Georgetown : Even fruit juices in too large quantities could negatively affect persons suffering from diabetes. This is according to Clinical Manager at the Walter Reed Army Military Medical Center in Washington D.C., Dave Oliver, who is a specialist in clinical dialysis and a registered nurse infusionist. In essence, he has the expert capacity to support all technical spectrums of kidney disease ranging from prevention to treatment and transplant related issues. His expert ability is one of the reasons that he has been supporting renowned Kidney Transplant Surgeon, Dr Rahul Jindal, to undertake kidney transplants in Guyana.
According to Oliver while there are varying ways that can be used to address kidney failure, prevention should be placed at the pinnacle of addressing this health condition. Prevention awareness, according to him is in fact the least expensive alternative which includes being knowledgeable about one’s blood pressure, blood sugar and diet. “Being aware of these factors is very important for folks who may or do have some signs of kidney failure…” Taking precautionary measures such as pressure screens and the use of necessary medications are regarded as relatively inexpensive means of addressing renal failure.
Oliver pointed to the fact that high blood pressure is known to damage virtually every organ in the body with the most visible effect being kidney failure, heart conditions and vision problems.
Given the impact that a high blood sugar level can have on an individual with diabetes, Oliver said that it is especially important for “diabetics to avoid foods that are high in concentrated sugar which can damage many organs, especially the kidney which can help to push the pressure up. You need to control the foods.” And not only foods high in sugar could pose a threat to persons with diabetes as according to Oliver too much salt can also be dangerous.
Oliver’s contribution to the kidney transplant programme in Guyana will also include training of local health workers at the Balwant Singh Hospital, as according to him, “my goal is to make my needed presence obsolete. I would like to begin to train a few staff to take over my duties.” He nonetheless acknowledged that the hemo-dialysis capability of the nurses supporting the local transplant programme has been laudable. “The nurses here have done a marvelous job and are becoming better at what they do….the only thing missing is the peritoneal dialysis expertise aspect…it is not as technically difficult, as it does not require machines, a high level of training, huge resources such as facility space and time but it does require the expertise of knowing how it works in the theory,” Oliver asserted.
As such training of staffers will begin shortly which will include the proper use of catheters, Oliver said, adding that efforts will be made to make it (catheters) an available resource for Guyana. He further explained that the hierarchy of dialysis as it relates to cost puts the transplant operation at the top followed by hemo-dialysis which requires personnel, space, machinery and machinery maintenance. The lesser expensive mode of addressing kidney failure is that of peritoneal dialysis which requires a solution which is manufactured. The process uses the patient's peritoneum in the abdomen as a membrane across which fluids and dissolved substances (electrolytes, urea, glucose, albumin and other small molecules) are exchanged from the blood. Fluid is introduced through a permanent tube in the abdomen and flushed out either every night while the patient sleeps (automatic peritoneal dialysis) or via regular exchanges throughout the day (continuous ambulatory peritoneal dialysis). Although this measure is regarded as low-tech and mimics normal real function, Oliver pointed out that it must be done properly, “so what we are trying to do is to make sure that we have people here who can do it technically properly and that it can be evaluated and managed so that patients stay healthy…”
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