dialysis

Dialysis treatment time—every minute counts! A message from our CMO.

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For most in-center patients, hemodialysis means three treatments per week, each four hours in duration. The weekly total of 12 hours represents a small fraction (less than 10%) of the round-the-clock work normally performed by healthy kidneys to continuously clean the blood. Removing the toxins and excess fluid that accumulate in-between treatments requires maximizing every minute of your treatment time.

It is not uncommon that patients may wish to come off dialysis early for a variety of reasons—fatigue, muscle cramping, even boredom, to name a few. While they may not feel any immediate symptoms, shortening treatment time can have a negative long-term impact on overall health. Coming off early once can easily become a recurring pattern of behavior.

Raghu Durvasula, MD, MHA
Chief Medical Officer

Finishing dialysis even five minutes earlier than prescribed would result in 13 hours of missed dialysis time over the course of the year, the equivalent of more than three skipped treatments!

As a result, wastes inevitably begin to accumulate leading to patients feeling unwell, with reduced energy, poor appetite, chronic nausea, shortness of breath, and worsening blood pressure control.

Furthermore, a reduction in treatment time is known to be associated with increased risk of emergency department visits and hospital admissions, while ultimately reducing long-term survival.

If you are having difficulty completing your full treatment, be sure to discuss it with your care team. It is important to figure out why, then find solutions that could help you get through the entire treatment as prescribed.

Every minute counts, so don’t cut yourself short. Staying well-dialyzed will keep you healthy and energetic, so that you are better able to enjoy those activities and life pursuits that matter most to you!

Kidney care comes full circle

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Jacee Numbrado, dialysis tech at the Cogen Center in Bremerton.

At the young age of 18, while living in the Philippines, Jacee Numbrado was diagnosed with glomerular nephritis, resulting in end-stage kidney disease. He had been experiencing gouty arthritis symptoms for a week when he awoke one night with such intense pain, he was taken to the hospital where lab studies revealed a high creatinine level. He was given the choice of treating his condition with medication or starting dialysis. Jacee opted for medication which sadly did not help— he ended up going on dialysis two times a week while living in the Philippines.

Jacee and his family moved to the United States in 2019; he started dialysis at Olympic Peninsula Kidney Center (now Puget Sound Kidney Centers-Cogen Bremerton) that June. Soon after, with the support of clinic staff—who Jacee says “were always positive, made him feel comfortable and hopeful”—Jacee decided to pursue a kidney transplant.

In August 2021, Jacee received a kidney transplant at Virginia Mason. He did well during his weeklong stay in the hospital and was then released for observation at home for a month.

In July 2022, Jacee was hired as a dialysis technician at Puget Sound Kidney Centers-Cogen Bremerton. He is now helping provide care where he himself received care—a true full circle. Jacee wants to bring back what he received as a patient—hope and positivity.

“Every day is a new day and the staff at PSKC made this possible for me,” he says, “so I hope to do the same for patients I care for.”

Our Lakewood center opens its doors, a beautiful new facility to serve Pierce County patients

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About the state-of-the-art center

On Oct. 3, 2019, over 100 people came out to celebrate the opening of our new dialysis center in Lakewood, WA. Guests enjoyed tours and refreshments at this beautiful facility. At full capacity, this new 29-station dialysis center will accommodate up to 174 in-center dialysis patients. The center, designed by Botesch, Nash & Hall, was created to be a warm, welcoming and comfortable environment for patients and visitors.

“This new facility reflects our ongoing desire to provide a high quality and beautiful care environment for our patients, all in an effort to enhance their quality of life,” says Harold Kelly, PSKC president and CEO.

The 18,150 square foot facility includes three isolation rooms and a permanent bed for patients who need to lie down during dialysis. The facility will house a specialized training area for home dialysis patients, and the center will host free kidney health education classes for patients and the broader community.

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Left: Harold Kelly, president and CEO at PSKC, addresses the crowd at the opening ceremony. Right: Our Lakewood staff are ready to serve our new patients in the area.

Introducing our Lakewood medical director

Dr. Ramon Anel has practiced for over 24 years, specializing in critical care medicine and nephrology. He graduated from the University of the Philippines Manila College of Medicine and completed his residency at Advocate Illinois Masonic Medical Center in Chicago. Dr. Anel currently practices with the Providence Medical Group in Olympia.

