Sun Health  
     
     
Patient Education

Patient Education Resources


GFR and Kidney Function
GFR and NKF Guidelines / NKF
GFR Calculator /  WebLink
GFR PDA download /  WebLink







Dialysis
Renal Rehabilitation /  WebLink
National Kidney Foundation /  WebLink

LDL Apheresis
B.Braun LDL Apheresis /  WebLink
Kaneka Pharma LDL Apheresis /  WebLink


Cholesterol Education
New Cholesterol Guidelines /  WebLink

Prescription Discount Card


Sun Patient Card
Doctors Helping Patients

The Sun Patient Card is a prescription discount benefit of the SunAssociation. Look for other benefits in the future.

We welcome you to join the Association by trying the Prescription Discount Card.

- All prescription medicines are covered. Diabetes supplies
including test strips, insulin syringes and needles are covered.

- All major pharmacy chains are included. Many smaller pharmacies are also included. If your pharmacy is not part of the
network, please ask them to join.

- Membership in the Association is free for 1 year.

- Annual family dues after the first year will be $20.

- Easy activation: present the Sun Patient Card and your prescriptions to your pharmacy. Enrollment will be done by your pharmacist. Enjoy your saving instantly!

- Savings up to 35% compared to prescriptions filled with no
prescription drug card.

Please visit www.esunhealth.net to order your free card.

Medical Nutrition Therapy
By Sun Health

Medical Nutrition Therapy

One of the most important parts of treating and slowing the progression of kidney disease is diet. When patients are referred to the Chronic Kidney Disease Clinic, they will be seen by a Registered Dietitian who has been trained and certified as a specialist in kidney disease nutrition.

This service includes an initial visit of about 60 to 90 minutes and follow-up visits of about 30 to 45 minutes one month and three months later.

Medicare has recently started paying for this service. Most private insurance companies also will pay for Medical Nutrition Therapy.

Ambulatory Blood Pressure Monitor
By Sun Health

Ambulatory blood pressure monitoring is a technology that measures blood pressure over a period of 24 hours while you participate in your daily routine. A removable blood pressure cuff is placed on your arm that is attached to a monitor the size of a Walkman radio. You will be asked to keep a diary while you are wearing the device and record the time of day you sleep, exercise, work, and take medications.

The cuff takes readings automatically every 15 to 30 minutes, and stores them in its memory. After 24 hours, the information is downloaded into a computer and a report is given to you and your physician.

Because there are a significant number of blood pressure readings taken over a 24-hour period (outside of the doctor?s office) this technology is used to give your physician a better view of your true blood pressure. This information helps your physician prescribe and adjust your blood pressure medications.

Exercise and Dialysis
By Sun Health

The Easy Bike Program is a stationary bike program that is done during dialysis. It is designed to increase and maintain your fitness level as part of your dialysis treatment.

In order to begin the Easy Bike Program at Sun Health, you must have a stress test or a prescription from your primary doctor. Your nurse at dialysis can order a stress test for you.

There are 2 ways to join the Easy Bike Program. You may choose the one that is most comfortable for you.

1. Come in early to dialysis and ride the bike before your treatment. Sun Health has an exercise room for patients equipped with bikes, TV, and educational information.

2. Ride the bike during dialysis. To do this you will sit in your normal treatment chair with your feet down instead of up. A staff member will put the bike in front of you and get you started. You will begin your exercise program with 5 minutes of cycling and slowly increase your time up to an hour depending on how you feel.


Exercise is very important for dialysis patients!

*Increase heart fitness, muscle strength, & flexibility

*Improve ability to walk and do daily activities

*Possible decrease in blood pressure (if yours runs high) & use of blood pressure meds

*Improve blood count

*Easier removal of fluid during your dialysis treatments

*Decrease amount of leg cramps

*Better appetite and sleep patterns

Waste products that build up between dialysis treatments and lack of exercise can lead to loss of muscle tone and muscle mass. Exercise is very important for people on dialysis to maintain and improve fitness levels.

