Revolutionizing Healthcare: A Comprehensive Guide to Setting Up a State-of-the-Art Dialysis Center

Introduction


In the realm of healthcare, the demand for specialized medical facilities continues to rise, and one such critical area is the provision of dialysis services. With an increasing prevalence of kidney-related disorders and the growing aging population, the need for efficient and advanced dialysis centers is more crucial than ever. This article aims to provide a comprehensive guide on setting up a cutting-edge dialysis center that prioritizes patient care, technological innovation, and operational excellence.

Location and Facility Design


Selecting the right location for a dialysis center is a pivotal step in its success. Ideally, the center should be easily accessible to patients and healthcare professionals, ensuring convenience and efficient service delivery. The facility design should prioritize a patient-centric approach, providing a comfortable and calming environment to alleviate the stress often associated with dialysis treatment. Adequate space for treatment stations, waiting areas, and administrative offices should be carefully planned to optimize workflow.

Equipment and Technology Integration


Investing in state-of-the-art dialysis machines and equipment is paramount for ensuring the highest quality of care. Modern dialysis machines offer enhanced efficiency, safety features, and remote monitoring capabilities. Furthermore, incorporating health information technology (HIT) systems can streamline administrative tasks, improve patient data management, and facilitate seamless communication between healthcare professionals.

Staffing and Training


A well-trained and compassionate team is the backbone of any successful dialysis center. Recruit experienced nephrologists, registered nurses, technicians, and administrative staff who understand the unique needs of dialysis patients. Continuous training programs should be implemented to keep the staff updated on the latest advancements in dialysis treatment, infection control measures, and patient care protocols.

Regulatory Compliance and Accreditation


Adhering to regulatory standards and obtaining necessary certifications is crucial for the credibility and success of a dialysis center. Complying with local, state, and federal regulations ensures the safety of patients and staff. Seeking accreditation from reputable healthcare organizations adds an extra layer of validation, assuring patients and referring physicians of the center’s commitment to quality care.

Patient-Centered Care


Fostering a patient-centered approach is essential in creating a positive and supportive environment within the dialysis center. Implementing personalized care plans, offering educational resources, and promoting patient engagement empower individuals to actively participate in their treatment journey. Additionally, incorporating amenities such as Wi-Fi, entertainment options, and comfortable seating can enhance the overall patient experience.

Community Outreach and Education


Building strong community relationships is vital for the success and sustainability of a dialysis center. Establish partnerships with local healthcare providers, community organizations, and patient advocacy groups to promote awareness about kidney health and the services offered by the center. Hosting educational events, participating in health fairs, and providing resources to the community can contribute to a proactive and informed approach to kidney care.

Conclusion


Setting up a dialysis center requires careful planning, a commitment to excellence, and a focus on patient well-being. By integrating cutting-edge technology, prioritizing patient-centered care, and adhering to regulatory standards, a dialysis center can become a beacon of hope for individuals grappling with kidney-related disorders. Ultimately, the success of a dialysis center lies in its ability to provide compassionate and high-quality care that positively impacts the lives of those it serves.

Advin Health Care provides Dialysis Center Setup World Wide


Advin Health Care specialized in the field of Turnkey Dialysis setup. It has completed many Turnkey projects all over the world with an installation base of more than 500 dialysis machines. The company has a dedicated team of Bio-Medical Engineers across the globe for installation and after-sales services. Advin Health Care supplies complete range of dialysis products…

Arab Health 2024 Dubai UAE – Healthcare Exhibition

Arab Health 2024 Dubai UAE


Arab Health is one of the largest and most influential healthcare exhibitions and conferences in the Middle East. Held annually in Dubai, United Arab Emirates, it brings together healthcare professionals, industry leaders, and exhibitors from around the world to showcase the latest advancements in medical technology, healthcare services, and pharmaceuticals. The event serves as a platform for networking, knowledge exchange, and collaboration in the healthcare sector.

Arab Health typically features a wide range of activities, including an extensive exhibition showcasing cutting-edge medical equipment, devices, and innovations, as well as a conference with expert speakers discussing key topics and trends in the healthcare industry. Professionals attending Arab Health have the opportunity to explore new products, learn about emerging technologies, and engage in discussions that contribute to advancements in healthcare practices.

Advin Health Care is a fastest growing medical company having more than 15 years of experience and significant presence over 85+ Countries, headquartered at Ahmedabad, Gujarat, India.

Advin Health Care has become one of the most trusted brands for Medical Equipment, Medical Disposables by understanding and catering to the requirements of surgeons and providing excellent quality of products with significant focus on research and development.

We supply wide range of medical products that includes:

Urology: Specializing in urinary and reproductive health, urologists diagnose and treat conditions like kidney stones and prostate issues, ensuring optimal urological well-being.

  • Urology Products Range: Electrosurgical Equipment, Urology Equipment, TURP Resectoscope Products, Urology Instruments, Urology Disposables.

Laparoscopy: Minimally invasive surgery using small incisions, laparoscopy allows precise diagnosis and treatment of abdominal and pelvic issues, minimizing scarring and expediting recovery.

Gynecology: Focused on female reproductive health, gynecologists provide comprehensive care, addressing issues from reproductive system disorders to prenatal care, ensuring women’s overall well-being.

Nephrology: Nephrologists specialize in kidney health, diagnosing and treating conditions such as kidney disease and hypertension, aiming to optimize renal function and overall well-being.

  • Nephrology Products Range: Dialysis Machine, Dialysis Equipment, Dialysis Concentrates, Dialysis Consumables, Dialysis Disinfectant.

Cardiology: Cardiologists specialize in heart health, diagnosing and treating conditions like heart disease and hypertension, emphasizing preventive care to promote cardiovascular well-being.

