Sunday 10th July, location: Tower Bridge, London.

Yup, it’s the London Bridges walk again, in aid of Kidney Research. I’m looking forward to it again this year, it’s shorter, so 13 miles last year, just 7 this year. Easier on the feet, legs, body………

I’m being joined by Jordan again, my 11 year old son, and this year James is coming too, he’s 9 but is keen to take part.

More on this after the event. Not too late to join in!

Tags: Charity, kidney research, London Bridges Walk

On going to the local unit for dialysis last night, I was shown to one of the side rooms, normally set aside for isolation, but also used for general use when required – which is fine.

On checking the machine in preparation, I find that although the room has been steam cleaned after a previous isolation use, the machine has blood ingrained in the body of the machine, and on the control services. I was able to clean this off easily with a sterile wipe. On complaining about this to the sister in charge, she shrugged her shoulders and I did not see her at any time during the session to come and check on the issue. Complacency is NOT acceptable, and I find this incredibly annoying.

There are an increasing number of ‘rules’ to do with cleanliness given down from on high in Leicester, who ‘manage’ the unit, but shame the basics from the unit and also the hospital porters who carry out the steam cleaning lack any attention to detail. This is the second time in a week that I have had to clean blood off a machine’s control surfaces. The method of cleaning using bleaching agents is not enough, and the desire to rush to the next shift means that the machines, whilst might get a reasonably full wipe down, are not properly cleaned.

I suggest the management of the unit needs to pay closer attention to the whole process.

I accept that there is pressure to get a large number of patients ‘through the mill’ at handover, but the fact that staff that have resigned have not been efficiently replaced has increased pressures and as such procedures start to fall short of acceptable. Add to the fact that with the pressure due to staff shortages, this has increased the incidence of sickness, and is evident when the numbers of trained nursing staff is trimmed to dangerously low levels covering the shifts, we see the general downward spiral, which you can witness in any business when things are not kept in tight control.

I could go on about dialysate running out, no plasters…. blah, blah, blah!

I  must stop being a grumpy old bugger! (But yes, I am still angry about being presented with dirty machines).

Tags: attitude, dialysis, organisation, planning

Well, I now have dates for training on the NxStage. All being well, and with a following wind downhill, I start on the 15th on the unit and then the machine is installed at home the following week and I am supervised in the community (!) for 3 days and then set free!!  I will need to be signed off on the usual competencies for good dialysis practice as well as the competencies for the NxStage. I just need to consider that the bad habits of 20 years of self care are not too at odds with those competencies! I guess all the short cuts I take in prep etc to save time, albeit safe to do, are parked for now! Although in truth the shortcuts I take are only relevant to the Fresenius 4008. I will have to learn a whole stack of new ones!!

I am also going to have a week of daily dialysis on the Fresenius in May, which will be a good test and the blood result from that will not only help with drug dosage for InnoHep and Renagel, but also provide good comparisons for the NxStage so I can really judge what true benefits I am getting.

More soon!

Tags: daily dialysis, dialysis, Home Dialysis, NxStage, self-care, training

A new development on the unit in the last week. After dialysing for eleventy-ten years and self caring throughout that time, using 15g needles and high pump speeds, a ‘specialist’ nurse has now dictated that I should be using 14g needles with a pump speed in excess of 400ml/min. I currently run with  a pump  speed of around 470ml/min which tends to net out at a flow of 415ml/min. Interesting to read all the studies on this issue, that conclude that the needle size at 15g has now detrimental effect at high pump speeds. The only issue that manifests itself is a higher venous and lower arterial pressure, and this is primarily down to circuit pressure. I see no need therefore to change my needle size to 14g especially moving on to daily dialysis. My fistula, touch wood, has lasted for over 20 years, so I am adding to the risk of loss with daily dialysis without compounding the issue. Anybody else had a similar issue to address?

Tags: daily dialysis, Home Dialysis, self-care

Ok, a departure from my normal blog posts. Google has developed a monster with the SEO machine. If you run a small site, and your subject/product/service is a low key item then you may stand a chance of ranking on Google at some point, but if you are in a bigger industry, the competition to rank for your key terms will be cut throat.

Now Google, apparently frown on obvious link purchasing, and will penalise sites that do just that, yet the money that is being invested by businesses through SEO agencies to go out and buy ‘discrete’ links to look like they have been built naturally, is huge. In fact, it is fair to say, that unless you have fairly bottomless pockets, to not only build your ranking position, but maintain it when you get there, then you will never feature, and this is alos likely to be on the long tail terms also.

Frankly it’s a monster, and a farce. All that Google spout about impartiality and good ethical backlinks showing a site’s true worth, is a complete falsehood.

Most users are getting to grips with the fact that the search page shows bought placement and apparently FREE placement. Well, be warned, the top ranking sites in the FREE section have been bought also. It’s a moneypit, and a vast majority of big businesses have fallen for it and will continue to pay vast sums for ever more!! Maybe one day they will wake up – or will they be so scared their competitors will continue to spend they must continue too? Is this chicken or egg?

Hey, I’m lucky, my keywords are not that big, so I get to page one completely free of charge. I’d hate to be running a car insurance or mobile phone business!!

(UPDATE) – Interesting how all my posts get ranked immediately on Google as a latest feed, but for this subject, being negative, no where in sight! Is that really a surprise as it is a criticism of Google?

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