Dialysis, school me.
Discussion
Countdown said:
How many siblings does your wife have? Any reason why she (I.e. you) are picking up the tab on your own?
She has three, but one I've not seen for nearly 20 years, the other two are US citizens and not interested in the slightest, too busy buying the latest iPhone etc. citizensm1th said:
your year has been s
te so far mate I hope it picks up
have you spoken to desperate? I believe he has contacts out your way I seem to remember
Desperate? Not sure who that is. Yes, it has been a bit miserable so far this year at times, with various things, and this hasn't helped. te so far mate I hope it picks uphave you spoken to desperate? I believe he has contacts out your way I seem to remember
Hospital told the wife yesterday she gets a 50% discount because the old bag is a senior citizen, so that drops the bill a bit. A ray of sunshine.
BlackVanDyke said:
Could you argue she'd get better medical care with one of the siblings in the USA?
It sounds like it's time for the rest of the family to chip in a bit...
She could, but someone would have to pay the US bills, about $5000 a day at current rates. It sounds like it's time for the rest of the family to chip in a bit...
Plus, the siblings there don't really care, as they were adopted by another aunt many years ago. They were sent away to a better life, rather than be brought up in poverty in the Philippines, and they seem to have forgotten their roots now.....
King Herald said:
BlackVanDyke said:
Could you argue she'd get better medical care with one of the siblings in the USA?
It sounds like it's time for the rest of the family to chip in a bit...
She could, but someone would have to pay the US bills, about $5000 a day at current rates. It sounds like it's time for the rest of the family to chip in a bit...
Plus, the siblings there don't really care, as they were adopted by another aunt many years ago. They were sent away to a better life, rather than be brought up in poverty in the Philippines, and they seem to have forgotten their roots now.....
It really sucks that you've ended up feeling so trapped in this - I suspect the ideal scenario would involve being able to pay for a third party to care for your MIL at least during the day so that you get a) someone else doing the daily essentials, including trying to improve her self-care a bit and b) a bit of space and emotional protection for you all from what sounds like a pretty unpleasant lady. But I appreciate given that you're already going to be stung for the dialysis itself, that that may not be an option. Do day centres/services exist there? Might be worth asking the hospital, even.
King Herald said:
Countdown said:
How many siblings does your wife have? Any reason why she (I.e. you) are picking up the tab on your own?
She has three, but one I've not seen for nearly 20 years, the other two are US citizens and not interested in the slightest, too busy buying the latest iPhone etc. citizensm1th said:
your year has been ste so far mate I hope it picks up
have you spoken to desperate? I believe he has contacts out your way I seem to remember
Desperate? Not sure who that is. Yes, it has been a bit miserable so far this year at times, with various things, and this hasn't helped. te so far mate I hope it picks uphave you spoken to desperate? I believe he has contacts out your way I seem to remember
Hospital told the wife yesterday she gets a 50% discount because the old bag is a senior citizen, so that drops the bill a bit. A ray of sunshine.
BlackVanDyke said:
Ah. Rats.
It really sucks that you've ended up feeling so trapped in this - I suspect the ideal scenario would involve being able to pay for a third party to care for your MIL at least during the day .......
We have a maid comes in four times a week, so she helps out round the house and general cleaning. She only costs £4 a day, so no financial dramas there. It really sucks that you've ended up feeling so trapped in this - I suspect the ideal scenario would involve being able to pay for a third party to care for your MIL at least during the day .......
NeMiSiS said:
I see it playing out like this.
You will pay for a 'few' cycles on the machine, she will feel better and in her infinite wisdom she will not bother going back to finish the treatment.
Yes, you've just repeated the cycle we've been through a dozen times already. She gets real sick, we cure her, she feels good and starts eating cakes and buns again...........You will pay for a 'few' cycles on the machine, she will feel better and in her infinite wisdom she will not bother going back to finish the treatment.
citizensm1th said:
you have email mate
Yes, cheers mate. :thumbsup: Despo's contacts are in Thailand and Malaysia, none in the Philippines. In real money this was looking like a bill of £250 a week, but with the discount, and hopefully some donations from the old bags siblings in the USA, I might not get screwed so badly. All depends how long it drags on for....
NeMiSiS said:
I see it playing out like this.
You will pay for a 'few' cycles on the machine, she will feel better and in her infinite wisdom she will not bother going back to finish the treatment.
You weren't far from the truth mate. She soon lapsed back into her old hard-headed arrogant attitude to the whole thing, sneaking about eating anything she wants to and acting ignorant about it if she is found out. Major argument last week between her and the wife over eating platefuls of rice for a meal several times a day, when she KNOWS damn well it is killing her. You will pay for a 'few' cycles on the machine, she will feel better and in her infinite wisdom she will not bother going back to finish the treatment.