Gastrology: Gastrologists focus on digestive system health, diagnosing and treating conditions like acid reflux, inflammatory bowel disease, and liver disorders, enhancing gastrointestinal well-being.

Arab Health 2024 Venue

Dubai World Trade Centre,

Sheikh Zayed Road, Dubai,

United Arab Emirates.

Fix An Appointment Now

 

Let’s Meet at Arab Health 2024

Let’s Meet at World’s Largest Medical Expo, Arab Health

Arab Health 2024 is a premier healthcare exhibition and congress that serves as a key gathering for professionals and stakeholders in the medical and healthcare industry. This annual event provides a platform for showcasing the latest innovations, technologies, and advancements in healthcare, bringing together leading manufacturers, suppliers, and healthcare professionals from around the world.

The Arab Health 2024 conference features a diverse range of topics, including medical equipment, pharmaceuticals, healthcare services, and emerging trends in the field. Attendees can expect to explore a comprehensive range of future ready products, attend informative sessions, and engage in networking opportunities with experts and decision-makers in the healthcare sector.

As a hub for collaboration, knowledge exchange, and business development, Arab Health 2024 plays a vital role in shaping the future of healthcare by fostering dialogue, promoting breakthroughs, and facilitating partnerships that contribute to the improvement of healthcare delivery globally.

Advin Health Care is a fastest growing medical company having more than 15 years of experience and significant presence over 85+ Countries, headquartered at Ahmedabad, Gujarat, India.

Advin Health Care has become one of the most trusted brands for Medical Equipment, Medical Disposables by understanding and catering to the requirements of surgeons and providing excellent quality of products with significant focus on research and development.

We supply wide range of medical products that includes:

Urology: Specializing in urinary and reproductive health, urologists diagnose and treat conditions like kidney stones and prostate issues, ensuring optimal urological well-being.

  • Urology Products Range: Electrosurgical Equipment, Urology Equipment, TURP Resectoscope Products, Urology Instruments, Urology Disposables.

Laparoscopy: Minimally invasive surgery using small incisions, laparoscopy allows precise diagnosis and treatment of abdominal and pelvic issues, minimizing scarring and expediting recovery.

Gynecology: Focused on female reproductive health, gynecologists provide comprehensive care, addressing issues from reproductive system disorders to prenatal care, ensuring women’s overall well-being.

Nephrology: Nephrologists specialize in kidney health, diagnosing and treating conditions such as kidney disease and hypertension, aiming to optimize renal function and overall well-being.

  • Nephrology Products Range: Dialysis Machine, Dialysis Equipment, Dialysis Concentrates, Dialysis Consumables, Dialysis Disinfectant.

Cardiology: Cardiologists specialize in heart health, diagnosing and treating conditions like heart disease and hypertension, emphasizing preventive care to promote cardiovascular well-being.

Gastrology: Gastrologists focus on digestive system health, diagnosing and treating conditions like acid reflux, inflammatory bowel disease, and liver disorders, enhancing gastrointestinal well-being.

Arab Health 2024 Venue

Dubai World Trade Centre,

Sheikh Zayed Road, Dubai,

United Arab Emirates.

Fix An Appointment Now

 

Heart Attack and Sudden Cardiac Arrest Differences

People often use these terms interchangeably, but they’re not the same. A heart attack is when blood flow to the heart is blocked. Sudden cardiac arrest is when the heart malfunctions and suddenly stops beating. A heart attack is a “circulation” problem and sudden cardiac arrest is an “electrical” problem.

What is a heart attack?


A heart attack occurs when a blocked artery prevents oxygen-rich blood from reaching a section of the heart. If the blocked artery is not reopened quickly, the part of the heart normally nourished by that artery begins to die. The longer a person goes without treatment, the greater the damage.

Symptoms of a heart attack may be immediate and intense or start slowly with mild symptoms. It’s important to note that it’s also possible to have mild symptoms or even no symptoms at all and still have a heart attack. Unlike with sudden cardiac arrest, the heart usually doesn’t stop beating during a heart attack. The heart attack symptoms in women can be different than in men.

What is cardiac arrest?


Sudden cardiac arrest occurs suddenly and often without warning. It happens when an electrical malfunction in the heart causes an irregular heartbeat (arrhythmia). With its pumping action disrupted, the heart can’t pump blood to the brain, lungs and other organs. When this occurs, a person loses consciousness and has no pulse. Death occurs within minutes if the victim doesn’t receive treatment.

What’s the link?


These two distinct heart conditions are linked. Sudden cardiac arrest can occur after a heart attack, or during recovery. Heart attacks increase the risk for sudden cardiac arrest. Many heart attacks don’t immediately lead to sudden cardiac arrest, but when sudden cardiac arrest occurs, heart attack is a common cause. Other heart conditions may also disrupt the heart’s rhythm and lead to sudden cardiac arrest. These include a thickened heart muscle (cardiomyopathy), heart failure, arrhythmias, particularly ventricular fibrillation, and long Q-T syndrome.

What to do: Heart Attack


Even if you’re not sure it’s a heart attack, call 911 or your emergency response number. Every minute matters! It’s best to call EMS to get to the emergency room right away. Emergency medical services staff can begin treatment when they arrive — up to an hour sooner than if someone goes to the hospital by car. EMS staff are also trained to provide resuscitation efforts to someone whose heart has stopped. People with chest pain who arrive by ambulance may also receive faster treatment at the hospital.

What to do: Sudden Cardiac Arrest


For adults, check for responsiveness then shout for nearby help. Next, call emergency medical services. Then call for, or get, an automated external defibrillator if one is available and use it as soon as it arrives. Begin high-quality CPR immediately and continue until professional emergency medical services arrive. If two people are available to help, one should begin CPR immediately while the other calls emergency medical services and finds an AED.

