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What is hemodialysis and how does it work? Who needs it? How do you prepare for it? In the United States, over 30 million Americans have kidney disease, and sometimes, kidney disease progresses to kidney failure or end-stage renal disease. When this happens, you cannot survive unless you have a kidney transplant or some form of dialysis. So today we're going to talk about hemodialysis.
Your kidneys are the two kidney bean-shaped organs that are located in your lower back, or in your flanks. And the kidneys are responsible for filtering out or cleaning your blood. They get rid of excess waste, excess toxins, and excess fluids. If your kidneys stop functioning, then you develop renal failure or end-stage renal disease.
What is Hemodialysis?
Hemodialysis, or blood dialysis, is the filtering of your blood outside of your body. So, if your kidneys stop working properly, the hemodialysis acts as a substitute kidney. Now it's important to note that hemodialysis does not actually correct your own kidney function. It does not fix or treat your kidneys.
#hemodialysis #drfrita
What is The Dialyzer?
The dialyzer is actually the filter. It's the main powerhouse of the hemodialysis system, and it is what actually acts as the substitute kidney. In the dialyzer, you have these hollow fibers that run through it, and these fibers are bathed in something called dialysates, or dialysis fluid.
How Often Are Patients Treated With Hemodialysis?
Most patients who are on hemodialysis are on it between three and six hours, about three days a week, especially if they go to a center.
How Does Hemodialysis Work?
So when you are on dialysis, how does your blood get from your body to the hemodialysis machine and then back to your body? Well, it does so through tubes, and those tubes are connected to your access, and we'll talk about access in just a moment. But as far as the tubing, the tubing is connected to your body.
Types Of Hemodialysis Access
Arteriovenous Fistula or AV Fistula
The AV fistula is the gold standard as far as hemodialysis access is concerned because it gives you the most efficient hemodialysis and it is the least likely to be infected.
Arteriovenous Graft or AV Graft
The AV graft is very similar to the AV fistula in that you still have a surgically connected artery and a vein, usually in the arm, but in the case where if you have veins that are rather thin or arteries that are thin and maybe too weak in order to really give you a properly functioning, substantial AV fistula, then the vascular surgeon may opt to add an artificial material in order to make that shunt a little stronger, or little more durable. And so, an AV graft is another option for dialysis access.
Catheter
If you're in a situation where you need temporary dialysis, or if you have acute kidney injury, then you may have a temporary Vascath placed, and it's usually placed in a vein of the neck, the internal jugular vein, or it can be placed in the groin, or in the femoral vein.
Who Needs Hemodialysis Treatment?
How do you know if you need hemodialysis, and when is it time to prepare? Well, if you follow up with your kidney doctor (nephrologist) regularly, he or she will be watching your labs. They'll be able to see those signs of your kidneys not functioning properly.
#dialysis #uvahealth
If your kidney function is declining and medications and other treatments arenโt working, dialysis can offer life-saving care. UVA has one of the largest dialysis programs in the country. Nephrologist Daphne Knicely, MD, explains the types of home dialysis and how they can work to fit your life.
Find out more at: https://uvahealth.com/services/dialysis
Transcript
Dialysis is just a way to replace the kidneys when they're not working anymore. So when the kidneys stop working, they stop getting rid of water, stop balancing the chemistry, stop getting rid of the toxins. Then dialysis does its job by balancing the chemistries, getting rid of the toxins, and help remove fluid. It doesn't fix the kidneys. It just replaces them.
I usually think of dialysis as two components. There's hemodialysis and peritoneal dialysis. So peritoneal dialysis can only be done at home. Hemodialysis can be done in a center, or it can be done at home.
Hemodialysis is where you have some sort of access to the blood. Either some sort of shunt in the arm that connects an artery and vein, or a catheter. And it allows for blood to leave you, go through a machine, get cleaned, chemistries balanced, and then comes back to you.
For home hemodialysis, the patient actually learns how to do that treatment. It's a very simple machine, very user-friendly. Training is usually about anywhere from four weeks up to eight weeks, and you work one-on-one with a nurse. You still see the physician. You come in about once a month, maybe twice a month, to get labs. You'll see a social worker, and a nutritionist at the same time.
