No dialysis - need suggestions

[HelpingGrandma]

My 86-year old grandmother has approximately 12% kidney function but has chosen to refuse dialysis. Her calves,ankles and feet are so swollen we can't find shoes or socks to fit her. It is mostly the tops of her feet that are so high they won't slide into a shoe. Does anyone know if any shoes for this type of problem?

Also, her heels are beginning to seep and she has developed two ulcers. Has anyone had this happen to a loved one? Without dialysis the doctors won't do much -- but any suggestions on how we as a family can help her during her remaining time would be much appreciated.

[chefnancy]

Re: No dialysis - need suggestions

You might try the "bootie" type slippers. They are quite loose and I think they would accommodate any type of swelling. I don't know what to suggest for shoes to wear outdoors, however. Can't her drs. give her any kind of diuretics to help with the problem? Maybe you would get better results in dealing with a hospice since she has refused dialysis.

[Polykid]

Re: No dialysis - need suggestions

Yeah, I agree with ChefNancy your grandmother should be on water pills to pull the extra fluid off her ankles. You need to speak with her doctor about that it will help immensely.

[shellmarie]

Re: No dialysis - need suggestions

Another thing that I would maybe look into are the slide on house shoes...get them in mens size and too big. What about diabetic socks? Would they work on her?
And definitely contact Hospice because I found out in dealing with my sister's brain cancer, that in some cases, Hospice will help out even if the person isn't in their last days. I respect the fact that you are supportive (or at least appears to be) of her decision. I know it has to be hard! My Dad is in ESRD with 6% kidney function and was doing peritoneal dialysis and did his first hemodialysis today. If he refused dialysis, I can honestly say that I would probably try to talk him into changing his mind. I don't know that I could be supportive, so I admire you for that.
Furosemide (Lasix) is a common water pill. Hydrochlorothiazide is also another water pill, but I'm not sure if they use that in kidney patients or not. Definitely give the doctor a call because even if she isn't going to do dialysis, she has the right to get the right kind of care.

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[MaHubs]

Re: No dialysis - need suggestions

I suggest you try to carefully monitor her diet. Sodium is in almost everything. Do you use any packaged or processed foods? Does she eat any fast foods? Read labels. Cook from scratch if you can. I KNOW how time-consuming it is. But it does pay off. Exercise helps but it sounds like she may not be able to now. My husband was able to wear over-size moccasins when he went through this. There are some foods that are natural diuretics...asparagus is one. Much of the poultry that is sold has been brined. Look up the nutritional density index and learn about which foods have the most nutrition for the calories. Some foods are naturally high in sodium also...shellfish and ocean fish. They live in salt-water, duh!! But so often we forget these simple things because for most of us that is not a critical item. If she is diabetic, you'll have to watch more factors.

Does she understand the benefits of peritoneal dialysis, particularly the nocturnal automatic cycler that does it all while she sleeps?? That was a God-send for us. It's simple to do. Maybe if she saw the machine and talked to other patients who use it, she might reconsider her decision about dialysis.

Ask your doctor or therapist if non-walking exercises would help get the fluids out of her body. This is just a wild guess on my part, I confess.

If she eats out, check the menu online before you go and look at the nutritional analysis so you can help her find foods she likes but that won't cause problems. Ask your dietician to help you with this.