Dry Weight
By Sun Health

Understanding Dry Weight

TOO DRY

When you are too dry, you have too little water in your body. During or after dialysis you may experience:

- Unusually high or low blood pressure
- Nausea
- Cramping
- Raspy Voice
- Lots of yawning
- Extreme tiredness
- Very dry mouth
- Dry, droopy skin

This can happen if too much water is taken off during dialysis.

If you are eating more than usual, let the dialysis staff know.


BALANCED

When you are balanced, you have just the right amount of water in your body, not too much and not too little. This means you are at your dry weight.

Your body weight should be about half water. Healthy kidneys keep your water in balance. The more you drink, the more you urinate. This does not happen when you have kidney failure. The water you drink stays in your body. Your dry weight is estimated using these tools:

- Usual body weight
- Critline, BIA, and BioZ
- Blood pressure
- Assessment of swelling in hands and feet
- Lung sounds
- How you feel


OVERLOADED

When you are overloaded, you have too much water in your body. You may experience:

- Swelling of hands, feet, ankles, face
- Shortness of breath when lying down or with exertion
- Fluid on lungs
- Bloated, heavy feeling
- Unusually high or low blood pressure
- Cough

This can happen if you drink more liquids than your body can handle or if you eat too little food.

If you are eating less than usual, let the dialysis staff know.

WHAT DIALYSIS CAN AND CANNOT DO:

Dialysis Can:
- Remove waste-urea, creatinine, potassium, phosphorus
- Remove water

Dialysis Cannot:
- Remove muscle, fat or protein
- Make you lose dry body weight

Finding your body fluid balance is very important for dialysis patients to feel good, maintain adequate blood pressure readings and stay away from problems relating to too little or too much body fluid, including shortness of breath.

Sun Health Dialysis uses 3 state-of-the-art technologies to help establish proper dry weights.

1. Crit Line
A crit line monitors a patient's blood count throughout a dialysis treatment and alerts staff when too much fluid is being taken off during treatment. A crit line also monitors oxygen levels in the blood during dialysis treatments.

2. Bioelectrical Impedance Analysis (BIA)
Bioelectrical Impedance Analysis (BIA) is a non-invasive totally painless test given before a dialysis treatment using 4 EKG electrodes. The entire test takes less than 5 minutes. It is used to estimate how much water is inside the cells and how much is outside the cells. BIA measures the amount of lean tissue (ie. muscle and bone), water, and fat are in your body.

3. BioZ
The BioZ measures fluid in the chest and cardiac output (how hard your heart is pumping). This helps your doctor monitor your dry weight and also evaluate any blood pressure medication you may be taking.

Together, this information helps Dr. Chawla and the Sun Health staff determine your nutritional and fluid status. Malnutrition, dehydration, or fluid overload can be detected earlier than if only your body weight is being monitored.

The goal of customizing dry weight is to reduce cramping, reduce low blood pressure episodes during dialysis and feeling tired after treatments, as well as reducing hospitalizations due to fluid overload.

Skin Care
By Sun Health

Why Does My Skin Itch?

Many people on dialysis experience itchy skin at one time or another.

The cause of this itching is not well understood. The following reasons can contribute to itchy skin:
*High phosphorus level
*High calcium level
*High parathyroid level
*Not enough or inadequate dialysis
*Dry skin
*High blood sugars

Bathing and Dry Skin
It is very important for people on dialysis to keep skin clean and well moisturized.

*Bathe or shower daily. Use bathoils, superfatted soap (Basis®) or oatmeal (Aveeno®) in bath water.

*Pat skin dry gently after bathing.

*Use lukewarm water; hot water can be very drying to the skin.

*Apply lotion or cream immediately after bathing. Warm lotion is absorbed better than cool lotions.

*Instead of scratching, try rubbing lotion into your skin.


Phosphorus is Important!
High phosphorus and/or calcium levels may cause itchy skin.

Look at your lab report every month. If your phosphorus level is higher than 6.0, consider making some dietary changes. Always remember to take your phosphorus binder or calcium supplement!

Ask your dietitian, nurse or physician if you are unsure of what action to take.

Helpful Hints to Remember Phosphorus Binders or Calcium Supplements

*Ask for help from your family
*Keep your meds on the kitchen table where you will see them.
*Keep a few binders/supplements in a small plastic container to store in your pocket, purse or car for eating out.
*Hang a ?reminder? sign in a highly visible place.

