The "The Dark Side of Dialysis", edition.

Good Monday morning. The Monday after Father's Day. I treated Dad and Brian to Hot n Juicy. Their choice. It never disappoints!  

So. The dark side of dialysis. What do I mean?  It has to do with the (mis)treatment of dialysis patients. There are approximately 400,000 of us who need dialysis. Most of the patients are going to dialysis centers.  And most of the dialysis centers are run by 2 large companies..Davita and Fresenius. Now CMS, the Center for Medicare and Medicaid Services, a government agency, "oversees" these companies. If a patient has an issue with their treatment, or their dialysis clinic, or the corporations, the issue can be mediated by CMS after going up the chain. Because the care of the patient should be the highest priority. Right? Life over profits, yes?

Well.  No. Profits first. Look. $77,000 per year per patient. $77,000 x 400,000 = $30,800,000,000.  Whoa!  There's money to be made and they can't have patients rocking the boat now can they. What do I mean by rocking the boat?  There are standards of that should be maintained. First and foremost is the cleanliness of the facilities. Dialysis patients are highly susceptible to infection. Clean and sterilize facilities are (should be) mandatory. The patients have large needles put in the arms at least 3 times a week by technicians. The blood of the patients is being moved out of the body through a dialysis machine, cleaned and returned to the body. Now there are a lot things that the blood flows or the needle access that need to be sterile. Lots of places for failures. 

Now you'd think the dialysis patients have the right to question procedures when it comes to them. Infections could kill us. Once, in my center in Detroit, I asked my tech to change her gloves. She complied with no questions. But some techs get an attitude. Once I saw a tech start to use a dialysis needle on a patient that had been removed from its sterile packaging. A senior tech read the riot act to that tech. When a patient finishes treatment and is off the machine, the machine and the chair is wiped down with industrial strength wipes. The center also had a cleaning staff. But this was in Detroit. At a private dialysis center. With lots of staff. 

I moved to Las Vegas and ended up at a corporate run center. The differences were mind boggling. The ratio of staff to patient was much larger, which meant the techs were rushed and more prone to mistakes and cleaning and sterilization was not as thorough. And the staff was stressed and there was high turnover. Not good for the patients.  

So sometimes patients rightfully complain. You'd think that would fix the problem. Heh. No. The complaint can start a retaliation of the patient who has the audacity to complain. A patient may complain that a tech causes pain while inserting the needles. There are incidents, too many to count, of the tech going out of the way to make sure the stick is painful. Or ignoring the concerns of the patient. And if the patient is really lucky, management will side with the employee, disregarding the concerns of the patient. And should the patient take it up the chain to the company, the patient will be labeled a troublemaker. So now the patient lets his concerns be known to CMS, but CMS sides with the company a majority of the time. So now, the clinic gets to kick the patient out of the center. 

But wait. There's more. The dialysis center will blackball the patient and other dialysis centers will not accept the patient. You understand that this is life threatening. Basically a death sentence. They say hey, you can go to the emergency room when you need treatment. But the ER will only take you if you are about to die..potassium levels and phosphourus levels elevated, excessive fluid retention, pulmonary edema. All because the dialysis has the ability and the right to deny service. Ugh. 

I was a pretty good patient. At least in Detroit. I crossed swords with a tech once. I was about 15 minutes late. She tried to fuss at me. Bitch, I'm a grown woman. Get out of my face. I'm late because I as having digestive issues. I could have been on time and pooped in the chair for you. I chose not to. But she kept on. How they'd have to change my chair time. I told her to get out of my face and send the charge nurse over. Lol. I actually did the talk to the hand thing. The charge nurse talked to the tech and I never had to deal with the tech again. And my time didn't change. 

In Vegas, my issue was with the charge nurse and my nephrologist. They treated us with contempt. I wasn't having it. Fortunately the social worker was my advocate.  Oh. Did I mention that the majority of patients kicked out of centers were people of color?  Anyway. I'll have more on this later. A slide show passed through my timeline about an organization, Dialysis Advocates. They work with people up and down the chains to make sure people are not mistreated and right the wrongs. And yeah, I have none of these issues because I do my dialysis treatment at home.  

That's it for today. Cooler here than Detroit today. Without the humidity. But don't worry. Back to triple digits by mid week. Stay cool and enjoy your day!