"But I like rice" was her answer when she was asked why the hell she did not eat fruit, veggies or any of the other things she KNOWS she should be on. I then caught her ladling sugar into her coffee because "It is tasteless without it"!
I've withdrawn my financial support now, as I threatened to the previous time this sort of argument went down. She's had no dialysis for a week now, had the catheter removed.
The old biotch even had the gall to tell the doctor we don't want to pay for her any more, not that we've stopped paying because she is such an arrogant vindictive old hag!
I guess the end will come soon, though I wanted her to go back to her village and not clutter my home up with the detritus of her life, but she begged to be able to stay here until the guy with the big scythe comes for her.
Awww, bugger.
Suggestion: make it official with the doctors. Take her back to an appointment at least once more, say that you feel that active treatment can no longer have any benefit as she is so totally noncompliant with all areas of the regime, and that you would like to discuss palliative care for her.
That way: a) the doctor may be able to offer help with controlling symptoms as she dies, b) it's all down on paper properly as a considered decision and can't be dressed up as her medical needs being neglected and c) you get the (disputable) peace of knowing that you really have done EVERYTHING available to help her.
It's a crying shame there isn't a diabetes unit that'd agree to admit her for a while...
My inclination would be to press on with the dialysis for as long as she'll consent to it, regardless of what other games she plays - she can't survive for long when she cares for herself so very badly, but at least it takes any decision of yours out of the equation.
Suggestion: make it official with the doctors. Take her back to an appointment at least once more, say that you feel that active treatment can no longer have any benefit as she is so totally noncompliant with all areas of the regime, and that you would like to discuss palliative care for her.
That way: a) the doctor may be able to offer help with controlling symptoms as she dies, b) it's all down on paper properly as a considered decision and can't be dressed up as her medical needs being neglected and c) you get the (disputable) peace of knowing that you really have done EVERYTHING available to help her.
It's a crying shame there isn't a diabetes unit that'd agree to admit her for a while...
My inclination would be to press on with the dialysis for as long as she'll consent to it, regardless of what other games she plays - she can't survive for long when she cares for herself so very badly, but at least it takes any decision of yours out of the equation.
To be honest, I simply don't care about how she feels, or suffers. I've put up with it for years. She has been such a contrary and vindictive hag, for years, that all her family have basically disowned her, nobody wants to help her, nobody visits her etc. Even the doctor in the UK, when we lived there, told he he can do no more for her if she won't even try to help herself.
I'm sick of the almost daily arguments between her and my wife because she has 'broken the rules', or gets all stty because she has been found out doing so. If you try to talk to her she just gets arrogant and obnoxious. I simply refuse to pour more of my own hard earned into her. None of her own family want to help now, and they all agree with what I'm doing.
In the Philippines you pay for everything, there is no NHS, no charity, no free health care. And I have paid out tens of thousands of pounds over the last 19 years I've been with my wife, and thus her mum.
I'm sick of the almost daily arguments between her and my wife because she has 'broken the rules', or gets all s
tty because she has been found out doing so. If you try to talk to her she just gets arrogant and obnoxious. I simply refuse to pour more of my own hard earned into her. None of her own family want to help now, and they all agree with what I'm doing. In the Philippines you pay for everything, there is no NHS, no charity, no free health care. And I have paid out tens of thousands of pounds over the last 19 years I've been with my wife, and thus her mum.
My father is on dialysis, and there is another way to look at it.
He was on 3 treatments a week, and suffers badly each time with at least a full 24-36 of recovery to feel any better, and was on multiple medications to deal with other issues. He also had a very compromised diet to try and help with other heart and bowel issues. The renal consultant recommended going down to 2 days weekly and cutting out many of the non-vital medications, and broadening his diet to things he enjoyed to give him a better quality of life, though possibly shorter.
Maybe this is the way forward with your mother in law, stop or reduce treatments and medications, let her eat what she likes and maybe she'll be happier hence less of a burden.
He was on 3 treatments a week, and suffers badly each time with at least a full 24-36 of recovery to feel any better, and was on multiple medications to deal with other issues. He also had a very compromised diet to try and help with other heart and bowel issues. The renal consultant recommended going down to 2 days weekly and cutting out many of the non-vital medications, and broadening his diet to things he enjoyed to give him a better quality of life, though possibly shorter.