Additional Relief

*Make sure you are getting enough dialysis.
*If you are diabetic, make sure your blood sugars are controlled.
*Use cool, moist compresses on itchy areas instead of scratching.
*Try using perfume free and dye free laundry detergent.
*Wear cotton clothing; it may be less irritating to skin than other fabric.
*Daily activities or exercise may leave you tired enough to sleep at night.
*Try using a humidifier at home, especially in the winter.
*Ask your doctor if there are medicines you can take to help relieve itching.

Dry, itchy skin is a common problem for people on dialysis. The reasons for these skin problems are not well understood.

Daily skin care, adequate dialysis, following your diet, and taking prescribed medicines can all help prevent itchy skin.


Diabetes Education Program
By Sun Health

To enroll in the Diabetes Education Program, you will need a referral from your physician. The Sun Health staff will provide referral forms and information to your physician, or one can be downloaded from this website. The first appointment is an assessment appointment. The educator will review what your history and needs are, obtain a height, weight, BMI, and foot check.

The second appointment is a week after your assessment appointment. You will meet with the nurse and dietitian who will provide you with an individualized meal plan and teach you about your specific diabetes needs. Often this includes blood glucose monitoring and medication teaching. If you do have a glucose meter, one will be provided free of charge. A full report will be sent to your primary doctor.

Over the next 9 months you will meet with the nurse and dietitian to review your educational goals, continue teaching as needed, and download your glucose meter. These reports will be sent to your doctor.

The Sun Health educators are Jodi Limacher, RD MS CDE and Barbara Madden, RN BSN. Both specialize in diabetes education and are available to answer any question you may have. The Sun Health Diabetes Education Program received recognition from the American Diabetes Association in April, 2002. This means that Sun Health has proved standards of excellence and also that Medicare and most insurances will pay for services received at Sun Health. Medicare will not pay for services at programs that do not have ADA recognition. Sun Health is the only program on the west side of Joliet that is Medicare approved.

Most insurance plans also pay for diabetes education. Sun Health will verify all your benefits before you start the program. For more information, please call 815-744-9300.

Education Program For Pregnant Women With Diabetes
By Sun Health

What is Diabetes?

Our bodies change the food we eat into sugar (glucose) and need insulin to move sugar from the blood into body cells. When there is not enough insulin, sugar levels in the blood get too high and cause health problems.

There are 3 types of diabetes:

Type 1: Occurs when there is very little or no insulin made by the body.

Type 2: Occurs when there is not enough insulin made by the body, or the body is not using insulin properly.

Gestational: Occurs only in pregnancy and usually goes away after the baby is born.


If you have been previously diagnosed with Type 1 or Type 2 diabetes and are either pregnant or considering pregnancy there are some special considerations that need to be made:

Considering Pregnancy

If you have Type 1 or Type 2 diabetes and want to become pregnant, it is important to get your blood sugar in control first.

Talk to your doctor about doing a hemoglobin A1C test and ask your doctor about your hemoglobin A1C goal.



Can I take my diabetes pills if I become pregnant?

Because oral diabetes medications cross the placenta, you should stop taking these pills if you become pregnant. Your doctor will likely switch you to insulin injections. In fact, it is best to do this before you become pregnant.


What could happen to my baby?

Unfortunately, women with diabetes are at higher risk for miscarriages, premature delivery, low birth weight babies, and babies with birth defects.


Preventing problems:

· Obtain optimal blood sugar control before becoming pregnant

· Follow-up with your obstetrician and diabetes doctor regularly

· Monitor your blood sugar frequently

· Take your insulin as instructed


Sun Health Diabetes Education follows women with:

· Gestational Diabetes

· Type 1 or Type 2 Diabetes who are considering pregnancy


Education Program Includes:

· A complete assessment to determine each individual?s needs.

· Personalized education session including meal planning, exercise planning, blood glucose monitoring, medication teaching, self care teaching.

· Weekly follow-ups for weight, ketone monitoring, and glucose meter downloads and reports.