Peritoneal dialysis takes place by putting a tube into your abdomen. And we take dialysis fluid that's chemically balanced. When we put it into the abdomen, it uses those little blood vessels to pull toxins out, to balance chemistries, kind of like little filters. Now, after it sits in there for several hours, we drain it out.
Anyone that needs dialysis is a candidate for home dialysis. There's not one type of dialysis that's going to make you live longer. They're all equal. The goal is to pick the type of dialysis that fits with your life.
Eric's Home Dialysis
For more information please visit: https://www.yalemedicine.org/c....onditions/acl-injury
Serious injuries, by and large, cause a lot of swelling in the knee. Especially in younger patients. Now, someone could be arthritic and they overdo it going for a big long hike and they get some swelling the next day. But rapid onset of swelling, it's like hard to make out where your kneecap is, is a pretty big cardinal sign that there's something serious that's happened to your knee. Rapid onset swelling is usually due to blood in the joint. "A meniscus that really tears and flips in the front. You tear your quad or your patellar tendon, your kneecap dislocates, you tear a little blood vessel, your ACL tears, a piece of cartilage in bone gets knocked off and causes bleeding. So a lot of the really significant injuries, people get rapid onset swelling within three to four hours and they should seek attention There's always exceptions to rules, but if your knee looks like a grapefruit, you should go get it checked.
Dr. Ebraheimโs educational animated video describing the anatomy and associated injuries of the knee joint.
Disrupted quadriceps
โขPatient is unable to actively extend the knee.
The most common cause of ACL ruptures:
โขTraumatic force being applied during twisting motion.
โขSide stepping or landing from a jump.
Patient complains of:
โขImmediate pain
โขKnee giving way
โขSwelling
Aspiration of the knee
โขIf aspiration of the knee joint shows evidence of blood within the joint there is 75-80% chance of ACL and meniscal injury.
Lachamnโs test- ACL knee exam
โขKnee is flexed at 30 degrees.
โขACL tear of the knee is identified by pulling on the tibia and examining the frontward motion of the lower leg in comparison to the upper leg.
Radiological exam โ ACL
โขMRI of the knee joint shows bone lesions or bruising associated with tears of the ACL. Injury is found in the typical location; middle of the femoral condyle and posterior part of the tibia laterally.
Posterior cruciate ligament tear (PCL)
โขCommon cause of injury is a bent knee hitting a dashboard in a car accident.
Tibial Sag Test โPCL knee exam
Quadriceps active test-PCL knee exam
โขThe examiner stabilizes the leg of the patient and then the patient is asked to actively contract the quadriceps muscle.
โขThe tibia is seen actively reduced from the posterior subluxed position.
Lachmanโs test-PCL knee exam
โขKnee is bent 20-30 degrees.
โขThe posterior drawer test is carried out while the patient is in a supine position and the knee is flexed to 90 degrees.
โขThe amount of translation of the tibia relative to the femur is observed.
The dial test is performed while the patient is in the supine or prone position and both knees are in 90 and 30 degrees of flexion. More than 10 degrees of external rotation indicates significant injury.
Common meniscal tears
Symptoms include
โขKnee pain
โขPain with straightening the knee
โขSwelling
โขLocking
โขWeakness
How to Tell if Knee Pain is Meniscus or Ligament Injury
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Bob and Brad discuss how to tell if you are having a meniscus or ligament injury. They also include some tests you can try at home to distinguish the two.
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Our videos offer the best "get fit , stay healthy, and pain-free" information directed toward people 0 to 101 years old. Physical Therapists Bob Schrupp and Brad Heineck have over 50 years of combined com/shop/physicaltherapyvideo We try to add a twist of our humor into each video in our quest to be the "Most Famous experience in the physical therapy field. Not only will these videos provide outstanding health information on treating yourself at home, we also do product reviews. For our favorite products on Amazon click on this link. https://www.amazon. Physical Therapists on the Internet" In our opinion of course!!! Subscribe to us now and join the fun.
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Dr. Rowe shows how to quickly fix knee popping, clicking, and cracking sounds.
This exercise will focus on lengthening tight muscles and tendons that may be causing a noisy knee. It's especially good for osteoarthritis (wear and tear arthritis) of the knee.
It can be done at home, requires no equipment, and may also give knee pain relief... even within seconds.