In children and infants, airway obstruction is often the cause of cardiac arrest. Calling emergency response should be followed immediately by initiating high-quality CPR. If help is nearby or a cell phone is available, activating the emergency response and starting CPR can be nearly simultaneous. But in the out-of-hospital setting, a single rescuer who doesn’t have access to a cell phone should begin CPR (compressions-airway-breathing) before leaving the infant or child to call for help because respiratory arrest is the most common cause of cardiac arrest and help may not be nearby. If the person has suddenly collapsed, rescuers should use an automated external defibrillator (AED), because early defibrillation can be lifesaving.

Achalasia

Achalasia is a rare disorder that makes it difficult for food and liquid to pass from the swallowing tube connecting your mouth and stomach (esophagus) into your stomach.

Achalasia occurs when nerves in the esophagus become damaged. As a result, the esophagus becomes paralyzed and dilated over time and eventually loses the ability to squeeze food down into the stomach. Food then collects in the esophagus, sometimes fermenting and washing back up into the mouth, which can taste bitter. Some people mistake this for gastroesophageal reflux disease (GERD). However, in achalasia the food is coming from the esophagus, whereas in GERD the material comes from the stomach.

There’s no cure for achalasia. Once the esophagus is paralyzed, the muscle cannot work properly again. But symptoms can usually be managed with endoscopy, minimally invasive therapy or surgery.

Symptoms


Achalasia symptoms generally appear gradually and worsen over time. Signs and symptoms may include:

  • Inability to swallow (dysphagia), which may feel like food or drink is stuck in your throat
  • Regurgitating food or saliva
  • Heartburn
  • Belching
  • Chest pain that comes and goes
  • Coughing at night
  • Pneumonia (from aspiration of food into the lungs)
  • Weight loss
  • Vomiting

Causes


The exact cause of achalasia is poorly understood. Researchers suspect it may be caused by a loss of nerve cells in the esophagus. There are theories about what causes this, but viral infection or autoimmune responses have been suspected. Very rarely, achalasia may be caused by an inherited genetic disorder or infection.

Diagnosis


Achalasia can be overlooked or misdiagnosed because it has symptoms similar to other digestive disorders.

To test for achalasia, your doctor is likely to recommend:

  • Esophageal manometry. This test measures the rhythmic muscle contractions in your esophagus when you swallow, the coordination and force exerted by the esophagus muscles, and how well your lower esophageal sphincter relaxes or opens during a swallow. This test is the most helpful when determining which type of motility problem you might have.
  • X-rays of your upper digestive system (esophagram). X-rays are taken after you drink a chalky liquid that coats and fills the inside lining of your digestive tract. The coating allows your doctor to see a silhouette of your esophagus, stomach and upper intestine. You may also be asked to swallow a barium pill that can help to show a blockage of the esophagus.
  • Upper endoscopy. Your doctor inserts a thin, flexible tube equipped with a light and camera (endoscope) down your throat, to examine the inside of your esophagus and stomach. Endoscopy can be used to define a partial blockage of the esophagus if your symptoms or results of a barium study indicate that possibility. Endoscopy can also be used to collect a sample of tissue (biopsy) to be tested for complications of reflux such as Barrett’s esophagus.

Preventing Chronic Kidney Disease

You are more likely to develop kidney disease if you have

  • diabetes
  • high blood pressure
  • heart disease
  • a family history of kidney failure

What can I do to keep my kidneys healthy?


You can protect your kidneys by preventing or managing health conditions that cause kidney damage, such as diabetes and high blood pressure. The steps described below may help keep your whole body healthy, including your kidneys.

During your next medical visit, you may want to ask your health care provider about your kidney health. Early kidney disease may not have any symptoms, so getting tested may be the only way to know your kidneys are healthy. Your health care provider will help decide how often you should be tested.

See a provider right away if you develop a urinary tract infection (UTI), which can cause kidney damage if left untreated.

Make healthy food choices

Choose foods that are healthy for your heart and your entire body: fresh fruits, fresh or frozen vegetables, whole grains, and low-fat or fat-free dairy products. Eat healthy meals, and cut back on salt and added sugars. Aim for less than 2,300 milligrams of sodium each day. Try to have less than 10 percent of your daily calories come from added sugars.

Tips for making healthy food choices

  • Cook with a mix of spices instead of salt.
  • Choose veggie toppings such as spinach, broccoli, and peppers for your pizza.
  • Try baking or broiling meat, chicken, and fish instead of frying.
  • Serve foods without gravy or added fats.
  • Try to choose foods with little or no added sugar.
  • Gradually work your way down from whole milk to 2 percent milk until you’re drinking and cooking with fat-free (skim) or low-fat milk and milk products.
  • Eat foods made from whole grains—such as whole wheat, brown rice, oats, and whole-grain corn—every day. Use whole-grain bread for toast and sandwiches; substitute brown rice for white rice for home-cooked meals and when dining out.
  • Read food labels. Choose foods low in saturated fats, trans fats, cholesterol, salt (sodium), and added sugars.
  • Slow down at snack time. Eating a bag of low-fat popcorn takes longer than eating a slice of cake. Peel and eat an orange instead of drinking orange juice.
  • Try keeping a written record of what you eat for a week. It can help you see when you tend to overeat or eat foods high in fat or calories.
Make physical activity part of your routine

Be active for 30 minutes or more on most days. If you are not active now, ask your health care provider about the types and amounts of physical activity that are right for you. Add more activity to your life with these tips to help you get active.

Aim for a healthy weight

The NIH Body Weight Planner is an online tool to help you tailor your calorie and physical activity plans to achieve and stay at a healthy weight.

If you are overweight or have obesity, work with your health care provider or dietitian to create a realistic weight-loss plan. View more weight control and physical activity resources to help you get and stay motivated.

