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Dialysis patients instructed on fistula care

JDWNRH: After being on dialysis twice a week for the last 11 years, Tashi Norbu, 32, recently learnt that it was not advisable to prick his wrist in the same place every time he got a dialysis.

A Japan International Cooperation Agency (JICA) volunteer, Satoko Tanikawa, said doing that would cause the skin to wear out and become weak.  She said there was a risk of germs entering the body.

The JICA volunteer nurse, along with three other nurses from the dialysis unit with the referral hospital in Thimphu, held an education program for about 15-dialysis patients’ fistula care at the patient guesthouse yesterday.

Satoko explained in English, which the other nurses translated into Dzongkha, Lhotshamkha and Sharchopkha.

Before a haemodialysis, an opening has to be made in the body, so that the blood can be accessed by haemodialysis and made to flow out and go back in.  When an artery in the forearm is sewed to a vein through a surgery, a fistula is created, which allows needles to be inserted into the vein for dialysis treatment.

Nurse Satoko said a fistula could be used for several years, even more than 10 years, but one should know how to take care of it, during and after dialysis, so that it doesn’t cause complications.

“We explain to patients on how to take care of the fistula when they come for dialysis, but most don’t know the basics,” said Satoko. “There is only one nephrologist in the country and it’s difficult for all kidney patients to meet him and get his advice; which is why we’re conducting the workshop to educate patients.”

More than 100 kidney patients come to Jigme Dorji Wangchuck national referral hospital for dialysis.

A dialysis unit nurse, Wangmo, said that kidney patients were required to have dialysis thrice a week but since the hospital had only eight machines, the patients were treated twice a week.  The referral hospital also has patients coming from Paro and Wangduephodrang.

Dechen Tshomo

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