. If you have diabetes, hypertension, or a family history of kidney disease, your risk of developing kidney problems increases.

A kidney specialist, or nephrologist, is trained to diagnose and treat kidney-related diseases. They can help manage conditions like CKD, kidney stones, and electrolyte imbalances, and provide guidance on preventing kidney damage.

Types of Kidney Specialists When it comes to kidney care, there are different types of specialists you may encounter:

Nephrologists: These are doctors who specialize in the diagnosis and treatment of kidney diseases. Urologists: While they treat the urinary tract system, urologists also address issues related to kidney stones and other structural problems in the kidneys. Dialysis Specialists: These professionals manage patients who require dialysis, a treatment that replicates the kidney’s filtering function when the organs are no longer able to perform effectively. How to Choose the Right Kidney Specialist Selecting the right kidney specialist is crucial for effective treatment. Here are some factors to consider:

Experience and Qualifications: Look for a specialist with extensive experience in treating kidney diseases. Board certification and specialized training in nephrology are important indicators of a doctor’s expertise. Patient Reviews: Reading reviews from other patients can provide insights into the quality of care you can expect. Referrals and Second Opinions: Don’t hesitate to ask for referrals from your primary care doctor or seek a second opinion if you’re unsure about your diagnosis or treatment plan. Kidney Specialist Services in Greater Noida West Greater Noida West is home to several reputable kidney specialists and clinics. These professionals offer a wide range of services, from routine check-ups to advanced treatments for complex kidney conditions. Whether you need management for chronic kidney disease, treatment for kidney stones, or guidance on dialysis, you’ll find experienced specialists in the area. Innovations in Kidney Care The field of nephrology is constantly evolving, with new treatments and technologies being introduced regularly. In Greater Noida West, patients have access to some of the latest innovations in kidney care, including minimally invasive procedures for kidney stones, advanced dialysis techniques, and cutting-edge imaging technologies for accurate diagnosis.

The Patient Experience Visiting a kidney specialist can be daunting, especially if you’re dealing with a serious condition. However, understanding what to expect can help ease your concerns. During your first visit, the specialist will review your medical history, conduct a physical examination, and may order tests such as blood work, urine analysis, or imaging studies. Based on the results, they’ll discuss your treatment options and create a personalized care plan.

Patient testimonials highlight the compassionate care provided by kidney specialists in Greater Noida West. Many patients report feeling reassured and well-informed after their consultations.

Preventive Care and Kidney Health Prevention is always better than cure, and this is especially true for kidney health. To maintain healthy kidneys, it’s important to:

Stay hydrated by drinking plenty of water. Follow a balanced diet low in sodium, sugar, and unhealthy fats. Monitor your blood pressure and blood sugar levels regularly. Avoid overuse of medications like painkillers, which can damage the kidneys over time. Schedule regular check-ups, especially if you have risk factors like diabetes or high blood pressure. The Importance of Early Detection Early detection of kidney disease can significantly improve outcomes. Simple screening tests, such as blood and urine tests, can help identify kidney problems before they progress. If you’re at risk, make sure to get screened regularly and consult a kidney specialist if you notice any unusual symptoms.

Dialysis Centers in Greater Noida West For patients with advanced kidney disease, dialysis may become necessary. Dialysis centers in Greater Noida West offer both hemodialysis and peritoneal dialysis, providing life-sustaining treatment for those with severe kidney failure. Facilities like Sharda Hospital and Jaypee Hospital have well-equipped dialysis units staffed by experienced professionals.

Kidney Transplant Services In cases of end-stage renal disease, a kidney transplant may be the best option. Greater Noida West is home to several transplant centers where skilled surgeons perform kidney transplants with a high success rate. These centers also offer pre-transplant evaluation, donor matching, and post-transplant care to ensure the best possible outcomes for patients.

Cost of Kidney Care in Greater Noida West The cost of kidney care can vary depending on the type of treatment required. For example, dialysis and transplant procedures are more expensive than routine consultations and medications. However, many hospitals in Greater Noida West offer affordable care options and work with insurance providers to help manage costs. Be sure to discuss payment plans and insurance coverage with your healthcare provider.

Conclusion Kidney health is crucial for overall well-being, and finding the right specialist can make all the difference in managing kidney-related conditions. Whether you’re in need of routine care, advanced treatment, or preventive advice, Greater Noida West offers a range of services from highly qualified kidney specialists. Don’t wait until symptoms worsen—early detection and proper care can lead to better outcomes and a healthier life.

FAQs What are the early signs of kidney disease?

Early signs include fatigue, swelling in the ankles, changes in urination, and high blood pressure. If you experience any of these, consult a kidney specialist. How can I find the best kidney specialist in Greater Noida West?

Look for specialists with experience, good patient reviews, and board certification in nephrology. Referrals from your primary care doctor can also help. Is dialysis the only treatment for kidney failure?

No, other treatments include medication and lifestyle changes. In severe cases, a kidney transplant may be recommended. Can kidney disease be cured with lifestyle changes?

While lifestyle changes can help manage kidney disease, they may not cure it. Early detection and treatment are crucial. What should I bring to my first appointment with a kidney specialist?

Bring your medical history, a list of medications, and any recent test results. Be prepared to discuss your symptoms and health concerns.

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