Get enough sleep

Aim for 7 to 8 hours of sleep each night. If you have trouble sleeping, take steps to improve your sleep habits.

Stop smoking

If you smoke or use other tobacco products, stop. Ask for help so you don’t have to do it alone.

Limit alcohol intake

Drinking too much alcohol can increase your blood pressure and add extra calories, which can lead to weight gain. If you drink alcohol limit yourself to one drink per day if you are a woman and two drinks per day if you are a man.

Explore stress-reducing activities

Learning how to manage stress, relax, and cope with problems can improve emotional and physical health. Physical activity can help reduce stress, as can mind and body practices such as meditation, yoga, or tai chi.

Manage diabetes, high blood pressure, and heart disease


If you have diabetes, high blood pressure, or heart disease, the best way to protect your kidneys from damage is to

Keep blood glucose numbers close to your goal. Checking your blood glucose, or blood sugar, level is an important way to manage your diabetes. Your health care team may want you to test your blood glucose one or more times a day.

Keep your blood pressure numbers close to your goal. The blood pressure goal for most people with diabetes is below 140/90 mm Hg. Read more about high blood pressure.

Take all your medicines as prescribed. Talk with your health care provider about certain blood pressure medicines, called ACE inhibitors and ARBs, which may protect your kidneys. The names of these medicines end in –pril or –sartan.

Be careful about the daily use of over-the-counter pain medications. Regular use of nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen, can damage your kidneys. Learn more about over-the-counter medicines and your kidneys.

To help prevent heart attacks and stroke, keep your cholesterol levels in the target range. There are two kinds of cholesterol in your blood: LDL and HDL. LDL or “bad” cholesterol can build up and clog your blood vessels, which can cause a heart attack or stroke. HDL or “good” cholesterol helps remove the “bad” cholesterol from your blood vessels. A cholesterol test also may measure another type of blood fat called triglycerides.

Foley Catheters

You may be scheduled for a major surgery, having difficulty emptying your bladder, or experiencing urinary incontinence causing bladder leakage, and your doctor references the use of a Foley catheter. You may start asking yourself questions such as: What is a Foley catheter? Why would I need a Foley catheter? Where would I purchase a Foley catheter? We will discuss exactly what this type of catheter is, why it is used, and some things to expect if you ever need to use one. We will also provide a handy Foley catheter sizes chart for reference when you need to reorder.

What is a Foley Catheter?


Named after Frederic Foley, an American urologist, the Foley catheter design was created to provide continuous drainage of the bladder. A balloon filled with sterile water is incorporated near the tip of the catheter tubing and once inserted through the urethra and inflated, this balloon prevents the catheter from sliding out of the bladder or moving out of place.

The Foley catheter is often referred to as an indwelling catheter. As this term suggests, it is inserted into the bladder and intended to remain there for either a short or prolonged period of time, depending on the circumstance. The main purpose of the Foley catheter is to drain urine from the bladder into a collection device, typically a leg bag or drain bag.

If you are in a hospital, the collection or drainage bag will typically be emptied and changed by a nurse. Sometimes it will be next to the bed or hung on the rail of the bed for easy access. Should you be discharged from the hospital and need to administer insertion and removal of the Foley catheter yourself, a portable leg or drainage bag will be used that easily attaches to the thigh or calf with a device such as the Foley Stabilization Device.

When is a Foley Catheter Needed?


Some scenarios when the use of a Foley catheter might be necessary are:

  1. A major surgical procedure involving anesthesia where the patient will be unaware of the need to urinate.
  2. A patient in recovery that may be too weak or sick to safely make it to the restroom to urinate on their own.
  3. A chronic condition such as urinary incontinence where they are unable to control bladder leakage.
  4. Spinal trauma which may cause bladder dysfunction due to nerve-related damage.

Foley Catheter Sizes


Foley catheters are measured in terms of French units (Fr.) and range in size from 8Fr. to 26Fr. in diameter. Each Fr. unit is equal to 0.33mm (0.013″ or 1/77″) in diameter. Determining the proper French size of the indwelling catheter will depend upon the age of the person the Foley catheter will be inserted into. A child, for instance, will require the use of a smaller Fr. size Foley catheter due to their anatomy being much smaller than that of a grown adult.

It is also common for the Fr. size to increase when a person uses an indwelling catheter often and for extended periods of time. Another reason a larger Fr. size is used is for adequate drainage due to blood clots if there is blood in the patient’s urine. Great precaution should be taken when choosing the proper Foley catheter size, as one that is too large will risk damage to the urethra and cause pain and trauma to the urethral tissue. On the other hand, choosing a Foley catheter that is too small will result in potential leakage and kinking.

Different sizes of the Foley catheters are identified by color-coded ports at the balloon inflation site for easy identification. As previously mentioned, all catheters require a physician’s prescription so the correct size of the Foley catheter that is right for you will be determined by them. This Foley catheter sizes chart shows the corresponding colors and their individual French sizes.

How to Insert a Foley Catheter


Prior to insertion of a Foley catheter, the skin is cleansed with mild soap and water at and around the urethral site of entry to ensure good hygiene. The indwelling catheter is then inserted by gently pushing the catheter insertion tip up through the urethra and guiding it into the bladder. Once the tube is fully in the bladder, the balloon is gradually inflated with a syringe containing sterile saline to the recommended volume marked on the balloon port of the catheter. The indwelling catheter will then remain in place for an extended period of time. The two eyelets at the end of the Foley catheter tube allow urine to flow from the bladder, down the tubing, and into a collection container such as theUrine Drainage System or bag like the Leg Bag, and then emptied as needed.

