An informal survey done in one of the country’s leading dialysis providers revealed that most patients between 20 and 60 years old either quit their jobs or were forced to retire by their family members upon diagnosis of kidney failure.  Most of them underwent the difficult transition of being providers to becoming dependents.  When asked if they would like to work again, the majority indicated that they would like to but could not see how.   

Does being diagnosed with end stage kidney disease requiring regular dialysis prevent a person from keeping a job?   The answer is NO.  Taking a temporary leave of absence is inevitable due to the symptoms of weakness, fatigue, and shortness of breath that is occasionally felt by a patient with kidney failure and due to the initial adjustments one goes through from the effects of a dialysis procedure.  However, continuing to work is a financially and an emotionally rewarding option for the patient and his family. 

Here are five useful tips on how to cope as a dialysis patient without sacrificing your job:

1. Know what you can do and accept what you cannot do.

You will be surprised at how much a dialysis patient can still achieve despite their condition.  Businessmen, executives, managers, cashiers, secretaries, receptionists, accountants, doctors, lawyers, teachers, writers and other employees have successfully continued their careers.  However dialysis patients do not typically regain the full physical strength they once possessed.  A physically demanding job is not a suitable choice.  Dialysis patients also have a dialysis access to protect – in the arm called arteriovenous fistula for hemodialysis patients and a catheter in the abdomen for peritoneal dialysis patients.  These are some of the limitations you have to deal with in keeping your job. Your nephrologist can assist in letting you know what tasks you can and can not do depending on the type of dialysis you undergo.   Even a job that entails a lot of travel is not impossible to keep.  For patients on hemodialysis, this is where a dialysis chain with several branches becomes an advantage. 

2. Choose a dialysis schedule that will fit your work schedule

Hemodialysis is typically prescribed as a twice or thrice a week treatment.  Each session lasts for about 4 hours and takes up 12 hours of your week.  Since most dialysis centers open as early as 5 a.m. in the morning and some closing as late as 1 a.m., you can schedule your dialysis treatments either before or after your work depending on the kind of work you do and your schedule.  A teacher I know who holds morning classes would schedule her dialysis sessions at 1:00pm while a self-made businessman would come at 5 a.m. and be at his office by around 10 a.m.  Both managed to be successful in their fields while maintaining their dialysis treatments.  Some choose their day-off as one of their treatment days.  For those on peritoneal dialysis, you can inquire from your kidney doctor about automated peritoneal dialysis whereby a patient undergoes dialysis during his sleep while being hooked to a machine called a cycler.  This frees up the patient from any dialysis exchanges during the day while he works. 

3. Never miss or shorten your dialysis treatment

As you get on with your prescribed dialysis treatments, you will feel a sense of well being compared to the time when diagnosed. Your appetite will improve and you start gaining back the lost weight.  This is the best time to resume your career.  Unfortunately, for most patients, this is the time they cut back on the number of prescribed days or hours of dialysis, which results in the constellation of fatigue, weakness, nausea, swelling and/or shortness of breath recurring; brought about by the complications of their kidney failure like anemia, uncontrolled hypertension and volume overload.  They are back to square one. 

4. Comply with the prescribed diet and medications

It is a common misconception that dialysis is able to correct all the medical complications brought about by kidney failure.  Since a standard hemodialysis prescription is just 12 hours a week, this clearly is not enough to rid our body of all the toxins it accumulates 24/7. One of the most commonly prescribed medicines is a hormonal injection called erythropoietin which is meant to increase the red blood cells of our blood. A patient who is non-compliant runs the risk of developing severe anemia.  An anemic patient usually complains of dizziness, headaches, body weakness and palpitations.  As you know, these symptoms can greatly interfere with our ability to carry out activities even menial ones. 

5. Choose a good dialysis center that is near your work or home

Needless to say, choosing where you dialyze is one of the most important considerations you must make to maximize the benefits of your therapy. Is it equipped with state-of-the-art equipments to deliver the optimal clearance and ultrafiltration to make you feel better?  Does it have the expertise to address your dialysis requirements?  Does it have a good infection control program? When you have answered YES to all of the above questions, choose the one nearest you.  This saves you the inconvenience of a long travel time and the opportunity of complying with your dialysis treatments by leaving your office early or reporting late. 

Working with kidney failure is challenging but not insurmountable when one follows an expert’s advice and maintains a positive attitude.  Keeping a job is not only financially rewarding but is a fulfilling experience.

Hemotek Renal Center is on the 3rd Floor, PPL Bldg., United Nations Avenue corner San Marcelino Street, Paco, Manila. For inquiries, please call 536-1091 or visit www.hemotek.net or e-mail services@hemotek.net.