Maybe this is the way forward with your mother in law, stop or reduce treatments and medications, let her eat what she likes and maybe she'll be happier hence less of a burden.
chevy-stu said:
Maybe this is the way forward with your mother in law, stop or reduce treatments and medications, let her eat what she likes and maybe she'll be happier hence less of a burden.
It has all stopped now, I care not any more. She can eat and drink what she likes now. I just hope when she goes it is not long and messy.King Herald said:
No dialysis for the last ten days or more, and she is still plodding along same as ever. I assumed she would be in serious trouble by now????
I've left home to work offshore for a month today, so I wonder if I'll ever see her again?
Is she urinating at all? Hallucinating? Loss of appetite?I've left home to work offshore for a month today, so I wonder if I'll ever see her again?
i reckon 4-6 weeks will be the ball park but some people have made it out to a year, that is unlikely for her with her lifestyle.
Silent1 said:
Is she urinating at all? Hallucinating? Loss of appetite?
i reckon 4-6 weeks will be the ball park but some people have made it out to a year, that is unlikely for her with her lifestyle.
I don't pay any attention to her at all now. She still eats anything she can get her hands on, even though she knows the 'rules'. I feel bad for my wife, being home alone with her, but I hope it is all over when I get back there next. i reckon 4-6 weeks will be the ball park but some people have made it out to a year, that is unlikely for her with her lifestyle.
I assume there will be a funeral, which someone will have to pay for.........
King Herald said:
She is diabetic and has several other ailments, a swollen heart too, whatever the technical term, I forget now.
Heya. Just seen your post.If she has a 'swollen heart' as you say, it's called 'cardiomyopic hypertrophy.' This is usually due to poor lifestyle choices, like drinking, smoking, eating poor-quality foods, and a lack of exercise.
These things eventually lead to hypertension, or 'high blood pressure' from the damage to the circulatory arteries. After many years of abuse, the arteries harden and 'fur up' - which due to the loss of flexibility, means that each beat of the heart has to progressively overcome a higher pressure in the system. The heart, like other muscles in the body, then tries to compensate by becoming thicker, and enlarging itself, in an attempt to push the blood through an ever-decreasing width of arteries.
Trouble is, the thickening basically reduces the size of the pumping chambers inside the heart - resulting in less efficiency, and the road to eventual heart failure.
If someone has cardiomyopic hypertrophy - and then goes on to ignore the advice of clinicians about a change of lifestyle - then they basically deserve what's coming to them, in my opinion.
Now, to address the other Medical Complaint - Diabetes. Diabetes is a HORRENDOUSLY horrible condition. There are two types - Type 1 is a recessive genetic condition, that is inherited from your parents, genetically. It means that your Pancreas does not ever produce insulin to make your body's cells take up glucose from the blood for energy - hence you have to usually inject insulin yourself, for the rest of your life. It's unlucky, but you're stuck with it and there's nothing you can do about it.
But...type 2 Diabetes is usually self-inflicted, and caused by the poor lifestyle choices above. It IS reversible in most cases, if people make a fairly drastic change to their diet and exercise regime. However, it shocks me that many people diagnosed with type 2 do not bother to make much of a change, despite good advice, and put up with the symptoms and risk a mega amount of damage to their body - from blindness to losing limbs!!!
With regard to Kidney failure...some people are just unlucky and suffer bilateral Kidney failure from genetic conditions. As you've experienced, they then usually have to go onto dialysis, and depending upon their age and prognosis - may go onto the Kidney transplant register.
Others are the agents of their own Kidney's demise - again, through abuse and bad lifestyle choices. It is again shocking how many people will continue to stay with their original choices even after a diagnosis of Kidney Failure - and just keep on abusing themselves and their damaged organs, relying on dialysis to keep them alive.
Dialysis really is a last resort for life support for people with renal failure - but because it is pretty normal and widespread, and supported by hospitals and clinics - people often fail to recognise, understand and accept the real and present danger to the support of their own life. It amazes me how flippantly and readily people just treat going to a clinic several times a week for dialysis - almost like it's a 'normal' thing to do for them, with no regard as to how they might have facilitated and caused their Kidney failure in the first place!
Going onto your question of dialysis - as you say, the NHS in England provides a free at the point of use treatment - but you're finding private hospitals charging a fair margin for it?
It's a simple procedure in theory, but there are costs and observations that need to be observed.
Mechanical dialysis relies on the theory of osmotic diffusion. By that I mean, the renal products pumped through the machine are subject to an osmotic concentration gradient through a semi-permiable membrane in the machine, in order to diffuse waste products from the fluid before it is returned to the body. Therefore there is a 'parts' cost for the machine of a membrane layer that is manufactured to very fine tolerances and filtration levels - plus a 'sacrificial' fluid that is pumped round inside the machine which draws the body's waste products towards it - and that is then disposed of at the end of the session.
