How do blood thinners affect menstrual cycles. What are the potential impacts of anticoagulants on menstrual flow. When should you consult a doctor about changes in your period while on blood thinners. How can women manage heavier periods caused by anticoagulant medications.

The Impact of Blood Thinners on Menstrual Cycles

Many women who are prescribed blood thinners have concerns about how these medications might affect their menstrual cycles. While anticoagulants typically do not alter the frequency or regularity of periods, they can have notable effects on menstrual flow.

Do blood thinners increase menstrual bleeding? Yes, anticoagulant medications can lead to heavier menstrual flow and a slightly higher likelihood of passing blood clots during menstruation. This occurs because blood thinners interfere with the body’s normal clotting processes, which can result in more prolonged and profuse bleeding during menstruation.

However, it’s important to note that while increased bleeding is possible, there are usually no special preparations needed when starting blood thinners. The key is to be aware of the potential for heavier periods and to monitor your flow carefully.

When to Seek Medical Advice

At what point should you consult your doctor about menstrual changes while on blood thinners? If you find yourself needing to change sanitary products more frequently than every two hours during the first day or two of your period, it’s advisable to inform your healthcare provider. This level of bleeding may be considered excessive and warrant medical attention.

Understanding Blood in Urine: Causes and Diagnostic Approaches

The presence of blood in urine, medically known as hematuria, can be alarming and may stem from various underlying conditions. While it doesn’t always indicate a serious problem, it’s a symptom that should never be ignored.

What are the potential causes of blood in urine? Hematuria can result from:

• Intrinsic kidney disease
• Kidney stones
• Tumors in the upper or lower urinary tract
• Urinary tract infections
• Medication side effects

How is hematuria diagnosed? Physicians typically employ a multi-faceted approach to diagnose the cause of blood in urine:

1. Cystoscopy: A urologist examines the bladder lining and urethra using a thin, flexible scope.
2. CT scan: This imaging technique assesses the upper urinary tract, including the kidneys and ureters.
3. Urinalysis: Analysis of urinary sediment can reveal signs of intrinsic kidney disease.

In cases where chronic pain medications are involved, it’s crucial to consider the possibility of medication-induced kidney damage or bleeding. If standard evaluations fail to identify the cause, consultation with a nephrologist may be necessary for a more in-depth assessment of kidney function.

The LEEP Procedure and Post-Operative Care

The Loop Electrosurgical Excision Procedure (LEEP) is a common gynecological procedure used to remove abnormal cervical tissue. Following this procedure, proper post-operative care is essential for optimal healing and to reduce the risk of complications.

Douching After LEEP: Guidelines and Precautions

Why might a doctor recommend douching after a LEEP procedure? Douching with a vinegar solution can help maintain proper vaginal pH and reduce the risk of infection during the healing process. However, it’s crucial to follow your doctor’s specific instructions regarding timing and frequency.

How should you prepare a vinegar douche solution? A simple and effective solution can be made by mixing one part vinegar with three to four parts water. This dilution helps ensure the solution is not too acidic and less likely to cause irritation.

What equipment do you need for douching? You can use a commercially available douche kit or a simple squeeze bottle. Whichever method you choose, it’s important to clean the equipment thoroughly with warm, soapy water between uses to prevent bacterial growth.

Are there any risks associated with douching after LEEP? While generally safe when performed as directed by your healthcare provider, douching can potentially cause irritation or discomfort. If you experience any unusual symptoms or pain during or after douching, it’s important to inform your doctor promptly.

Frequent Urination: Causes and Management Strategies

Frequent urination, characterized by the need to urinate multiple times within a short period, can be both bothersome and indicative of underlying health issues. Understanding the potential causes is the first step in finding an effective solution.

Common Causes of Frequent Urination

What conditions can lead to an increased need to urinate? Several factors may contribute to frequent urination:

• Irritable bladder syndrome
• Urinary tract infections
• Food sensitivities
• Hormonal changes (e.g., during menopause)
• Weakened pelvic floor muscles (often due to pregnancy and childbirth)
• Bladder prolapse

Diagnostic Approach and Management Strategies

How can you identify the cause of frequent urination? The diagnostic process typically involves:

1. Eliminating potential dietary triggers (caffeine, alcohol, citrus foods)
2. Conducting a urine culture to rule out infection
3. Consulting with a urologist for specialized testing if necessary

What treatment options are available for frequent urination? Depending on the underlying cause, treatments may include:

• Dietary modifications
• Pelvic floor exercises
• Medications to relax bladder muscles
• Hormone replacement therapy for menopausal women
• Surgical interventions for structural issues like bladder prolapse

The Role of Hormones in Bladder Health

Hormonal fluctuations throughout a woman’s life can significantly impact bladder function and urinary habits. Understanding this connection can help women better manage their urinary health at different life stages.

