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Yesterday, Neu’s tests showed a greater drop in kidney function than even I had expected, he’s now at 11% (minimum required before dialysis becomes necessary is around 15%). The doctor was concerned with Neu’s consistently low blood pressure and has taken him off captopril completely. We have to monitor Neu’s BP and report to the doctor by phone or email on Sunday to let him know what the levels have been, in case Neu needs a further adjustment to his medication. So far Neu’s BP has been around 111/70 which the doctor will be pleased with.
On Monday we are going back to Fortaleza to a dialysis clinic, where Neu will be assessed for suitability for peritoneal dialysis. This form of dialysis involves the peritoneal cavity being filled with a solution, into which the bodies toxins transfer through the peritoneal membrane by osmosis (that is one science lesson I remember). Several hours later the fluid is drained out and replaced by fresh solution.
Apart from the time needed to drain and fill the cavity with the solution, the patient is free to get on with their lives. There is an increased risk of infection with this type of dialysis, the catheter site where the fluid enters and leaves the body is a possible route for infection to invade the body, so all possible care will have to be taken to avoid this. The doctor has advised us that we should make one room of our house as dust proof as possible, we will have to replace the shutters at the windows with glass, put a false ceiling under the terracotta tiles, ceramic tiles over the cement floor and washable paint on the walls. I hope we can do it all quite cheaply but it will be worth the expense.
If Neu was to have the alternative hemodialysis he would need to travel into Fortaleza 4 times a week and stay attached to the dialysis machine for 4 hours each time, as the journey time is at least 2 hours each way there wouldn’t be much left of his day or his week for that matter.
We are keeping or fingers crossed that he will be considered suitable for peritoneal dialysis, even with having to do the alterations in the house, it will just be so much better for all of us if he is at home.

©Claire Pattison Valente 2012

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