A simple gesture

At the mamak yesterday evening. A scraggy woman was asking the waiter about the price of each item.

After digging out the coins from her pocket, she started to count them. The waiter told her it was only enough for a curry puff but she wanted more. They haggled.

“Bagi apa dia mau. Saya bayar,” a patron who was nearby interjected.

The waiter asked her what she wanted and then said, “Dia mau nasi putih, nasi ayam dan…”

“Ok,” the patron nodded. His companion asked for the bill to be included in theirs.

The waiter acknowledged and went to pack the food. The woman gave a weak bow and clasped her hand in appreciation.

When the waiter came back with the food, she again bowed and left.

No words were exchanged, but what a sight it was.

A simple gesture that added a few extra ringgits in the bill wouldn’t put a dent in the patron’s wallet but it was a situation between the woman who will hardly be full with just one curry puff for dinner or retiring for the night without hunger pangs.

Double dose of peritoneal dialysis

My usual 10-hour peritoneal dialysis ended at 8.30am just now. I’m hooked up to the cycler again for another 10-hour session (to end at 10.00pm tonight) in preparation for the Peritoneal Equilibration Test (PET) tomorrow.

This test checks whether wastes from my blood stream are absorbed quickly or slowly by the dialysis fluid. By the end of this session, 10 liters of dialysis fluid would have gone into and out of my peritoneal cavity, pulling with it another few hundred millilitres of water and wastes from my body.

Hopefully I will not get too dehydrate after this. Dehydration will cause hypotension. And I get light lightheaded once in a while nowadays afyer dialysis, what more I’m doing two sessions back to back.

One hour after the session on the cycler ends, I will be fill another 2 liters of fluid manually and allowed to dwell until tomorrow morning.

When dialysis is working too well

The ultrafiltration of 1166ml is the highest amount of water drawn from my body using two 1.5% peritoneal dialysis solution.

The uf (ultrafiltration) for this morning was 1166ml. That is the amount of water pulled out from my body at the end of peritoneal dialysis.

Apart from losing the ability to filter waste from my blood, my kidneys are no longer able to draw out water as well.

Water retention will manifest in swelling of the feet and ankles. In severe cases, other parts of the body will swell too.

It can accumulate in the lungs causing shortness of breath. Excess water can also cause an increase in blood pressure.

In peritoneal dialysis, 2000ml of solution consisting of dextrose and other electrolytes are filled into the peritoneal cavity. It then dwells in the cavity for 1 hour 34 minutes where waste and water are pulled out from my body through osmosis.

The solution is then drained and fresh solution is filled in. This process is repeated five times within a period of 10 hours. At the end of the entire process, 10 liters of solution would have been used.

Any extra in the solution is water taken out from my body. The usual amount ranges between 600ml to 900ml.

This morning’s was the highest using two bags of 1.5% solution since I started dialysis in August 2018. Add that to the 900ml of urine my kidneys still produce daily and the total water taken out would nearly hit 2000ml.

Dialysis is so efficient that the doctor said I may be dehydrated. That was the reason I have been experiencing low blood pressure lately.

To prevent dehydration and bring up my blood pressure, I have to replenish with the amount of fluid that came out plus 500ml more.

On normal days now, I drink about 2 liters of water. This is a small luxury since most people with kidney disease have to limit their water intake. Some are restricted to no more than 500ml per day only.