Medical directors are an important part of the Puget Sound Kidney Centers team as they are responsible for assuring the safety and quality of care patients receive at each unit. They are also responsible for implementing the quality advancement projects that assure PSKC continues to identify areas for improvement and innovation. In this capacity, Dr. Anel serves along with a team of professionals that include nurses, technicians, renal dietitians and social workers.

“Dr. Anel has been instrumental in introducing PSKC to the Lakewood community,” says Jenni Tyner, director of nursing at PSKC. “We are delighted to partner with him as we serve the dialysis community of Lakewood.”

Welcome, Dr. Anel, and thank you for your leadership.

Puget Sound Kidney Centers has seven dialysis centers in Washington state. See where we’re located and learn more about us. You can even follow us on social media – we’re on Facebook, Instagram, Twitter and Pinterest.

Living Life to the Fullest

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Musician, actress, singer, poet, activist, student and social worker are all titles held by Andrea Skywalker over the course of her extraordinary life. Born in Germany to a German mother and a Black American/Cherokee father, she credits her father’s military background and her mother’s meticulous nature with instilling in her a discipline and drive that would help her pursue her many interests. She has traveled extensively, and, with a degree in Human Services, she has enjoyed a long career as a social worker for the State of Washington. During her tenure as a social worker, she worked with victims of domestic violence, seniors and other people in need. “I like helping people who can’t help themselves.” She adds, “I want to leave something positive and beautiful in this world to promote unity.” Andrea enjoys the performing arts and has appeared on the stage and screen as a singer, musician and actress. She continues to perform at local venues.

In 1999 she suffered a major stroke which left her in the hospital for 2 months. She had to re-learn how to walk, talk and function, and her determination would be essential in her rehabilitation efforts, “As soon as I could walk, I went back to work. Never give up” she advises based on her own experience. When her doctor told her six years ago that her kidney function was declining and she should prepare for dialysis, Andrea was adamant that dialysis was not for her and she managed to keep her kidneys functioning for six more years. Eventually her kidneys would fail and she was faced with the ultimate choice. At this point, she did choose to continue living with the aid of dialysis treatments; “I decided I’m too busy to die.” Just a few months after beginning dialysis Andrea celebrated the debut of her first book, entitled “The World As I See It.” Now Andrea has just completed a second book and will soon be recording a music CD. She shares, “Even though dialysis is time consuming and takes up three days of each week, I often think about where I’d be without the dialysis. I choose to be grateful and to be happy that I’m still alive.

Enjoy a poem from Andrea’s new book, “The World As I See It”:

I’M SUPPOSED TO LIVE
I GOT THINGS TO GIVE
I GOT PLACES TO SEE
DON’T YA KNOW
I GOT PLACES TO GO
IN WIND – RAIN – AND SNOW
AND THE CLOCK KEEPS TICKING
REAL SLOW

WHEN I WAS 63
I WAS TIRED AND CRANKY
AND MY PRESSURE
WAS WAY TOO HIGH
AS MY KIDNEYS WERE FAILING
AND I LAY AILING
I WOKE UP AND SAID
NO – I’M NOT GOING TO DIE

I’M SO LUCKY I GET A SECOND CHANCE
TO WALK AND TALK
AND LEARN HOW TO DANCE
MAYBE FIND A LITTLE ROMANCE
TO APPRECIATE EACH MOMENT AND SAY
HOW ARE YOU TODAY

LET’S TAKE A CHANCE
AND DANCE THE NIGHT AWAY
CAUSE I’M SUPPOSED TO LIVE

By Andrea Skywalker @2017

Top ten tips for people starting dialysis

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Dialysis can be daunting – learning more about it and understanding your options might help you feel calmer and better prepared. Here are ten ways to get ready for dialysis.

1. Find a kidney doctor if you don’t already have one. A nephrologist — a kidney doctor — is an expert on kidney care. If you’re in the Pacific Northwest, use our search tool to find a nephrologist near you.

2. Learn about your treatment options. If you need dialysis, there are different options that might work for you. Learn about home dialysis and in-center dialysis, then talk to your kidney doctor about what could work best for you.

3. Meet with a nutritionist at your dialysis center to discuss the kidney diet. If you need dialysis, you’ll likely benefit from changing your diet. Eating the right foods while on dialysis will help you feel better.

4. Take a class about kidney health. There are many resources out there to help you learn how to feel good while on dialysis. Sign up for our free classes to understand your treatment options, how diet and exercise can make you feel better, and other ways to help slow the progression of your kidney disease.

