Here's a fictionalized account of Henderson's interaction with his doctor, focusing on his itching skin and restless leg syndrome:
Henderson's Appointment
Henderson sat in the waiting room, flipping through a magazine as he waited for his name to be called. He had been experiencing severe itching and restless leg syndrome for weeks, and it was affecting his quality of life. Finally, the nurse called his name, and he stood up, ready to discuss his issues with the doctor.
In the Doctor's Office
As Henderson entered the office, the doctor greeted him warmly. "Good morning, Henderson. How have you been feeling lately?"
Henderson explained, "Doc, I've been having this terrible itching all over my body. It's worse after dialysis, and I've also been experiencing restless leg syndrome. It's really disrupting my sleep."
The doctor nodded sympathetically. "Let's tackle these issues one by one. The itching could be due to several factors, including high phosphorus levels or dry skin. Have you been using any emollients or phosphate binders?"
Henderson replied, "I've been using some moisturizers, but I'm not sure about the phosphate binders. I'll check with my dialysis team."
The doctor continued, "We can also consider medications like gabapentin or difelikefalin for the itching. Difelikefalin is a new treatment that has shown promise for dialysis patients. Additionally, phototherapy with UVB light might help."
Regarding the restless leg syndrome, the doctor suggested, "For RLS, we can try gabapentinoids like gabapentin or pregabalin. These are effective for both RLS and itching. We should also ensure you're iron-replete and avoid medications that might exacerbate RLS. Intradialytic exercise, such as cycling, can also be beneficial."
Henderson asked, "What about lifestyle changes? Are there any specific things I can do to help manage these symptoms?"
The doctor advised, "Yes, staying active during the day can help with sleep. Avoid caffeine, alcohol, and nicotine, and maintain a regular sleep schedule. For itching, keeping your skin moisturized and avoiding warm temperatures can help."
Conclusion
Henderson left the office feeling hopeful. He had a plan to manage his itching and restless leg syndrome, and he was eager to start implementing the changes. With the right treatments and lifestyle adjustments, he was confident that he could improve his quality of life.
This interaction highlights the common issues faced by dialysis patients and the various strategies available to manage them. Itching and restless leg syndrome are prevalent among those undergoing dialysis, but with the right approach, these symptoms can be effectively managed.
Citations:
- http://www.davita.com/treatment-services/dialysis/on-dialysis/skin-problems-and-dialysis
- https://www.kidneyresearchuk.org/2023/04/17/first-itch-treatment-for-haemodialysis-patients-recommended-for-approval-by-nice/
- https://pmc.ncbi.nlm.nih.gov/articles/PMC8702820/
- http://www.bcrenal.ca/resource-gallery/Documents/Management%20of%20Restless%20Leg%20Syndrome%20in%20Patients%20with%20Chronic%20Kidney%20Disease.pdf
- https://pubmed.ncbi.nlm.nih.gov/16620140/
- https://stgrenal.org.au/for-health-professionals/learning-resources/symptom-management/restless-legs/
- https://kidneycareuk.org/kidney-disease-information/living-with-kidney-disease/managing-symptoms/patient-info-itching-and-chronic-kidney-disease-ckd/
- https://www.kidney.org/news-stories/coping-symptoms-while-dialysis
- https://kidneycareuk.org/kidney-disease-information/living-with-kidney-disease/managing-symptoms/patient-info-itching-and-chronic-kidney-disease-ckd/5-things-every-patient-needs-to-know-about-kidney-itching/
- https://pmc.ncbi.nlm.nih.gov/articles/PMC8094883/
- http://www.bcrenal.ca/resource-gallery/Documents/Management%20of%20Pruritus%20in%20Patients%20with%20Chronic%20Kidney%20Disease.pdf
- https://www.ontariorenalnetwork.ca/sites/renalnetwork/files/assets/HowToManageItchySkin.pdf
- https://www.kidney.org/kidney-topics/pruritus-itchy-skin
- https://revistanefrologia.com/en-pruritus-in-dialysis-patients-review-articulo-S2013251422000190
- https://www.kidneyfund.org/article/fda-approves-first-injection-treatment-help-alleviate-severe-itching-while-undergoing-dialysis
- https://www.kidney.org/news-stories/itching-and-kidney-disease
- https://kidneycareuk.org/kidney-disease-information/living-with-kidney-disease/managing-symptoms/patient-info-restless-legs-syndrome/
- https://www.ontariorenalnetwork.ca/sites/renalnetwork/files/assets/RestlessLegsSyndromeResource.pdf
- https://pmc.ncbi.nlm.nih.gov/articles/PMC7520405/
- https://www.youtube.com/watch?v=JzfSdJEgGtg
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