How to Remove a Foley Catheter


Removal of the Foley catheter is a very quick and simple process that is usually painless. The balloon is deflated using a syringe to retract the saline solution. Once all of the saline is removed, the balloon flattens and the Foley catheter tubing is gently pulled out of the bladder and down the urethra until it is completely out of the body. Typically, this process must be done by a healthcare professional.

How Often is a Foley Catheter Changed?


Indwelling catheters stay inside the body for much longer periods of time than intermittent catheters. 4-week intervals is the typical time period between changeouts, however, each individual’s circumstances and needs determine the length of time that the Foley catheter will need to remain in the body. Hydrophilic and silicone indwelling catheters do not require changeouts as often as plain latex Foley catheters simply because the latex catheters are more prone to encrustation leading to obstruction.

Some common indications that a Foley catheter needs to be changed are:

  1. If there is leakage around the Foley catheter tubing, a changeout would be necessary.
  2. Any time a catheter remains in place for an extended period of time, the risk for infection increases. If you experience a fever, bladder spasms, cloudy urine, or blood in the urine, the Foley catheter should be changed.
  3. The excretion of proteins and calcium from the body promote encrustation formation, causing obstruction and the need to change the Foley catheter more frequently.

It is recommended to observe the sensitive skin in and around urethral entry site of the catheter as well as the urine that is being collected in the drainage bag. Contact your healthcare provider if you experience any of the following symptoms:

  • You notice blood or blood clots in your urine.
  • Your urine looks cloudy and gives off a foul smell.
  • You are running a fever of 101 degrees or higher.
  • You are not urinating  or not as much and experiencing abdominal pains.

Always consult with your physician about any changes to your urine, skin, or if you’re experiencing pain. Preventive measures may be required so the condition does not worsen.

How to Care for Your Foley Catheter?


Indwelling catheters are intended for single-use and disposed of after each period of use. The skin and catheter tubing at the Foley catheter’s entry point should be cleaned with mild soap and water at least twice a day for general personal hygiene purposes and to reduce potential infection. It is also convenient to clean the entire system while in the shower, making sure you rinse well and gently dry. Bathing is not recommended with an indwelling catheter as the risk for infection increases.

Since the tubing will be long enough to travel down the leg and into a drainage bag, it should be securely taped or strapped to the leg or another tube holder of choice, to help it stay securely in place. When the catheter pulls or moves, there is a risk for pain and bladder spasms.

The Foley catheter’s drainage bag should always be placed below the waistline to prevent the backflow of urine returning the bladder. Since the Foley catheter will always be attached to the drainage bag, it is considered a closed system. The catheter drainage bag should remain fully connected to the Foley catheter tubing at all times until a bag changout is needed, typically twice a day; once in the morning to switch to the leg bag and once in the evening to changeover to the night bag.

Each time the catheter drainage bag is changed, the end of the catheter and the connector on the new drainage bag need to be wiped with alcohol prep wipes. The video below may be helpful to show you these steps.

Alzheimer’s Disease

Alzheimer’s disease causes a decline in memory, thinking, learning and organizing skills over time. It’s the most common cause of dementia and usually affects people over the age of 65. There’s no cure for Alzheimer’s, but certain medications and therapies can help manage symptoms temporarily.

What is Alzheimer’s disease?


Alzheimer’s disease (pronounced “alz-HAI-mirs”) is a brain condition that causes a progressive decline in memory, thinking, learning and organizing skills. It eventually affects a person’s ability to carry out basic daily activities. Alzheimer’s disease (AD) is the most common cause of dementia.

The symptoms of Alzheimer’s worsen over time. Researchers believe the disease process may start 10 years or more before the first symptoms appear. AD most commonly affects people over the age of 65.

How common is Alzheimer’s disease?


Alzheimer’s disease is common. It affects approximately 24 million people across the world. One in 10 people older than 65 and nearly a third of people older than 85 have the condition.

What are the stages of Alzheimer’s disease?


Alzheimer’s disease organizations and healthcare providers use various terms to describe the stages of Alzheimer’s disease based on symptoms.

While the terms vary, the stages all follow the same pattern — AD symptoms progressively worsen over time.

No two people experience AD in the same way, though. Each person with Alzheimer’s disease will progress through the stages at different speeds. Not all changes will occur in each person. It can sometimes be difficult for providers to place a person with AD in a specific stage as stages may overlap.

Some organizations and providers frame the stages of Alzheimer’s disease in terms of dementia:

  • Preclinical Alzheimer’s disease.
  • Mild cognitive impairment (MCI) due to Alzheimer’s disease.
  • Mild dementia due to Alzheimer’s disease.
  • Moderate dementia due to Alzheimer’s disease
  • Severe dementia due to Alzheimer’s disease.

Other organizations and providers more broadly explain the stages as:

  • Early.
  • Middle.
  • Late.

Don’t be afraid to ask your healthcare provider or your loved one’s provider what they mean when they use certain words to describe the stages of Alzheimer’s.

What are the signs and symptoms of Alzheimer’s disease?


The signs and symptoms of Alzheimer’s disease (AD) vary based on the stage of the condition. In general, the symptoms of AD involve a gradual decline in some, most or all of the following:

  • Memory.
  • Reasoning and handling of complex tasks.
  • Language.
  • Understanding visual form and space relationship.
  • Behavior and personality.

People with memory loss or other signs of Alzheimer’s may have difficulty recognizing their mental decline. These signs may be more obvious to loved ones. Anyone experiencing dementia-like symptoms should see a healthcare provider as soon as possible.

How is Alzheimer’s disease diagnosed?


Healthcare providers use several methods to determine if a person with memory issues has Alzheimer’s disease. This is because many other conditions, especially neurological conditions, can cause dementia and other symptoms of Alzheimer’s.

In the beginning steps of an Alzheimer’s diagnosis, a provider will ask questions to better understand your health and daily living. Your provider may also ask someone close to you, like a family member or caregiver, for insight into your symptoms.