Let us know how it works for you!
***************************
Dr. Michael Rowe
St. Joseph, Michigan chiropractor
If you are looking for effective neck, back, or sciatica pain relief, contact us at 269-408-8439 or visit us at https://www.BestSpineCare.com
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#kneepain #kneepainrelief #kneearthritis
How to Know If You Have a Serious Knee Injury or Problem
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Bob & Brad discuss how to know if you have a serious knee injury. They show you what to look for and what you should do.
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Our videos offer the best "get fit , stay healthy, and pain-free" information directed toward people 0 to 101 years old. Physical Therapists Bob Schrupp and Brad Heineck have over 50 years of combined. We try to add a twist of our humor into each video in our quest to be the "Most Famous Physical Therapists on the Internet" In our opinion of course!!! Subscribe to us now and join the fun. Not only will these videos provide outstanding health information on treating yourself at home, we also do product reviews.
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Common causes of the knee pain
Knee pain is very common and in this video we will present the most common problems that can cause pain in the knee. (Patella) itself, which is in front of the knee, or from the tendons that are attached to the kneecap (patellar tendon and quadricep tendon). One of the most common problems is patellar chondromalacia which is chronic pain due to the softening of the cartilage beneath the kneecap. The cartilage of the kneecap will have some erosions, defects, or holes from mild to complete inside the joint (exactly in the back of the kneecap).
โข Pain in the front of the knee
โข Occurs more in young people
โข Becomes worse from climbing up stairs and going downstairs
Treatment is usually nonsteroidal anti-inflammatory medication, physical therapy, and surgery is very rare. Also in front of the kneecap, the patient may get pain due to prepatellar bursitis.
When there is prepatellar bursitis, the patient will see that the swelling, the inflammation, and the pain is located over the front of the kneecap. The bursa becomes inflamed and fills with fluid at the top of the knee, causing pain, swelling, tenderness and a lump in that area on top of the kneecap. If the pain is in front of the knee but below or above the patella, this may indicate that the patient has tendonitis. Patellar tendonitis is an overuse condition that often occurs in athletes who perform repetitive jumping activities. Patellar tendonitis is a knee pain that is associated with focal patellar tendon tenderness and it is usually activity related. It is located below the kneecap and is called "jumper's knee". Patellar tendonitis affects approximately 20% of jumping athletes. There will be tenderness to palpation at the distal pole of the patella in extension and not in flexion. Quadriceps inflexibility, atrophy and hamstring tightness are predisposing factors for this condition. Treatment is rest, anti-inflammatory medication, stretching and strengthening of the hamstrings and quadriceps. Use an eccentric exercise program. The early stages of patellar tendonitis will respond well to nonoperative treatment. Another important cause of knee pain is a meniscal tear. The meniscus is the cushion that protects the cartilage in the knee. Injury will cause pain on the medial or the lateral side of the knee exactly at the level of the joint. The patient will complain of a history of locking, instability and swelling of the knee. McMurray test will be positive. A painful pop or click is obtained as the knee is brought from flexion to extension with either internal or external rotation of the knee. Arthritis of the knee Knee arthritis is very common. The cartilage cells die with age and its repair response decreases in the joint collapses with increased breakdown of the framework of the cartilage. The patient will have progressive blurring away of the cartilage of the joint with decreased joint space as seen on x-rays. Another source of pain is the Baker's cyst. The cyst is in the back of the knee between the semimembranosus yes and the medial gastrocnemius muscles. Another important source of knee pain is a ligament injury. Here is a normal knee without a ligament injury. Here you can see from the front, you can see the lateral and medial collateral ligament. You can see the ACL and PCL from the side view. These ligaments are usually injured as a result of a sports activity. Here is an example of a sports knee injury. Here is an example of the medial collateral ligament injury. This is the most commonly injury knee ligament injury to this ligament is on the inner part of the knee. Here is an example of an injury of the anterior cruciate ligament. It involves a valgus stress to the knee. Lachman test is usually positive, and MRI is diagnostic. Another important cause of knee pain is iliotibial band syndrome of the knee. Inflammation of the thickening of the iliotibial band results from excessive friction as the iliotibial band slides over the lateral femoral condyle. The iliotibial band is a thick band of fascia that extends along the lateral thigh from the iliac crest to the knee. And as the knee moves, the IT band was repeatedly shifted forwards and backwards across the lateral femoral condyle. The patient will complain of swelling, tenderness, and crepitus over the lateral femoral condyle. The condition occurs in the ITB S occurs in runners, cyclist and athletes that require repeated knee flexion and extension. The pain may be reproduced by doing a single-leg squat. The Ober's test is used to at assess tightness of the iliotibial band. MRI may show edema in the area of the ITB. Treatment is usually nonoperative with rest and ice, physical therapy, with stretching, proprioception, and improvement in neuromuscular coordination. Training modification and injections may be helpful. Surgery is a last resort. Surgical excision of the scarred inflamed part of the iliotibial band.