Menopause and Bladder Changes

How does menopause affect bladder function? The decline in estrogen levels during menopause can lead to several changes in the urinary system:

• Weakening of bladder muscles
• Thinning of the urethra lining
• Decreased bladder capacity
• Increased susceptibility to urinary tract infections

These changes can result in symptoms such as frequent urination, urgency, and incontinence. Hormone replacement therapy may be considered as a treatment option in some cases, although it’s important to discuss the potential risks and benefits with a healthcare provider.

Pregnancy and Postpartum Bladder Issues

How do pregnancies affect bladder health? Multiple pregnancies can lead to:

• Weakened pelvic floor muscles
• Increased pressure on the bladder
• Changes in bladder position (bladder prolapse)

These changes can persist after childbirth, contributing to urinary symptoms such as frequent urination, stress incontinence, and the constant sensation of needing to urinate. Pelvic floor exercises, also known as Kegel exercises, can be particularly beneficial in strengthening the muscles that support the bladder and improving urinary control.

Innovations in Women’s Urological Health

Recent advancements in medical technology and treatment approaches have significantly improved the management of women’s urological health issues. These innovations offer new hope for those struggling with chronic bladder problems and other urinary tract disorders.

Minimally Invasive Surgical Techniques

How have surgical options for bladder issues evolved? Modern surgical approaches for treating conditions like stress incontinence and pelvic organ prolapse now include:

• Tension-free vaginal tape procedures
• Robotic-assisted laparoscopic surgeries
• Injectable bulking agents for urethral support

These minimally invasive techniques often result in shorter recovery times, less post-operative pain, and improved outcomes compared to traditional open surgeries.

Neuromodulation Therapies

What are neuromodulation therapies for bladder control? These innovative treatments involve stimulating specific nerves to improve bladder function:

• Sacral neuromodulation
• Percutaneous tibial nerve stimulation

These therapies can be particularly effective for patients with overactive bladder or urge incontinence who haven’t responded well to more conservative treatments.

Holistic Approaches to Women’s Urological Health

While medical interventions play a crucial role in managing urological issues, holistic approaches can complement traditional treatments and improve overall bladder health.

Dietary Modifications for Bladder Health

How can diet impact bladder function? Certain foods and beverages can irritate the bladder and exacerbate urinary symptoms. Consider avoiding or limiting:

• Caffeine
• Alcohol
• Artificial sweeteners
• Spicy foods
• Acidic fruits and juices

Increasing water intake and incorporating bladder-friendly foods like pears, watermelon, and whole grains can also support urinary tract health.

Mind-Body Techniques for Bladder Control

Can mental strategies improve bladder control? Several mind-body techniques have shown promise in managing urinary symptoms:

• Mindfulness meditation
• Biofeedback therapy
• Yoga for pelvic floor strength

These practices can help improve awareness of bladder sensations, reduce stress-related urgency, and enhance overall pelvic floor function.

By combining medical treatments with lifestyle modifications and holistic approaches, many women find significant relief from urological symptoms and improved quality of life. It’s important to work closely with healthcare providers to develop a comprehensive management plan tailored to individual needs and preferences.

Specialist Answers on Women’s Health Problems

By Dr. Orli Etingin

Reviewed: February 4, 2008

Fact-Checked

Q1. I just started taking a blood thinner. Will it affect my period? And if so, how? I’d like to know what to expect and whether I should do anything to prepare.

— Judith, North Carolina

Blood thinners usually do not affect how often you get your period, but they can increase the flow of blood and slightly increase the chance of passing clots during your period. That said, there is nothing special to prepare for when you take blood thinners. Just be aware of the possibility of increased bleeding, and let your doctor know if the bleeding seems excessive (that is, if you have to change your tampons or pads more than every two hours in the first day or two).

Q2. I have blood in my urine. My doctor checked my bladder with a scope twice and said it looks fine. I have back problems and take a lot of medication for the pain — I wonder whether this might have anything to do with the blood I’m seeing. Any suggestions?