A registered dietitian and registered nurse specializing in diabetes education teach the self-management program.


For more information, please contact Jodi Limacher, MS RD CDE at 815.744.9300

Education Program for Gestational Diabetes
By Sun Health

What is Diabetes?

Our bodies change the food we eat into sugar (glucose) and need insulin to move sugar from the blood into body cells. When there is not enough insulin, sugar levels in the blood get too high and cause health problems.

There are 3 types of diabetes:

Type 1: Occurs when there is very little or no insulin made by the body.

Type 2: Occurs when there is not enough insulin made by the body, or the body is not using insulin properly.

Gestational: Occurs only in pregnancy and usually goes away after the baby is born. It happens because pregnancy hormones work against the action of insulin, making it less effective. Gestational diabetes is usually detected between the 24th - 28th week of pregnancy. This is because pregnancy hormones are usually at their highest levels during this time.

Risk Factor Quiz

Are you a member of a high-risk ethnic group (Hispanic, African American, Native American, South or east Asian, Pacific Islander, or Indigenous Australian?)

Are you overweight or very overweight?

Are you related to anyone who has diabetes now or had diabetes in their lifetime?

Are you older than 25?

Did you have gestational diabetes with a past pregnancy?

Have you had a stillbirth or a very large baby with a past pregnancy?

If you answered YES to TWO or more of these questions, you are at HIGH RISK for gestational diabetes.

What could happen to my baby?

When gestational diabetes is detected early, it can be managed and controlled to prevent complications for both you and your baby. However, when blood sugar is not kept in control, there are two possible problems:

· Large baby (macrosomia). The excess sugar in your blood will cross the placenta. In turn, your baby will make extra insulin, causing your baby to grow faster and bigger. Occasionally, this will require that your baby be delivered by cesarean section.

· Low blood sugar (hypoglycemia). If your blood sugar is not well controlled at the time of delivery, your baby may have a sudden drop in his own blood sugar. This is due to your baby?s high insulin levels. It is very important to control your own blood sugar so that your baby will lower his own insulin levels gradually before he is born.

Keeping your blood sugar at a normal level during pregnancy and right before your delivery can prevent these problems.

Sun Health Diabetes Education follows women with:

· Gestational Diabetes

· Type 1 or Type 2 Diabetes who are considering pregnancy


Education Program Includes:

¨ A complete assessment to assess each individual?s needs.

¨ Personalized education session including meal planning, exercise planning, blood glucose monitoring, medication teaching, and self care teaching.

¨ Weekly follow-ups for weight, ketone monitoring, and glucose meter downloads and reports.

· Post-partum follow-up for weight loss counseling and at risk profiling for Type 2 Diabetes.

A registered dietitian and registered nurse specializing in diabetes education teach the self-management program.

For more information, please contact Jodi Limacher, MS RD CDE at 815-744-9300.


Infusion Therapy


Sun Health Infusion Therapy offers ambulatory IV services in a safe and comfortable environment. Short-term and long-term intravenous (IV) therapy are provided with special attention and careful monitoring.

To ensure safety, all IV treatments are administered through an electronic pump under the supervision of a Registered Nurse. IV therapy can last from one half hour to several hours, depending on your prescription.

If you are well enough to be at home, but still need IV medication, your doctor may prescribe outpatient Infusion Therapy instead of admitting you to the hospital or nursing home.

Medicare and most insurances pay for outpatient infusion therapy. Sun Health will verify your Medicare and/or insurance to ensure this is a covered benefit.

Available services:

¨ Intravenous antibiotics

¨ Intravenous SoluMedrol

¨ Subcutaneous Erythropoietin

¨ PICC line management

¨ Central line management

¨ On site lab

¨ Insurance verification

¨ Care coordination with patients and families

¨ Close communication with referring physicians

¨ Convenient scheduling 7 days a week

¨ Easy parking and first floor clinic


Advantages to receiving Infusion Therapy in an outpatient setting include:

= Decreased time in hospital or nursing home

= Ability to return to work or school

= Decreased risk of infections

= Less expensive



For additional information about Infusion Therapy or any other services offered at Sun Health, please call 815-744-9300.



 


Related Documents: