My patient’s stomach felt hard – not because he had a six-pack, but because the pressure in his stomach was much higher than in a healthy person. No wonder, because the man came to us with pancreatitis, an inflamed pancreas. Infections quickly lead to an increase in pressure. An unpleasant matter: incredibly severe stomach pain, fatigue, nausea, fever – my patient had not eaten anything at all. It is likely that the infection in his gall bladder – he also had one – had backed up into the pancreas. The pressure in his stomach was now affecting the kidneys, because they had to overcome more resistance in their work. In the worst case scenario, this leads to kidney failure – and that is exactly what happened to my patient. He had to go on dialysis.
The dialysis machine does the job that a healthy kidney would normally do: filter toxins out of the body. There are many reasons why the kidneys are unable to function properly and a machine is needed – my patient, for example, had abnormal cells in his pancreas, which made him susceptible to a number of things. One thing led to another, or to put it simply: the man was just unlucky.
SZ nursing column: On the ward, episode 79
:What alcohol can do
Pola Gülberg repeatedly treats patients with an inflamed pancreas – a very painful disease that can be fatal. What many people don’t know is that in many cases it could be prevented.
Minutes: Johanna Feckl
Our dialysis machine is a big machine, about the size of a medium-sized refrigerator. The patient’s blood is fed into it and diluted with a liquid. It then continues to flow, while the dialysis liquid – the dialysate – is around it and filters toxins out of the blood. You can imagine the dialysate as a kind of magnet: it attracts the harmful substances towards itself.
A dialysis cycle on our machine lasts 72 hours, or three days. That’s a lot of time to rid a person’s entire blood of all toxins – and therefore a very gentle option. In my patient’s case, we even reduced the flow rate so that the blood is cleaned even more slowly and therefore more gently. There is only about 500 milliliters of blood in the dialysis machine at a time, while the rest continues to circulate in the body. Because if you are already sick and weakened, the more blood is missing from the body, the more sick and weakened you are.
Open detailed viewIntensive care nurse Pola Gülberg from the Ebersberg District Hospital. (Photo: Peter Hinz-Rosin)
After one cycle, we turned the machine off again for my patient. His condition had improved and so we wanted to see whether his kidney would start working again – not every case of kidney failure immediately requires a donor organ. It was only after 24 hours that the man’s bladder catheter filled up – a sign that the organ was working. Nevertheless, a laboratory test was necessary because it could have been that not all of the harmful substances had been filtered out. My patient was lucky in his misfortune: his kidney was functioning perfectly again.
Pola Gülberg is an intensive care nurse. In this column, the 40-year-old talks every week about her work at the district hospital in Ebersberg. The collected texts can be found at sueddeutsche.de/thema/Auf Station to find.
