Frequently Asked Questions
We understand you may have many questions so we have shared some of our frequently asked questions. Let us know if you cannot find your answer or would like us to expand on an explanation.
We understand you may have many questions so we have shared some of our frequently asked questions. Let us know if you cannot find your answer or would like us to expand on an explanation.
There may be times when visitors will not be permitted in our facilities due to safety concerns. This is a precaution to prevent any possibility of exposure to blood, and for the general safety of our patients and staff. If visitors are allowed, they will only be permitted to enter the treatment floor after all patients have started their dialysis treatment. Because of space restrictions, the number of visitors should be limited to one. Young children under the age of thirteen are discouraged from visiting except as an educational event. We do reserve the right to ask any visitor to leave our facilities at any time for any reason. Any changes to our visitor policy will be communicated to you by your healthcare team.
Most in-center hemodialysis patients are scheduled three days a week for three to four hours. Your dialysis prescription is unique to your needs. It is very important that you receive your full dialysis treatments as your doctor has prescribed. Coming for every treatment and staying for the full time is important to getting “adequate” dialysis. You may not think cutting treatment by 30 minutes or missing a treatment once a week makes a difference, but over time every minute adds up. Missing or shortening treatments can cause fluid overload, which can cause shortness of breath and possible hospitalization. You may experience severe cramping and low blood pressure at the next treatment because extra fluid will need to be removed. Anemia and bone disease can worsen if you miss injected medications. High potassium can cause heart problems, including irregular heartbeat, heart attack, and/or death. High blood pressure can cause a stroke which can lead to permanent disability and/or death.
You will be weighed each time you come. This is important information because it is used to help determine the amount of dialysis that you need. It is important that you thoroughly wash your dialysis site prior to the beginning of your treatment. Your nurse will show you how to prepare your site and how long you should scrub. This is done to help prevent infection.
Generally, it is best to try and make it through your entire treatment without having to go to the restroom. However we understand emergencies happen. If you need to use the restroom during treatment it is important you maintain your personal dignity and safety.
To do this staff must make sure your vital signs are stable before you get up. Blood will be returned to you before you can be assisted to the bathroom, which takes some time. If your treatment time is interrupted, the risk of clotting in the dialyzer may be increased and it will delay your off time. You will need to be re-cannulated or central venous catheter re-accessed.
To avoid the need to use the restroom during dialysis, please do not use laxatives before coming to dialysis. Also, avoid eating large meals before dialysis as this may cause your bowels to move. Low blood pressure may start the urge for your bowels to move as well.
Each Lincoln facility is open six days a week, Monday through Saturday. Dialysis Center of Lincoln (O Street) has three shifts of dialysis on Monday, Wednesday, and Friday, as well as two shifts on Tuesday, Thursday, and Saturday. Dialysis Center of Lincoln Southwest has two shifts on Monday, Wednesday, and Friday, as well as two shifts on Tuesday, Thursday, and Saturday. Dialysis Center of Lincoln Northwest has three shifts of dialysis on Monday, Wednesday, and Friday, as well as two shifts on Tuesday, Thursday, and Saturday.
Outside food and beverages are generally not allowed during dialysis. If you have any questions or concerns about this, please contact your unit dietitian and nurse manager. The Dietitian can help you develop a meal plan around dialysis to meet your needs.
Smoking is not permitted anywhere within the Dialysis Center of Lincoln and is strongly discouraged for all patients. Smoking has been found to cause heart and lung disease. It is important for you to reduce any unnecessary strain on your heart.
The admissions coordinator can answer specific time and shift questions. Treatment times may be assigned according to shift availability, transportation needs and distance traveled. Personal preference is accommodated if at all possible. After your time has been set up, it is important that you be on time for your treatment. If you arrive prior to your scheduled time, it is important that you remain in the waiting room until your appointment time.
Dialysis is generally paid for by Medicare and/or other insurance. All Plans vary so your insurance coverage will depend on your plan. It is important to bring your insurance cards the first day you come for dialysis so your coverage can be determined as soon as possible. If there are any changes in your coverage this information needs to be given to the billing department within 30 days of the change.
