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  • bleeding

    my husband has just passed over to stage 5 and the dr says we need to start getting ready for dialysis quick here is the problem my husband is a retired mini bus driver his primary clients were to take patients to dialysis His main fear he says is (now remember this is 20 to 15 years ago) the patients were not able to stop bleeding when they were removed from the machine apparently the clinic would have to call paramedics to and transport the patient to the hospital for so much loss of blood is this true or what can I say to reassure him. Thanks everyone in advance for good answers

    Annie

  • #2
    Excessive bleeding can be a problem, but usually it's not. I've had some bleeding problems a few times when I've pulled my needles, but it's actually not that common. It often simply depends on whoever is holding the sites after the needle is pulled. If they do it right, there should be no excessive bleeding. Access condition and heparin can also play a factor in post tx bleeding. I had to go to the emergency room one time for excessive bleeding, but that was because my access was clotting and that built up a lot of pressure and just kept forcing the blood out. I wouldn't worry about it too much, as long as your husband has a good access, and knowledgeable clinic staff.

    Adam
    When my emotions start to cramp, the Lord turns off my UF and gives me some saline.

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    • #3
      thanks Adam

      btw I like your signature line!

      Like I said before my husband hasn't started dialisys yet this really isn't new to us we have had some time to prepare last year he was in stage 4 and last week the dr said he was in stage 5 but she didn't want to see him for 3 weeks she did a sonagram of the kidneys and said their was no shrinkage and they were within normal size? she changed some meds and put him on phoslo and bicitra (neither which are spelled right cause it is so early in the am) she wants blood work drawn in 2 weeks in the mean time she said we could visit the new DaVita center by us if we wanted. He is also seeing a hemotologist who did a complete anemia work up on him and a ct scan the blood work showed no reason for the anemia and the ct scan showed no tumors but the stomach looked thick skinned so just in case they are doing a upper endoscopy the hemotologist also did a bone marrow asp. and started him on injections weekly for the anemia.

      You guys are always great at listening and sharing. Thanks


      JLYSDI

      Annie

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      • #4
        Anemia is a common problem for kidney patients. The kidneys secrete a hormone which is necessary for making red blood cells. The injections the doctor ordered are probably to replace this hormone so your husband can once again make red blood cells. I personally have not had any problems with excessive bleeding after coming off dialysis and don't see that problem often among the other clients at my center. Dialysis IS pretty scary before you start, but once you have a few treatments you see that there was nothing to be scared of, especially not bleeding to death by accident.
        To the stars through difficulty!

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        • #5
          ongoing debate among doctors...

          Patients that tend to bleed after dialysis has an option to use SURE-SEAL bandaids. The debate that goes around using these is 'well, they will start bleeding at home once they remove the bandaids and would rather them bleed at the unit so we can catch it'. Plateletes (thrombocytes) are the stuff in blood that causes it to clot. Red blood cells are made in the bone marrow and an enzyme in the kidneys tell the bone marrow when to make more red blood cells. During dialysis, some red blood cells are destroyed. To counter that, a medication such as ProCrit, EpoGen or anasrep is used to signal the bone marrow to produce more red blood cells. There is a difference between an arterial bleed and tissue seepage. Arterial bleeds gush out where tissue seepage is really slow. What you have to watch for is the arterial bleeding where a large amount of blood can be lost in a short period of time. Patients that are apt to arterial bleeding after dialysis should remain at the unit 30 minutes to an hour after the needles are removed. The option to use the sure-seal bandaids are with the nephrologist. Personally, my arterial bleeding stops within 5 minutes of needle removal but have tissue seepage sometimes when I get home. Thats ok because only slight pressure will remedy tissue seepage where hard pressure is required on arterial bleeding. If you suffer from allot of bleeding after dialysis, ask your nephrologist to check your plateletes. If it is low, the nephrologists can help counter that by lowering the amount of heperin thats given during dialysis. Heperin thins the blood so that clots dont form in the artificial kidney and lines. The nephrologist may also instruct you to cut back on use of aspirin since aspirin irreversibly disrupts platelet function. Any platelets disrupted by use of aspirin may take up to a week to be replaced once the aspirin intake is halted.

          |_arry

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          • #6
            " If you suffer from allot of bleeding after dialysis, ask your nephrologist to check your plateletes. If it is low, the nephrologists can help counter that by lowering the amount of heperin thats given during dialysis. Heperin thins the blood so that clots dont form in the artificial kidney and lines. The nephrologist may also instruct you to cut back on use of aspirin since aspirin irreversibly disrupts platelet function. Any platelets disrupted by use of aspirin may take up to a week to be replaced once the aspirin intake is halted."


            Could you expand on platelets please, since he has started his injections from the hemotologist his platelet count has went way up? Thanks Annie

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            • #7
              Platelets are cells which help blood to clot. If there are too few of them, bleeding can become uncontrolled. If there are too many, clotting may be a problem. Most people who are anemic also have low platelet counts. I am sure your husband's hematologist is keeping a close eye on his platelet count.
              To the stars through difficulty!

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