They’ll ask about:

  • Overall health.
  • Current medications.
  • Medical history.
  • Ability to carry out daily activities.
  • Changes in mood, behavior and personality.

A provider will also:

  • Perform a physical exam and a neurological exam.
  • Perform a mental status exam, which includes tests to assess memory, problem-solving, attention, basic math and language.
  • Order standard medical tests, such as blood and urine tests, to rule out other possible causes of the symptoms.
  • Order brain imaging tests, such as a brain CT, brain MRI or positron emission tomography, to support an Alzheimer’s diagnosis or to rule out other possible conditions.

Hemorrhoids (Piles)

Hemorrhoids (HEM-uh-roids), also called piles, are swollen veins in your anus and lower rectum, similar to varicose veins. Hemorrhoids can develop inside the rectum (internal hemorrhoids) or under the skin around the anus (external hemorrhoids).

Nearly three out of four adults will have hemorrhoids from time to time. Hemorrhoids have a number of causes, but often the cause is unknown.

Fortunately, effective options are available to treat hemorrhoids. Many people get relief with home treatments and lifestyle changes.

What causes hemorrhoids?


Straining puts pressure on veins in your anus or rectum, causing hemorrhoids. You might think of them as varicose veins that affect your bottom.

Any sort of straining that increases pressure on your belly or lower extremities can cause anal and rectal veins to become swollen and inflamed. Hemorrhoids may develop due to:

  • Pelvic pressure from weight gain, especially during pregnancy.
  • Pushing hard to have a bowel movement (poop) because of constipation.
  • Straining to lift heavy objects or weightlifting.

What are the symptoms of hemorrhoids?


Internal hemorrhoids rarely cause pain (and typically can’t be felt) unless they prolapse. Many people with internal hemorrhoids don’t know they have them because they don’t have symptoms.

If you have symptoms of internal hemorrhoids, you might see blood on toilet paper, in your stool or in the toilet bowl. These are signs of rectal bleeding.

Signs of external hemorrhoids include:

  • Itchy anus.
  • Hard lumps near your anus that feel sore or tender.
  • Pain or ache in your anus, especially when you sit.
  • Rectal bleeding.

Prolapsed hemorrhoids can be painful and uncomfortable. You may be able to feel them bulging outside of your anus and gently push them back inside.

How are hemorrhoids diagnosed?


A healthcare provider diagnoses hemorrhoids based on symptoms and a physical exam. You may also have:

  • Digital rectal exam: Your provider inserts a gloved, lubricated finger into your rectum to feel for swollen veins.
  • Anoscopy: Your provider uses an anoscope (lighted tube) to view the lining of your anus and rectum.
  • Sigmoidoscopy: Your provider uses a sigmoidoscope (lighted tube with a camera) to view inside the lower (sigmoid) part of your colon and rectum. Procedure types include flexible sigmoidoscopy and rigid sigmoidoscopy (proctoscopy).

These tests may be uncomfortable but aren’t painful. They typically take place in a doctor’s office or outpatient center without anesthesia. You go home the same day.

Your provider may perform a colonoscopy to confirm findings from other tests or check for signs of colon cancer. This outpatient procedure requires anesthesia.

What are the complications of hemorrhoids?


Hemorrhoids can be uncomfortable and painful, but they don’t tend to cause serious problems. Rarely, people with hemorrhoids develop:

  • Anemia.
  • Blood clots in external hemorrhoids.
  • Infection.
  • Skin tags (flap of tissue that hangs off skin).
  • Strangulated hemorrhoids (muscles in the anus cut off blood flow to a prolapsed internal hemorrhoid).

How can I treat hemorrhoids at home?


Hemorrhoids often go away on their own without treatment. Symptoms like pain and bleeding may last one week or slightly longer. In the meantime, you can take these steps to ease symptoms:

  • Apply over-the-counter medications containing lidocaine, witch hazel or hydrocortisone to the affected area.
  • Drink more water.
  • Increase fiber intake through diet and supplements. Try to obtain at least 20 to 35 grams of daily fiber intake.
  • Soak in a warm bath for 10 to 20 minutes a day.
  • Soften stool by taking laxatives.
  • Take nonsteroidal anti-inflammatory drugs (NSAIDs) for pain and inflammation.
  • Use toilet paper with lotion or flushable wet wipes to gently pat and clean your bottom after pooping. You can also use a tissue or washcloth moistened with water. (Discard wipes in the trash, not by flushing. Launder washcloths separately in hot water to avoid spreading infections often found in poop.)

How do healthcare providers treat hemorrhoids?


You should see your healthcare provider if symptoms get worse or interfere with your daily life or sleep. Also, seek help if signs don’t improve after a week of at-home treatments. Your provider may treat hemorrhoids with:

  • Rubber band ligation: A small rubber band placed around the base of a hemorrhoid cuts off blood supply to the vein.
  • Electrocoagulation: An electric current stops blood flow to a hemorrhoid.
  • Infrared coagulation: A small probe inserted into the rectum transmits heat to get rid of the hemorrhoid.
  • Sclerotherapy: A chemical injected into the swollen vein destroys hemorrhoid tissue.

Surgical treatments include:

  • Hemorrhoidectomy: Surgery removes large external hemorrhoids or prolapsed internal ones.
  • Hemorrhoid stapling: A stapling instrument removes an internal hemorrhoid. Or it pulls a prolapsed internal hemorrhoid back inside of your anus and holds it there.

Peritoneal Dialysis

What is peritoneal dialysis and how does it work?


Peritoneal dialysis is a treatment for kidney failure that uses the lining of your abdomen, or belly, to filter your blood inside your body. Health care providers call this lining the peritoneum.