— Sandra, West Virginia

Blood in the urine can be a sign of intrinsic kidney disease, kidney stones, tumors of the upper and lower urinary tract, and a number of other things, including a urinary tract infection.

Cystoscopy is a procedure by which a urologist looks at the bladder to inspect its lining and the urethra, the tube that leads from the bladder to the outside of the body. Another important step in the evaluation of blood in the urine is the assessment of the upper urinary tract. This is usually performed with a CT scan that images the kidney and the lining of the urinary tract, from the kidney all the way to the bladder.

Chronic pain requiring extensive oral medications can lead to a number of conditions, including kidney damage and bleeding. If a standard evaluation of the upper urinary tract (with CT) and lower urinary tract (with cystoscopy) fails to find any abnormalities, the possibility of intrinsic kidney disease should be considered. Analysis of the urinary sediment (the solid particles in the urine) can detect signs of intrinsic kidney disease. Results of such a urinalysis are usually evaluated by a physician trained as a nephrologist.

Q3. I recently had a LEEP procedure, and my doctor told me to douche with vinegar after two weeks. I’ve never douched before. How do I do it? Is there anything I should know before I start? And am I better off just buying a douching product in the store?

— Suzanne, Pennsylvania

Douching involves rinsing the inside of the vagina with water or some other liquid. It’s usually done to treat an infection or inflammation, though some women use douches to decrease vaginal odor.

You can use a commercially available douching product, though these often contain preservatives, which can sometimes cause vaginal irritation but aren’t otherwise harmful. Since your doctor recommended using vinegar, however, you can simply dilute one part vinegar to three or four parts water and douche with that. Buy a simple squeeze bottle or a douche kit at the drugstore, and be sure to rinse it off with warm soapy water between douches. Let your doctor know if you notice any irritation or pain once you start douching.

Q4. I think I have a bladder problem. During one hour I need to go as many as three to four times. I drink water and other liquids, but I don’t drink an excessive amount. What could it be?

— Jennifer, North Carolina

It could be any number of things. Bladder problems are very common in women of all ages. They can be caused by infections, inflammation, sensitivities, and the overall physical condition of the bladder. The scenario you describe sounds like “irritable bladder,” in which the bladder is hypersensitive and feels full even if it’s not. This can be the result of an infection or a sensitivity to a specific food. The first thing to try is to eliminate caffeine, alcohol, and citrus foods, and get a urine culture to be sure you don’t have an infection. If altering your diet doesn’t work and you don’t have an infection, the next step is to see a urologist for further testing.

A few other common causes of bladder problems are related to age and pregnancy. A change in your hormonal status, like that which happens during menopause, often causes bladder muscles to weaken and the bladder to feel full even when it’s not. Multiple pregnancies can cause bladder muscles to lose their firmness, allowing the bladder to “fall” into the pelvis, causing the constant sensation of needing to urinate. The good news is that there are effective treatments for all of these conditions, so if you don’t get relief from changing your diet, do see your doctor. Chances are he or she can help.

Learn more in the Everyday Health Women’s Health Center.

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Heavy menstrual cycles and those anticoagulant drugs you’re taking – Heart Sisters

by Carolyn Thomas   ♥   @HeartSisters

Sara Wyen is a writer and founder of Blood Clot Recovery Network, a site that helps patients through the recovery process from deep vein thrombosis* or pulmonary embolism*. Her own story about a freakishly heavy period while taking her anticoagulant medication is a good one to share with any women you know who are prescribed these drugs.    .            .    

Sara was just 29, a runner (even a coach of other runners), eating right, and beginning what she calls her dream career – when her life was forever changed after an undetected blood clot in her leg suddenly broke free and lodged into her left lung.  

“I went from being happy, healthy and sure of the direction my life was taking to being gravely unhealthy, unsure of anything, and in the worst pain I could ever recall.”

Sara was discharged from the hospital on low molecular weight heparin blood thinning injections. Heparin is an anticoagulant drug that treats and prevents the formation of blood clots, often used in patients after heart attack, atrial fibrillation or any condition linked to an increased risk for blood clots.  Anticoagulants are sometimes called “blood thinners”. They don’t actually thin your blood, but they can help prevent blood clots from forming.