Patients react to dialysis differently. Some may accept it right away and others may take more time to adjust. Both responses are normal. Starting dialysis can be similar to a grief process. Instead of grieving a loved one, you are grieving the way of life you had before starting dialysis. You may experience a variety of feelings, including denial, acceptance, depression, anger, fear, guilt, confusion, and anxiety. You or your loved ones may notice a change in your behavior. You may feel irritable, moody, confused, depressed, easily tired, edgy, or angry. You may notice memory loss, sleep problems, and a decreased energy level. Mood swings are normal and can be caused by the buildup of waste products in your blood (which are removed by dialysis), medications, or stress. This is usually temporary.
It can take time to successfully adjust to dialysis. Some signs of successful adjustment include feeling a sense of routine in your dialysis care, knowledge wins over anxiety, the passage of time, you and your family feel more settled, and you experience a sense of calmness. If you feel you are struggling with your adjustment to dialysis, speak with your social worker. Renal social workers have the training to help patients adjust to dialysis. Education, professional help, communication, attitude, a sense of humor, and maintaining activity can your adjustment to dialysis go more smoothly.
You will be assigned a time for your dialysis. You will want to arrive 10-15 minutes before your scheduled time. The nurse will come to get you from the waiting room when your station is ready for you.
Many patients drive themselves to dialysis without any problems. When you are first starting dialysis, you may experience side effects that make it difficult or inadvisable for you to drive. These side effects may go away with time. Nursing staff will not allow you to drive if you have any medical concerns upon leaving treatment. It is suggested that you have backup transportation in the event you cannot drive or until you know the effects of your dialysis.
If you are told you may be able to stop dialysis, you are considered to be an “acute” patient. This means that your kidneys are believed to have temporarily failed. This can be caused by a variety of health issues, including illness, effects of medication, dehydration, or other medical conditions. Sometimes the kidneys fail for unknown reasons. Individuals with Chronic Kidney Disease Stages 1 through 3 may experience the temporary need for dialysis before being declared End Stage Renal Disease. You will have blood testing twice a month and your nephrologist will carefully monitor your kidney function. Additional lab tests may be ordered. If your labs show improvement, your dialysis schedule may be lessened to see how you react. Your nephrologist will determine if and when your kidneys regain function and if you are able to stop dialysis. You may need to continue seeing an outpatient nephrologist following dialysis.
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Individual televisions are available to patients while on dialysis. Patients are welcome to bring books or activities that can be done while on dialysis. Wireless internet is available in the treatment room if you have a laptop and want to use it during dialysis. The waiting room is also equipped with a television for family members and friends (circumstances permitting).
Although it is unlikely you will have to miss any dialysis during fall and winter, it is good to think about it and plan for the possibility. Each year the nurses will provide you with information regarding basic items that are helpful to keep together for an emergency as well as medication to have on hand if it is necessary to delay dialysis for a short time.
Many dialysis patients are chilled while on dialysis so it may be helpful if you bring a pillow and blanket for your use.
Adequate parking is available at each dialysis center. There are designated handicapped parking spots for vehicles with handicap permits. Some of the dialysis units have drop off and pickup areas. Although primarily used by Handivan buses and ambulances they may be used for patient drop off from other vehicles as well. However, five minute parking limit must be followed to allow traffic to continue moving.
You will be seen by a kidney doctor assigned to your shift once a month. A nurse practitioner will also be seeing you several times through the month. You will be constantly monitored during dialysis by the nursing staff and if problems arise they will contact the kidney doctor. A kidney doctor reviews all of your lab results, medication, and dialysis orders each month so that you will have the best results from your dialysis.
You will be encouraged to be directly involved in your dialysis treatment. You will be taught to perform some of the tasks of dialysis, such as taking your temperature, weighing yourself, and preparing your access site before and after each treatment. Dialysis staff will be available to explain all aspects of your treatment so you will know how you are doing. Annually, you will be part of developing your care plan. At that time you will be invited to meet with the physician and other clinical staff to discuss your care. You will also be able to take part in the monthly care conferences if you have issues to be discussed.