A few weeks before you start peritoneal dialysis, a surgeon places a soft tube, called a catheter, in your belly.

When you start treatment, dialysis solution—water with salt and other additives—flows from a bag through the catheter into your belly. When the bag is empty, you disconnect it and place a cap on your catheter so you can move around and do your normal activities. While the dialysis solution is inside your belly, it absorbs wastes and extra fluid from your body.

 

After a few hours, the solution and the wastes are drained out of your belly into the empty bag. You can throw away the used solution in a toilet or tub. Then, you start over with a fresh bag of dialysis solution. When the solution is fresh, it absorbs wastes quickly. As time passes, filtering slows. For this reason, you need to repeat the process of emptying the used solution and refilling your belly with fresh solution four to six times every day. This process is called an exchange.

You can do your exchanges during the day, or at night using a machine that pumps the fluid in and out. For the best results, it is important that you perform all of your exchanges as prescribed. Dialysis can help you feel better and live longer, but it is not a cure for kidney failure.

How will I feel when the dialysis solution is inside my belly?

You may feel the same as usual, or you may feel full or bloated. Your belly may enlarge a little. Some people need a larger size of clothing. You shouldn’t feel any pain. Most people look and feel normal despite a belly full of solution.

What are the types of peritoneal dialysis?


You can choose the type of peritoneal dialysis that best fits your life:

  • continuous ambulatory peritoneal dialysis (CAPD)
  • automated peritoneal dialysis

The main differences between the two types of peritoneal dialysis are

  • the schedule of exchanges
  • one uses a machine and the other is done by hand

If one type of peritoneal dialysis doesn’t suit you, talk with your doctor about trying the other type.

CAPD doesn’t use a machine. You do the exchanges during the day by hand.


You can do exchanges by hand in any clean, well-lit place. Each exchange takes about 30 to 40 minutes. During an exchange, you can read, talk, watch television, or sleep. With CAPD, you keep the solution in your belly for 4 to 6 hours or more. The time that the dialysis solution is in your belly is called the dwell time. Usually, you change the solution at least four times a day and sleep with solution in your belly at night. You do not have to wake up at night to do an exchange.

Automated peritoneal dialysis. A machine does the exchanges while you sleep

With automated peritoneal dialysis, a machine called a cycler fills and empties your belly three to five times during the night. In the morning, you begin the day with fresh solution in your belly. You may leave this solution in your belly all day or do one exchange in the middle of the afternoon without the machine. People sometimes call this treatment continuous cycler-assisted peritoneal dialysis or CCPD.

Where can I do peritoneal dialysis?


You can do both CAPD and automated peritoneal dialysis in any clean, private place, including at home, at work, or when travelling.

Before you travel, you can have the manufacturer ship the supplies to where you’re going so they’ll be there when you get there. If you use automated peritoneal dialysis, you’ll have to carry your machine with you or plan to do exchanges by hand while you’re away from home.

How do I prepare for peritoneal dialysis?


Surgery to put in your catheter

Before your first treatment, you will have surgery to place a catheter into your belly. Planning your catheter placement at least 3 weeks before your first exchange can improve treatment success.

Although you can use the catheter for dialysis as soon as it’s in place, the catheter tends to work better when you have 10 to 20 days to heal before starting a full schedule of exchanges.

Your surgeon will make a small cut, often below and a little to the side of your belly button, and then guide the catheter through the slit into your peritoneal cavity. You’ll receive general or local anesthesia NIH external link, and you may need to stay overnight in the hospital. However, most people can go home after the procedure.

You’ll learn to care for the skin around the catheter, called the exit site, as part of your dialysis training.

Dialysis training

After training, most people can perform both types of peritoneal dialysis on their own. You’ll work with a dialysis nurse for 1 to 2 weeks to learn how to do exchanges and avoid infections. Most people bring a family member or friend to training. With a trained friend or family member, you’ll be prepared in case you have a sick day and need help with exchanges.

If you choose automated peritoneal dialysis, you’ll learn how to

  • prepare the cycler
  • connect the bags of dialysis solution
  • place the drain tube

If you choose automated peritoneal dialysis, you also need to learn how to do exchanges by hand in case of a power failure or if you need an exchange during the day in addition to nighttime automated peritoneal dialysis.

How do I perform an exchange?


You’ll need the following supplies:

  • transfer set
  • dialysis solution
  • supplies to keep your exit site clean

If you choose automated peritoneal dialysis you’ll need a cycler.

Your health care team will provide everything you need to begin peritoneal dialysis and help you arrange to have supplies such as dialysis solution and surgical masks delivered to your home, usually once a month. Careful hand washing before and wearing a surgical mask over your nose and mouth while you connect your catheter to the transfer set can help prevent infection.

Use a transfer set to connect your catheter to the dialysis solution


A transfer set is tubing that you use to connect your catheter to the bag of dialysis solution. When you first get your catheter, the section of tube that sticks out from your skin will have a secure cap on the end to prevent infection. A connector under the cap will attach to any type of transfer set.

Between exchanges, you can keep your catheter and transfer set hidden inside your clothing. At the beginning of an exchange, you’ll remove the disposable cap from the transfer set and connect the set to a tube that branches like the letter Y. One branch of the Y-tube connects to the drain bag, while the other connects to the bag of fresh dialysis solution.

Use dialysis solution as prescribed


Dialysis solution comes in 1.5-, 2-, 2.5-, or 3-liter bags. Solutions contain a sugar called dextrose or a compound called icodextrin and minerals to pull the wastes and extra fluid from your blood into your belly. Different solutions have different strengths of dextrose or icodextrin. Your doctor will prescribe a formula that fits your needs.

You’ll need a clean space to store your bags of solution and other supplies.

