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Dialysis itself does not hurt. In hemodialysis the needles may hurt going in, but they should stop hurting after that. You can ask for numbing medicine before you get the needle sticks if they bother you. Many people get used to the needles in time. Painful muscle cramps can happen during hemodialysis, especially if you gain a lot of fluid weight between treatments. Your care team can help stop the cramps when they happen and work with you to keep them from happening again. You can help by following your fluid limits and learning about dialysis.
In peritoneal dialysis (PD), abdominal pain can be a sign of an infection called peritonitis. Some people who do PD with a cycler machine sometimes have pain at the end of a drain cycle. When you are trained in PD, you’ll learn ways to help prevent these problems.
Unless you are very sick for reasons other than kidney failure, dialysis should help you feel better. Some people feel better the first week. Others notice a difference after a few months. If your dialysis treatments make you feel ill or tired, tell your care team your symptoms so they can help you feel better.
Dialysis will not make your health worse. Many people need a few weeks to adjust to dialysis. It takes time to get used to the routine, the medicines and the treatments. Once dialysis is working well to remove extra wastes and fluids, you should begin to feel much better.
The best sign that you are getting good dialysis is that you feel well, look healthy and can do the things you want to do. With adequate dialysis, you should have a good appetite. When it’s time for your next treatment, you should feel like you don’t need it. This is the goal of dialysis.
It can be possible to get just a little bit less dialysis than you need — and over time — this could harm your health. Some signs that you may not be getting enough dialysis include:
If you are not getting enough dialysis, ask your doctor if you should have your dose of dialysis increased. In hemodialysis, this can mean using a bigger or more efficient dialyzer, using faster blood flow or using longer treatment times. In peritoneal dialysis, your dialysis dose can be raised by using larger bags for each exchange or by doing exchanges more often.
It may seem as if dialysis is so complex that only a medical professional could understand it. But in the early days of dialysis (the early 1970s), most people learned to do their own dialysis at home. Decades later, some of those people are still doing well — in part, because they learned their job on dialysis.
To do well on dialysis, your job is to become your own expert. You should learn to take care of yourself and maintain your own safety. While an at-home treatment will allow you to control your schedule, making it easier to keep a job and health insurance, you'll still have to do your job if you choose in-center hemodialysis.
Above all, your job is to use dialysis to make the most of your life, by resuming your normal activities or even starting new ones.
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