The Care Conference

One of the things that happens at DCI, and maybe it happens at all clinics, is the Care Conference. This is a brief meeting of the dialysis patient and the social worker, dietician, nurse manager, and in my case, Dr. Frock.

The first meeting happened pretty early on in my dialysis experience. I think it happened within the first month, and then again at six months, and then there was yesterday's conference. There isn't a lot of new ground broken at these meetings, since I see Dr. Frock once a month, and I have regular conversations with the others. It does provide a forum for all the parties to discuss my case at the same time. Since Jeannie only gets her information from me, the conference is a chance for her to hear from everyone directly, which I think is good for understanding.

I had two things I wanted to talk about with the group yesterday. The first item was the length of each dialysis session. Since going to the fistula for my dialysis, I've tacked on an extra 10-15 minutes to the time I'm at the clinic. The extra time is due to waiting for my arm to stop bleeding after the needles are taken out. I usually clot up pretty fast, but by the time someone comes and tapes me down, a nurse listens to me, and I get my blood pressure checked, I'm the last one out the door.

Since I go to work after dialysis, it's important for me to have enough time to get home, eat, and shower before heading in to the office. I've talked with Dr. Frock about cutting 15 minutes off my time, which would at least put me back to the time I had when we were using the catheters. Dr. Frock's answer to this was simply, no. He is not a fan of cutting back on time. He believes his patients should have 12 hours a week of dialysis, and that's it.

So, yesterday I wanted to talk about this with everyone in the room. My blood work is sensational and the number that shows how clean my blood is getting, the KT/V, is also above normal. I thought I had a good case.

Dr. Frock brought it up right away. I told him that I needed at least 15 minutes and maybe even a half hour to be able to get into work to handle my responsibilities there. While I really wanted to sit in the dialysis chair for less time, the bottom line was being able to get out of the clinic at a decent time to allow me to eat, get ready for work, and get to work by noon or so.

To show I was interested in other alternatives, I also mentioned I would be willing to come in earlier, as long as it didn't put stress on the staff and the current on/off schedules of the other patients. It turns out that Janet, the nurse manager, was going to implement an earlier starting time of 5:45 for the first patients. She offered me the 5:45 start for next Tuesday, which should give me an extra 30 minutes. I'd rather have less dialysis time, but 30 minutes is 30 minutes.

My other question was about my Epogen shot, which started up again last Tuesday. I stopped getting the weekly shot because my hemoglobin had gone up to around 12, which is above the range where they issue the shot. Sometime in between the January labs and the follow-up blood draw that happened around the 13th, my hemoglobin dropped, causing the resumption of the Epogen shot.

I learned all of this yesterday. When I needed to hear it was the day I got the shot. Instead, all I heard was that's the way the computer shoots out the instructions, so that's why I got the shot. I don't do well with explanations like that, so I asked Jan, the dietician about it. She showed me how to calculate my hemoglobin, so I would be able to tell from my hematocrit number what was happening.

Janet apologized for that explanation, gave me a more in depth explanation, and we moved on. It wasn't a big deal, but I do like to know why things are happening to me, and blaming a computer for all of that isn't very comforting. I like facts, especially when it comes to my care.

After getting through my two questions, we talked about my transplant status, and then the dietician and social worker added their comments. Everyone was real positive about my outlook and my health. I think they are all rooting for me to get a kidney, so I can get on with my life.

And that's the care conference. Pretty quick, but it's a nice way for us all to sit down and talk about my case.