Doing an exchange by hand


  • After you wash your hands and put on your surgical mask, drain the used dialysis solution from your belly into the drain bag. Near the end of the drain, you may feel a mild tugging sensation that tells you most of the fluid is gone. Close the transfer set.
  • Warm each bag of solution to body temperature before use. You can use an electric blanket, or let the bag sit in a tub of warm water. Most solution bags come in a protective outer wrapper, and you can warm them in a microwave. Don’t microwave a bag of solution after you have removed it from its wrapper.
  • Hang the new bag of solution on a pole and connect it to the tubing.
  • Remove air from the tubes—allow a small amount of fresh, warm solution to flow directly from the new bag of solution into the drain bag.
  • Clamp the tube that goes to the drain bag.
  • Open or reconnect the transfer set, and refill your belly with fresh dialysis solution from the hanging bag.

Using a cycler for automated peritoneal dialysis exchanges


In automated peritoneal dialysis, you use a machine called a cycler to fill and drain your belly. You can program the cycler to give you different amounts of dialysis solution at different times.

Each evening, you set up the machine to do three to five exchanges for you. You connect three to five bags of dialysis solution to tubing that goes into the cycler—one bag of solution for each exchange. The machine may have a special tube to connect the bag for the last exchange of the night.

At the times you set, the cycler

  • releases a clamp and allows used solution to drain out of your belly into the drain line
  • warms the fresh dialysis solution before it enters your body
  • releases a clamp to allow body-temperature solution to flow into your belly

A fluid meter in the cycler measures and records how much solution the cycler removes. Some cyclers compare the amount that was put in with the amount that drains out. This feature lets you and your doctor know if the treatment is removing enough fluid from your body.

Some cyclers allow you to use a long drain line that drains directly into your toilet or bathtub. Others have a disposal container.

What changes will I have to make when I start peritoneal dialysis?


Daily routine

Your schedule will change as you work your dialysis exchanges into your routine. If you do CAPD during the day, you have some control over when you do the exchanges. However, you’ll still need to stop your normal activities and take about 30 minutes to perform an exchange. If you do automated peritoneal dialysis, you’ll have to set up your cycler every night.

Physical activity

You may need to limit some physical activities when your belly is full of dialysis solution. You may still be active and play sports, but you should discuss your activities with your health care team.

Make changes to what you eat and drink

If you’re on peritoneal dialysis, you may need to limit

  • sodium
  • phosphorus
  • calories in your eating plan

You may also need to

  • watch how much liquid you drink and eat. Your dietitian will help you determine how much liquid you need to consume each day.
  • add protein to your diet because peritoneal dialysis removes protein.
  • choose foods with the right amount of potassium.
  • take supplements made for people with kidney failure.

Eating the right foods can help you feel better while you’re on peritoneal dialysis. Talk with your dialysis center’s dietitian to find a meal plan that works for you.

Medicines

Your doctor may make changes to the medicines you take.

Coping

Adjusting to the effects of kidney failure and the time you spend on dialysis can be hard for both you and your family. You may

  • have less energy
  • need to give up some activities and duties at work or at home

A counselor or social worker can answer your questions and help you cope NIH external link.

Take care of your exit site, supplies, and catheter to prevent infections


Your health care team will show you how to keep your catheter clean to prevent infections. Here are some general rules:

  • Store your supplies in a cool, clean, dry place.
  • Inspect each bag of solution for signs of contamination, such as cloudiness, before you use it.
  • Find a clean, dry, well-lit space to perform your exchanges.
  • Wash your hands every time you need to handle your catheter.
  • Clean your skin where your catheter enters your body every day, as instructed by your health care team.
  • Wear a surgical mask when performing exchanges.

What are the possible problems from peritoneal dialysis?


Possible problems from peritoneal dialysis include infection, hernia, and weight gain.

Infection

One of the most serious problems related to peritoneal dialysis is infection. You can get an infection of the skin around your catheter exit site or you can develop peritonitis, an infection in the fluid in your belly. Bacteria can enter your body through your catheter as you connect or disconnect it from the bags.

Seek immediate care if you have signs of infection

Signs of an exit site infection include redness, pus, swelling or bulging, and tenderness or pain at the exit site. Health care professionals treat infections at the exit site with antibiotics.

Peritonitis may cause

  • pain in the abdomen
  • fever
  • nausea or vomiting
  • redness or pain around your catheter
  • unusual color or cloudiness in used dialysis solution
  • the catheter cuff to push out from your body—the cuff is the part of the catheter that holds it in place

Health care professionals treat peritonitis with antibiotics. Antibiotics are added to the dialysis solution that you can usually take at home. Quick treatment may prevent additional problems.

Hernia

A hernia is an area of weakness in your abdominal muscle.

Peritoneal dialysis increases your risk for a hernia for a couple of reasons. First, you have an opening in your muscle for your catheter. Second, the weight of the dialysis solution within your belly puts pressure on your muscle. Hernias can occur near your belly button, near the exit site, or in your groin. If you have a swelling or new lump in your groin or belly, talk with your health care professional.

Weight gain from fluid and dextrose

The longer the dialysis solution remains in your belly, the more dextrose your body will absorb from the dialysis solution. This can cause weight gain over time.

Limit weight gain

With CAPD, you might have a problem with the long overnight dwell time. If your body absorbs too much fluid and dextrose overnight, you may be able to use a cycler to exchange your solution once while you sleep. This extra exchange will shorten your dwell time, keep your body from absorbing too much fluid and dextrose, and filter more wastes and extra fluid from your body.

With automated peritoneal dialysis, you may absorb too much solution during the daytime exchange, which has a long dwell time. You may need an extra exchange in the midafternoon to keep your body from absorbing too much solution and to remove more wastes and extra fluid from your body.

Your dietitian can provide helpful guidance to reduce weight gain.