Couple this with the cost of the equipment and the skill / training level of the clinician who connects the patient to the machine - and I reckon that the cost you describe is actually pretty good - with all things medical considered.
Anyway, hope this information helps! Always worth a Google round to help you to learn - but be selective in your reading, there's a lot of bull on the net. Try a Google search about dialysis on 'Google Scholar' to get some decent, evidence based practice reports by peer-reviewed clinicians on all things medical.
And - best of luck!
Ray Luxury-Yacht said:
Heya. Just seen your post.
If she has a 'swollen heart' as you say, it's called 'cardiomyopic hypertrophy.' This is usually due to poor lifestyle choices, like drinking, smoking, eating poor-quality foods, and a lack of exercise.
If she has a 'swollen heart' as you say, it's called 'cardiomyopic hypertrophy.' This is usually due to poor lifestyle choices, like drinking, smoking, eating poor-quality foods, and a lack of exercise.
She has, I believe, something called 'ischemia'.
Ray Luxury-Yacht said:
But...type 2 Diabetes is usually self-inflicted, and caused by the poor lifestyle choices above. It IS reversible in most cases, if people make a fairly drastic change to their diet and exercise regime. However, it shocks me that many people diagnosed with type 2 do not bother to make much of a change, despite good advice, and put up with the symptoms and risk a mega amount of damage to their body - from blindness to losing limbs!!!....
....Others are the agents of their own Kidney's demise - again, through abuse and bad lifestyle choices. It is again shocking how many people will continue to stay with their original choices even after a diagnosis of Kidney Failure - and just keep on abusing themselves and their damaged organs, relying on dialysis to keep them alive.
Yes, yes, and yes, she is responsible for basically everything that has happened to her. She has plenty of relatives in the Philippines, and around the world, and every one says she has been so incredibly lucky to have me looking after her, yet she STILL refuses to do anything to help herself.....Others are the agents of their own Kidney's demise - again, through abuse and bad lifestyle choices. It is again shocking how many people will continue to stay with their original choices even after a diagnosis of Kidney Failure - and just keep on abusing themselves and their damaged organs, relying on dialysis to keep them alive.
So, dialysis stopped two weeks ago, I have withdrawn all funding, she is still plodding along, still eating stuff she shouldn't do whenever she gets chance. I'm guessing that by the time I get back there in a month or so it will all be over.
I feel sorry for my wife, having to deal with this while I'm away working, but I feel nothing for the old bag herself.
King Herald said:
Ray Luxury-Yacht said:
Heya. Just seen your post.
If she has a 'swollen heart' as you say, it's called 'cardiomyopic hypertrophy.' This is usually due to poor lifestyle choices, like drinking, smoking, eating poor-quality foods, and a lack of exercise.
If she has a 'swollen heart' as you say, it's called 'cardiomyopic hypertrophy.' This is usually due to poor lifestyle choices, like drinking, smoking, eating poor-quality foods, and a lack of exercise.
She has, I believe, something called 'ischemia'.
Ray Luxury-Yacht said:
But...type 2 Diabetes is usually self-inflicted, and caused by the poor lifestyle choices above. It IS reversible in most cases, if people make a fairly drastic change to their diet and exercise regime. However, it shocks me that many people diagnosed with type 2 do not bother to make much of a change, despite good advice, and put up with the symptoms and risk a mega amount of damage to their body - from blindness to losing limbs!!!....
....Others are the agents of their own Kidney's demise - again, through abuse and bad lifestyle choices. It is again shocking how many people will continue to stay with their original choices even after a diagnosis of Kidney Failure - and just keep on abusing themselves and their damaged organs, relying on dialysis to keep them alive.
Yes, yes, and yes, she is responsible for basically everything that has happened to her. She has plenty of relatives in the Philippines, and around the world, and every one says she has been so incredibly lucky to have me looking after her, yet she STILL refuses to do anything to help herself.....Others are the agents of their own Kidney's demise - again, through abuse and bad lifestyle choices. It is again shocking how many people will continue to stay with their original choices even after a diagnosis of Kidney Failure - and just keep on abusing themselves and their damaged organs, relying on dialysis to keep them alive.
So, dialysis stopped two weeks ago, I have withdrawn all funding, she is still plodding along, still eating stuff she shouldn't do whenever she gets chance. I'm guessing that by the time I get back there in a month or so it will all be over.
I feel sorry for my wife, having to deal with this while I'm away working, but I feel nothing for the old bag herself.
