Peritoneal dialysis in your lifestyle

At home finally!

The nurse responsible for the training will come to your home the day you started the treatment to support him. He will offer you advice on:

• Material: How to save it / Where to save it.
• First exchange / cycling connection at home: Positive reinforcement / Will solve last minute doubts.

You will have telephone support 24 hours a day, 365 days a year by specialized staff in nephrology. She is not alone!
 

At home finally!

The nurse responsible for the training will come to your home the day you started the treatment to support him. He will offer you advice on:

• Material: How to save it / Where to save it.
• First exchange / cycling connection at home: Positive reinforcement / Will solve last minute doubts.

You will have telephone support 24 hours a day, 365 days a year by specialized staff in nephrology. She is not alone!
 

Weight control

Weight control

The total amount of fluid you can drink per day will depend on:

• Daily ultrafiltration (UF): It is the amount of extra fluid that is removed from your body by dialysis. You will keep a daily record of the amount of fluid extracted to control the fluid you lose.
• Residual diuresis: With dialysis, the amount of urine you make will decrease. It is important that you monitor the amount of urine. If you decrease, you will need to control your fluid intake more.
• Blood pressure and weight: Blood pressure and weight should be monitored daily, better at the same time. The weight try to always be with the same amount of clothes.
• Presence of edema: Edema is bloating due to excess fluid in your body. It usually accumulates in the ankles, legs and face. Squeezing a little with your finger, your finger sinks and it becomes marked.

In case of any variation of the above parameters, you should inform the DP team. It may be necessary to adjust the dialysis dose and / or control fluid intake.

Body image

Body image

2 liters of peritoneal fluid increases your abdominal perimeter by one size. In addition, part of the peritoneal catheter is outside your body. These two factors can affect your body image and interfere with your personal and / or sexual relationships. Wearing wide clothing will help the catheter to be disguised. In summer, you can also choose swimwear to hide it.

Staying in shape and exercising to strengthen your abdominal muscles can help. The catheter does not have to interfere with intimate relationships.

She must learn to look in front of the mirror with her new catheter and new look. Accepting it will make it easier for you to handle the subject naturally and other people will not care about it.

Emotional state

Emotional state

The onset of dialysis, and the changes it implies in your life, can make you feel a set of totally normal emotions that are part of the process of adapting to those changes. These emotions are part of mourning the loss of health and a "normal" life. You may feel:

• Stress
• Anxiety
• Depression

These emotions, in addition to you, can also be manifested by your loved ones. Talking often, honestly about your feelings with your family members will make you focus on the things that are really important to you.

Stress

Stress is the body's response to changes in situations that people go through. One of the causes of stress are changes:

• Learn the technique.
• Make important decisions that affect your life.
• Modifications in your lifestyle and that of your family.
• Rethinking projects.
• The loss or change of job prospects.

They are all situations that can make you feel overwhelmed. Talk to someone who can understand their situation (other patients, their family, the medical team, ...). It is advisable:

• Sharing your feelings can help you better cope with the illness.
• Defer important decisions for when your thoughts are clearer.
• Do activities that you enjoy.
• Do some type of physical activity.
• Relax listening to music, reading, yoga, meditation.
• Take a brief break or even a vacation.
• Individual or group therapies (coaching).

Anxiety

It is a state of tension, usually accompanied by stress, caused by a situation of threat, conflict or frustration.

Symptoms:

• Physiological: sweating, increased heart rate and blood pressure, increased or decreased appetite, sleep disorders.
• Intellectuals: difficulty concentrating, reduced ability to solve problems, difficulty in short-term memory and learning.
• Emotional: feelings of fear, guilt, shame, sadness.
• Social: insecurity in decision making, bigotry.
• Spiritual: difficulty in giving and receiving affection, loss of interest in things hitherto important, meaninglessness in his life.

