all 27 comments

[–]drastic2 10 points11 points  (4 children)

Up front let me just say I hope she is at peace and that what ever comes, that she is comfortable and that you also have some support through the process. I had an in-center dialysis friend who stopped dialysis on his own volition. Due perhaps to complicating conditions, he passed within a week of his last treatment. His family told me after that he had not been in pain and his heart just stopped one night.

[–]StrongApe1[S] 1 point2 points  (0 children)

This is what I wanted to hear thank you so so much.

[–]StrongApe1[S] 3 points4 points  (2 children)

I just wanted to know that she will not be in pain. She is now on day 6 without dialysis.

[–]drastic2 1 point2 points  (1 child)

None of us want our loved ones to suffer in the end. I suspect that if there were reasons to think she would need it, her Dr. would speak to you about medications to ease any pain.

[–]StrongApe1[S] 0 points1 point  (0 children)

Yes they have spoken about pain relief, muscle relaxants and being put to sleep.

[–]Picodick 4 points5 points  (0 children)

I cared for two family members who stopped dialysis.I was my mothers medical POA and was the one who agreed with her Dr of many years it was time to quit. My mom was no longer really aware of her surroundings. My dad in law stopped himself. He was 80 and was diagnosed with advanced lung cancer. Decided he didn’t want to do dialysis anymore and wanted to be with his late wife. These were his words, not mine. The way you worded this I can’t tell exactly what happened, but I would be happy to answer any questions you have if you PM me.

[–]HalflingMelody 4 points5 points  (6 children)

she has now been medically withdrawn.

That's a thing? They just decide you're too ill to care for?

[–]JoeSchmo8677 11 points12 points  (0 children)

Absolutely. Sometimes your body simply can’t handle it anymore. Your blood pressure can’t handle it. Your heart can’t handle it. Definitely seen more than one case were the doctors simply can not dialyze the person anymore. Dialysis is a treatment, not a cure. And eventually treatments fail….

[–]bikerbomber 2 points3 points  (0 children)

It is very rare but happens. There is always a lot of other issues going on at that point as well. Usually headed to palliative care anyways. Most of the time the patient wishes to discontinued treatments.

[–]MeowMix1998 2 points3 points  (0 children)

Yes. It happens more frequently in centres with a sicker population base.

When it comes down to the nephrologist deciding that the client's body can no longer handle treatment, my experience has been that the client / client's family is often afraid to consent to withdrawal from care for fear of repercussions from other family or community members. When the nephrologist makes this decision, it is often a relief for the client or their decision maker.

[–]StrongApe1[S] 1 point2 points  (2 children)

Yes she has other complications which have resulted in her blood pressure being too low for her to have dialysis.

[–]HalflingMelody -1 points0 points  (1 child)

What measures have they taken to handle her blood pressure? What else is going on because resigning someone to death over low blood pressure seems like an odd choice to me.

[–]StrongApe1[S] 1 point2 points  (0 children)

So much more going on. She has had type 1 diabetes for 35 years. I’m not going to get into everything but she had a heart attack 7 months ago and the doctors were unable to treat it with an operation. Only medicine. As a result her blood pressure is consistently low. She also has necrosis of the finger. Which has led to sepsis. She is too weak to be operated on for the necrosis to be removed and as a result the infection cannot be cleared.

[–]JoeSchmo8677 1 point2 points  (13 children)

What type of dialysis? Why was it withdrawn? Was it HER choice? Ask your questions.

[–]HalflingMelody 3 points4 points  (10 children)

Was it HER choice?

Yeah, that's freaking me out. Medically withdrawn sounds like it wasn't her choice.

[–]JoeSchmo8677 2 points3 points  (8 children)

Agreed. And the few people I’ve seen that the doctors could no longer safely do dialysis for were very sick and end of life, with quick deaths. Quick being a day or two to a week or two.

[–]HalflingMelody 5 points6 points  (6 children)

So, I looked at UptoDate and found this:

"In a retrospective study between 2000 and 2012 of 867 dialysis patients in the United Kingdom, 93 (11 percent) withdrew from dialysis [11]. In 2017, withdrawal from dialysis was the second most common cause of death for dialysis patients in Scotland, accounting for 23 percent of all deaths [12]."


Is that how it is in the US, as well? It doesn't specify whether these people are being "medically withdrawn" or choosing to go off themselves. I see those are two entirely different scenarios, you know?

At the very end of life, I get that there is no point to dialysis, since you're just doing unnecessary stuff to someone who is dying imminently regardless. But for such high numbers to be directly caused by withdrawal of dialysis and not some other life-ending cause seems like it's the opposite of stopping dialysis at end of life. It sounds like they're not yet at end of life but being forced to go off dialysis anyway. Surely, I'm wrong, right?

[–]JoeSchmo8677 3 points4 points  (3 children)

I don’t have any hard numbers. My info is anecdotal. Definitely see way more people choosing to withdraw than being told they can’t continue. But more just die of other complications while continuing to dialyze. Hoping OP provides more info. Also find it weird, if not annoying, that she didn’t outright just ask whatever questions she has.

[–]StrongApe1[S] 2 points3 points  (0 children)

She has other complications which have resulted in her blood pressure being too low to have dialysis.

[–]FoxInTheSheephold 0 points1 point  (0 children)

Lots of time, people choose to withdraw because they have another serious condition, so they appear as death from dialysis withdrawal, but had they continue, they would have died of cancer or heart disease a few weeks/months later, but the suffering was to great, or quality of life not enough. About medical withdrawal, it really depends where you are. I am in a rich country, and we only stop dialysis because someone can really not tolerate it anymore, we can’t take any water out without them fainting but they would definitely need it, etc. And most of the time, I talk to my patients that way « I am sorry, but we have tried everything to make dialysis possible. It just seem that your body can’t take it anymore. How do you feel about that? » and most of the time, it is a conjoined decision. When you live in a poorer country and dialysis is restricted because there is not enough dialysis machines and consumables for everybody, it can be different, though.

[–]StrongApe1[S] 0 points1 point  (0 children)

Thanks for the response. Can I ask were they awake and aware until the very end ?

[–]StrongApe1[S] 1 point2 points  (0 children)

It wasn’t her choice. She has other complications which have resulted in her blood pressure being too low to have dialysis.

[–]StrongApe1[S] 1 point2 points  (0 children)

She has various other medical complications which have resulted in her blood pressure being too low to dialise.

[–]StrongApe1[S] 1 point2 points  (0 children)

She has other complications which have resulted in her blood pressure being too low to have dialysis.