This is caused by the poor lifestyle choices I've already discussed. Often, people with ischemia then sometimes go on to develop an 'infarction' - this is when a clot or damaged arterial wall, in one or more of the coronary arteries, suddenly blocks the flow altogether. In medical terms we call this a 'myocardial infarction' - a blockage in one of the coronary arteries located in the musculature (myocardium) of the middle part of the heart's cardiac muscle cells - but basically you will know it as a 'heart attack.' This is obviously bad news as you probably know - it causes a dangerous cardiac arrhythmia at best, and a cardiac arrest at worst.
Any cardiac ischemia is a serious condition, and should be treated as such. Certainly, alongside medication to help the condition, some drastic lifestyle changes should be made, in order to avoid (and I will stick my neck out here and say an 'inevitable') heart attack. If a patient does not help themselves, then a heart attack is looming.
You might want to point out to her, that despite what she might see on the telly, on Holby City and other silly rubbish like that - that when a patient has a heart attack and DOES go into cardiac arrest - i.e. the heart actually stops beating - that it's not just a case of doing some CPR and using a Defibrillator to shock the heart back into working. This generally only works with a degree of success on younger patients with a pre-existing genetic heart condition like a disruption in their heart's electrical system.
For people who arrest with an infarction who have poor existing heart health - well, about 5% or less survive, even with Emergency Ambulance Intervention. Even then, many go on to die in the hospital anyway. Let's put it this way - so far, since I have been out on the road, me and my crew have never had a patient survive as of yet - despite us using ALL the advanced life-support methods and drugs we carry on our ambulance.
The cardiomyopic hypertrophy that I talked about in my last post, is often a result of ischemia and poor circulatory health like she has. It's yet another horrendously bad prognosis to live with in conjunction with ischemia. As I said, it is enlarged cardiac muscle tissue, which causes a decrease in the heart's pumping efficiency.
Other things she might want to worry about before her inevitable fatal heart attack: There is a very real possibility that, in conjunction with her diabetes, she might soon start suffering a build-up of fluid (or oedema) in her lower legs (if she hasn't already) which can start to block and stop the circulation in them. In time, I have seen plenty of cases where the feet and lower legs start to die from poor circulation (this is called tissue necrosis) which can lead to infection, gangrene and eventually amputation. Same often goes for the fingers.
Heart failure and circulating embolisms (clots), which she is also going to be prone to, also often end up in the lungs. This can then cause something called a pulmonary embolism - which at worst can lead to respiritory arrest (i.e. she will stop breathing) or at best, such severe shortness of breath that she will start to struggle to breathe in a way that feels like someone has their hands around her neck and are suffocating her.
Trust me, in the cases I have attended where people have chronic lung disorders like this, causing severe shortness of breath - it is horrendously distressing and very unpleasant to witness, even for us. It must be unbelievably horrible for the patient, and any family watching. They are literally fighting, with every single thoracic muscle, for every tiny bit of air they can try and breathe in. They are wheezing, sometimes thrashing around, clutching their chest, and often going blue all over. They are panic-stricken. I had one look at me the other day, with massive, wide-eyes - and in between each difficult breath, ask me "am I going to die?"
(As an aside - we kept him alive on our watch and into the Ambulance with a lot of drugs and a lot of oxygen, but no idea what happened to him once he was in A&E...morbidly, and looking at him and his vital signs - I have £50 that said he didn't make it...)
ALL of these problems I have discussed so far, are massively exacerbated by badly managed diabetes. In my medical experience so far, if I was suddenly presented with a choice of diseases that I HAD to suffer from - I would strike diabetes off the list first time, every time. Yeah, it might not be as immediate and suddenly mortal as some diseases, or as painful and debilitating as others. But what I CAN tell you is - is that it is creeping, insidious, nasty, slowly debilitating over a looong time, and something that can take parts of your life, mobility and senses away from you, bit by bit, over many many years. I've heard long-time diabetes sufferers, with chronic symptoms like blindness and amputations, say that they wish they'd had a heart attack or cancer - that way they wouldn't have suffered for so long.
Anyway, why did I write this long reply? Well, I guess I hope that you might cut it, and paste it into an email, and send it to her. I know you've sort of washed your hands of her and all that - but maybe I've given you one last little bit of info that may make a difference?
I thought that if you emailed it to her, and explained that it was a random bit of help from an anonymous internet Ambulance Service bloke - that she might realise the seriousness of her health situation, if someone on the internet was prepared to take the time out to explain and help?
I would like to attend one less patient who is on the verge of death from these problems, you see!
Hope it helps anyway.
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