Anxiety will be driven by concerns about how the illness will affect your personal relationships, work, economics, quality of life, or the management of your treatment. Think about the things you can do to make yourself feel better, talk to someone who can understand you, learn everything you can about your illness, and take an active part in making decisions. Get out, go for excursions, exercise or relaxation techniques.

Depression

It is normal to feel sad and wanting to cry sometime, but if sadness is transformed into a feeling that accompanies us most of the time, this is depression. It may be due to the difficulties that it represents for you:

• The loss of the previous lifestyle.
• Loss of independence.
• Changes in body appearance.
• Problems with sex or having children.

Sharing your problems and feelings with someone who understands you can make you feel less alone. Sometimes taking antidepressants for a short period of time can help.

Psychological care

Feel free to consult with your doctor or nurse about the possibility of seeking psychological help. Psychological care is designed to guide you and your family members through the changes that start treatment.

Psychological treatment should be personalized and targeted to help you overcome problems that limit your personal and emotional development. It will help you to modify behaviors for better adaptation to your illness.

Emotional health and physical health are strongly linked. Therapy can improve your overall health.

Exercise

Exercise

With peritoneal dialysis most sports and exercises can be performed: walking, biking, tennis, running, dancing. Sports that are not recommended are those that require abdominal strength. Check with your doctor before starting an exercise routine.

Moderate physical exercise is beneficial: Not only will it help you eliminate risk factors that may be linked to your illness, it will also make you feel better.

You can practice swimming, but with some precautions. It is recommended to swim in the sea and in private pools. Elsewhere, such as public pools, rivers and other freshwater sites, water may be contaminated. We recommend using a protective bag, which will prevent the catheter and hole from getting wet. After the bath you should always take care of the catheter.

El limit of physical exertion during exercise, you should put it yourself based on your age and fitness. An easy way to control your effort is to be able to have a conversation while you exercise. You must stop the exercise if you have difficulty breathing, cramps in the legs, irregular heartbeat or chest pain.

Work

Work

Continuing work can be beneficial for you - people who continue to work find it easier to maintain a better lifestyle, feel less depressed, have higher self-esteem and have higher incomes.

Talk to the peritoneal dialysis team before assuming you can no longer return to work. There may be options you may not have considered and they may help you keep your job. Peritoneal dialysis can be adapted to your work (DPA with a cycling machine, exchanges at your workplace, valuation of organizing out-of-hours exchanges, etc.).

You can contact the Social Worker of your Health Center to see if you can apply for the disability card or non-contributory pensions. Some companies are involved in hiring people with some degree of disability. There are also social workers in your hospital who can help.

Travel

Travel

• Short trips: you can bring the necessary material for dialysis yourself.
• Long journeys: you can contact the commercial house to send the necessary equipment to the vacation spot.
• Organized circuit trips: contact the commercial house and they will send the necessary material to the accommodation in each city where you are going to be.
• Abroad: commercial houses work worldwide, just comment with them and they will inform you about the best options.
• Travel by plane: If you have peritoneal dialysis with a cycling machine and you want to travel by plane, there is no problem, please inform the airline that you have a suitcase with the cycling machine and that it is an indispensable material for its treatment.

Sexual activity

Sexual activity

Some kidney patients never have a sexual problem, but they can and do happen. The causes are changes in your physical appearance, medication, fatigue, emotional factors or relationship problems with your partner.

• The most common alteration in the man is the sexual impotence. Discuss this with your doctor, which may be due to anemia, insufficient dialysis, and / or some medications. Viagra is an effective drug, but in a few cases there is no answer.
• The woman is more present decreased sexual desire and / or inability to reach orgasm. Discuss this with your doctor, which may be caused by hormonal disorders, anemia, insufficient dialysis, and / or some medications.

It is important to remember that relationships are more than sex and intimacy can take different forms. Discuss with your partner how your illness affects him / her. Do not assume that your partner is not approaching you because he or she is no longer attractive, you may be afraid to hurt him or her catheter.