Dr. Yeong Kwok speaks about knee pain and demonstrates a stretch designed to treat tendonitis.
Hey everyone! When I started posting more squat and lower-body workouts last week, I got many requests for this video. I actually had already had a knee pain video, but I felt like I could make it a lot better, so I remade it.
For more information, check out my friend โ@ChrisRaynorMD aka @stablekneez on Instagram. Dr. Chris is a great surgeon, creative content creator, and all around good guy. He knows a LOT more than I do about this stuff. If you're interested, check him out!
Knee pain can be caused by MANY things, and this video is not intended to diagnose or treat any medical conditions. Some issues cannot be solved with exercise or physical therapy alone.
However, I've found that building up do doing squats with a full range of motion can help with knee pain. It's interesting, because there are some fitness figures that are adamantly against deep squatting because they claim it is BAD for the knees. I like it, and I've found it to be a very natural position. However, I do think that many people may not be prepared for it. Like any exercise, it can potentially hurt you if you're not acclimated to it. You can use your arm to assist you through the motion until you're able to do it without your arms with no pain. I have a full YouTube video on this: www.hybridcalisthenics.com/deepsquat.
Beyond this, sometimes strengthening our calves and hamstrings can "mysteriously" fix our knee pain. Both of these muscle groups support the knees.
On the other hand, sometimes these muscles are simply too TIGHT. You muscle fibers may be getting too tight and constantly trying to hyperextend your knees. Savor some calf and hamstring stretches.
I should point out that my chosen hamstring stretch in this video, standing toe touches, are controversial to some. Again, I like them, so they're shown here. If you are against them or they hurt you, you're very welcome to choose a different hamstring stretch.
Finally, I talk about isometric exercises like the horse stance and wall sit that seem to help with knee pain.
I touch upon synovial fluid, which is largely responsible for healing and nourishing our joints. Synovial fluid mostly circulates with movement, so I've included some knee "circles."
Hope this helps!
Legal Notice: Consult your doctor before beginning any kind of exercise program. This video does not replace a physical therapy program or consultation with a medical professional.
#shorts #hybridcalisthenics #kneepain
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Welcome to the latest episode of HT Physio Quick Tips!
In this episode, Farnham's leading over-50's physiotherapist, Will Harlow, reveals the most common knee injuries that can be sustained from a fall. You'll learn the 5 most common knee injuries from falls, how to differentiate between them and the key signs to look for before getting help.
To register your interest for the upcoming Optimum Knee Health course and to be among the first to know when it is released, reach out to Will@ht-physio.co.uk
To get a copy of Will's new book, Thriving Beyond Fifty, you can find it on Amazon below:
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If you're suffering from nagging knee pain that hurts in the morning and stops you from walking as far as you'd like, you can take our free knee pain guide - which will give you 5 expert tips to put a stop to knee pain at home - by visiting here: https://ht-physio.co.uk/knee-pain-guide-download/
If you're over-50 with a painful problem in the Farnham, Surrey area, you can learn more about how Will Harlow and HT Physio can help you overcome a painful problem here: https://ht-physio.co.uk/
**Any information in this video should not be used as a substitute for individual medical advice. Please seek advice from your local healthcare professional before taking action on the information in this video.**
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Body Bizarre is a TLC show with a name I'm not too wild about, but with stories that are nonetheless fascinating. Today we look at separating conjoined twins, a girl with ants crawling out of her ears, a man who nearly lost his hand in a factory accident, a family that all has 6 fingers, and more.
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