5. Try to create a dialysis schedule around work and regularly scheduled activities. Dialysis is time-consuming but it doesn’t have to mean you’ll miss out on all your usual activities. Work with your dialysis care team to find a treatment schedule that helps you stay involved with work and your community.

6. Talk to the care team at your dialysis clinic about insurance. Speak with members of your dialysis clinic’s financial team to learn about Medicare and what kidney care it covers. 

7. Talk to someone who has been on dialysis. One of the best ways to understand what dialysis is like is to chat with people who are also on it. While undergoing treatment, talk to others who are dialyzing to get tips from them. Or, meet up with someone from The Road Back to Life, a group of people with kidney disease who have been on dialysis or received a kidney transplant.

8. Find recipes that follow your kidney diet and stock up on those foods. There are some absolutely delicious foods that align with the kidney diet. Check out our kidney-friendly recipes for some to try.

9. Make an exercise plan with your doctor. Fitness is important for everyone, including people on dialysis. Regular exercise — even short walks or stretching — will help you feel better and could help slow your kidney disease down. Work with your doctor to create a fitness plan that works for you.

10. Be your own advocate. No one knows you better than you. If something isn’t going well for you, speak up. Talk to your nephrologist or the kidney care team at your dialysis center to see how your care plan could change to make you feel better.

 

Although adjusting to being on dialysis can be difficult, there’s a community of people here to help. You’re not alone with your disease — talking with others and sharing your own experiences can help. Search, and share your own story, with #MyKidneyStory on Facebook, Instagram and Twitter.

The road to transplant: Armando’s journey

Community, Patient stories - -

Armando’s early days of dialysis.

In 2007, 17-year-old Armando Gonzalez Valadez was tired, didn’t have much energy and always felt sick.

Soon after, Armando was diagnosed with kidney failure and started dialysis in the Mount Vernon area. After about six months, he moved to Lynnwood and became a Puget Sound Kidney Centers patient in Mountlake Terrace. His idol, Superman, was proudly displayed on t-shirts he wore to treatment.

Armando’s determination and strong will was evident with him working two— sometimes three—jobs to make ends meet. In 2011, Armando began doing home dialysis treatments five nights per week, which allowed him the ability to juggle work during the day. He also began helping the Mountlake Terrace social workers run a monthly support group that provides education to only Spanish-speaking patients.

Armando after his kidney transplant.

Not content at just working and living in this country, Armando was passionate about becoming a U.S. citizen. All his hard work and determination paid off in March of 2014 when he finally obtained his citizenship. Then, on December 27 of the same year, he received “the call.” It was his turn for a transplant.

The operation was successful and Armando received what he describes as “The best Christmas present, ever!”

For Armando, life after transplant has only gotten better. Recently, he was promoted to manager of Interstate Batteries, a company that celebrates his transplant anniversary every year with a cake. He has also just purchased his first home and got married.

Armando has shown that not only can Superman “jump tall buildings in a single bound,” he can beat kidney failure too. Like Armando says, “You have to fight through some bad days to earn the best days of your life.”

Interested in learning more about kidney transplant? Read more about this treatment option here.

Lance and Marni: a caregiving story

Community, Patient stories - , -

Lance and Marni met 45 years ago in New Mexico, raised two daughters and have lived in Arlington for the past 20 years. About three years ago, they received some unexpected news. Marni was told that her kidneys were failing and she should prepare for dialysis. Just six months later, they found themselves checking in for dialysis treatment at PSKC Smokey Point.

Marni, on dialysis at PSKC Smokey Point, with husband Lance.

Lance, retired, studied the dialysis process. Since day one, he has documented every one of Marni’s treatments — her blood pressures, medications taken, blood sugar readings and more. Mostly, Lance looks for trends so they can catch it if something is amiss. He is happy to be Marni’s “medical advocate” and so much more by doing all the cooking, cleaning and housework as well.

Marni stays busy outside of dialysis, teaching tole painting classes out of their home every Thursday night. Supplies, including wood characters that Lance builds, are included in the cost of the class.

There are many ways to adjust to dialysis, and together Marni and Lance have figured out a way that works best for them. By writing it all down, Lance provides helpful information to get the best care for Marni and engages himself in a positive way. Marni continues to spread her passion for art even while tackling dialysis and other health challenges. A strong and solid pair, Lance and Marni are an inspiration to all.

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