HD

Today is NOT actually my true birthday in this world as my father registered late which was a year later when my younger brother was born at that early stage of our tiny Kampong village namely Kampung "Tenghilan" in the land below the wind now being called as Sabah state in Eastern Malaysia which was formed as a country namely Malaysia in the year of 1963. During that British colony time we rely & depend solely upon foreign clinic for any healthcare business. Therefore my actual birthday was in 1947 February 17 according to my late father’s personal hand writing note-book which I am holding still with it nowadays!

I had been taken care by Singapore General Hospital (SGH) for more than over 10 years as a Chronic Kidney Disease (CKD) patient since migrated to Singapore once upon a time. One day when I visited to hospital at SGH due to urine infection I was told that my both kidney no more good & as such eventually would fail & need for dialysis treatment or therapy. Then in July 2014 I began to visit my vascular AV Graft surgeon. My creatinine had shot up to as high as 600 to 700 level of reading during those period. That’s what SGH carried out my left hand side upper arm of AV Graft surgery in July 2014 due to my smaller blood vessels of arteries & veins for getting ready & preparation for hemodialysis treatment or therapy. Surprisingly I could face it accept it & managed it willingly & readily too despite my family worry about me.

Three (3) months after my vascular surgery on my LHS upper arm I was admitted to SGH for my sudden critical gout flare & attack. It was that time for my LESSON ONE of my hemodialysis treatment or therapy at SGH. Since young I had been donating my blood so it is smooth sailing of HD with no negative emotional feeling at all. However, I am lack of medical knowledge how to to deal with it initially. Such as what to know what not to know etc during those earlier hemodialysis period. But I began struggling with loss of appetite & become gradually weak both physically & mentally. I gradually dropped my normal usual weight from initial of 73 kg to as low as 58 to 59 kg at one stage at private clinic for the first 5 months. My family were worrying. I was getting thinner & weak too even though I was quite positive throughout those period of struggling HD journey.

Then I began to engage with NKF Singapore a bigger charity organization at Yishun DC1 on March 22nd 2015. Sometime that year in September, as I could remember, after a replacement of nurse manage’s arrival I was given to view my first ever “blood-labs-test” reports with all those figures or reading etc in a tabulator or chart form. From then onward I never ever turn back again as they are my perfect guideline or road map for my personal HD session even though it is issued in bi-monthly basis in addition to the weekly blood labs test on the spot at the centre such as HB level, Ca+ & sometime Glucose of sugar content. Within a year I suddenly bounced back both physically & mentally. I began very active once again in early 2016 by attending NKF's HQ events or activities as well as my family normal events or activities.

My original dry weight was set by SGH at 61 kg in 2014. Today I am at 62.4 kg which was being constantly adjustable to highest 64.6 kg & back to 62 kg then again back to 62.4 kg due to constant variable or fluctuation of my blood pressure during hemodialysis session. I believe & trust that my best practical weight is around 62 to 63 kg depending upon my BP as conditional factors too. Why do I say so? Simply I feel most lighter comfortable & active at this range of weight variance without any part of my body or legs swollen up provided I keep my goal target around 3% to 4% overload of dry weight in each HD session. 5% of dry weight is a little bit tough sometime may possibly subjective to stress & strain of my physical body such as cramp legs or stomach pain during HD or aching body while at home etc in addition perhaps partially due to the cause of cold air as my fingers & legs cannot stand the coldness & tend to get stiff & hence cramp legs arising as a result of poor blood circulation. Keep busy with exercise is the best-bet solution to me either pre-dialysis during dialysis or post dialysis. These days I hardly have dizzy feeling unless my BP dropped to lower scale or suddenly BP crash which I try my best to prevent happening by observing or monitoring closely my BP constantly during each session especially on 3rd hour onward. This is very critical & very important to me! I had experienced twice with critical BP crash that I needed oxygen supply etc. One was with fever & cold plus body’s sweating & hard breathing which ended up to emergency admission to hospital for operation as a result of gall bladder stone removal.

Apart from the above incidents I have encountered twice angioplasty balloon on my AV Graft. Once sometime toward the end of 2016 with low access flow around 600 ml/min that constantly giving alarm on my access flow pressure while another one was in early 2018 suddenly with zero access flow during normal pre- HD session upon stethoscope detection. These two occasions I will go for more details as time goes by & or if necessary at all.

The rest is history to me as far as HemoDialysis (HD) is concerned since beginning 2016, a year+ after, which I had been going through personal experiential experiment with experiences or exposures on hemodialysis treatment or therapy since 2014 October.

Today I like to reflect & revise my own stories for purpose of personal further learning & hope & wish to share & exchange some fresh ideas along the struggling journey among dialysis patients both in Singapore & Malaysia if possible. Thank You & Happy New Year！