Sara now advises women who start taking anticoagulants that the first question to ask their doctors should be:

“Should my menstrual cycle be this heavy while taking anticoagulants?”

Sara says she worried if heavy periods would become a major issue for her, since she had already struggled for a long time with uncomfortable periods.

Although her periods were more frequent and slightly heavier at first following treatment for her blood clot, her menstrual cycle eventually returned to what had been “normal” for her – “unpredictable, but mostly manageable.”

But one day, her period arrived at the regular time yet significantly heavier than usual. Sara says she wasn’t alarmed – at first.

“My first thought was, ‘Good. I’ll get it all out of the way in a day or two!’  I began to grow more and more concerned as the third day of my cycle arrived, and the bleeding worsened. By that time, I was going through a 10-hour pad in less than one hour, and I was soaking through my clothes. My doctor instructed me to go immediately to the Emergency Department, which I did – now completely panicked about my situation. After several hours, it was determined that I had uncontrolled uterine bleeding. In my case, it was a period that wasn’t stopping. The cause was an INR level that was way too high, which I did not know about. I needed a reversal treatment (oral vitamin K), to help bring my INR back into a safe range. I am very fortunate that I did not need a blood transfusion. The Emergency staff told me repeatedly that it was good I came in when I did because the bleeding may not have stopped on its own.”

Sara explained that although this was a extremely scary experience which took several weeks of medication adjustments, blood draws, and ultimately bridging with injections to stabilize her INR, it’s a lesson that she takes very seriously.

And if she experiences abnormal bleeding like that again, she’s determined not to simply assume that it’s “just” her period – because now she knows that something could be seriously wrong.

Researchers have studied heavy menstrual bleeding  incidents like Sara’s as the use of anticoagulants and/or anti-platelet treatments has increased to reflect the growing number of pre-menopausal female patients with cardiovascular disease.

A 2019 study, for example, estimated that the prevalence of heavy menstrual bleeding in pre-menopausal women under age 50 increased from 18% before anti-clotting therapy to almost 30% afterwards. Yet cardiologists or vascular specialists caring for pre-menopausal patients may fail to refer these women to a gynecologist – or even ask about their menstrual problems.(1)

A European study led by Dutch cardiologist Dr. Angela Maas studied the dual anti-platelet therapy commonly prescribed to women after having a coronary stent implanted. This typically includes taking aspirin plus an anti-platelet drug like clopidogrel (Plavix) or ticagrelor (Brilinta).  Dr. Maas and her colleagues conclude that “treating pre-menopausal heart patients demands specific expertise and close collaboration between cardiologists and gynecologists.”  

And equally important, they recommend that more safety data on uterine bleeding in pre-menopausal women who are taking the newer “novel” anti-platelet drugs should be obtained before drugs are approved. This is a concern for all younger women taking these drugs, given how under-represented women have been in cardiac drug trials.  See also:  Is It Enough to Have “Enough” Women in Cardiac Studies?

Meanwhile, what do pre-menopausal women do if they experience abnormally heavy menstrual bleeding while taking these prescribed meds? There are solid reasons your physicians recommend your anticoagulants or anti-platelet drugs – stopping suddenly can lead to dangerous blood clots. But living with heavy menstrual bleeding can also carry both physical and psychological dangers of its own.

For more info, read about current drug, device or surgical treatment options on the Mayo Clinic website.  

Read Sara Wyen’s full story here – including four key questions she recommends all women who have heavy periods while taking blood thinners must ask their doctors.

Doing so, she believes, may prevent the frightening emergency interventions that she had to go through.

Image: Mabel Amber, Pixabay

♥

*Definitions:

• deep vein thrombosis:  a serious condition that occurs when a blood clot forms in a vein deep inside your body – typically in the thigh or lower leg but may also occur in other areas
• pulmonary embolism: a serious condition caused by a blockage in one of the arteries in your lungs, in most cases, caused by blood clots that travel tn the lungs from deep veins in the legs or other parts of the body (deep vein thrombosis)
• anticoagulant medication:  (also called “blood thinners”) – they don’t actually thin your blood, but they can help prevent blood clots from forming
• heparin: an anticoagulant that treats and prevents the formation of blood clots, often used in patients with heart attack or atrial fibrillation
• INR:  (International Normalized Ratio) a measurement of how much time it takes for your blood to clot:  a low INR test result means your blood is not ‘thin’ enough or coagulates too easily and increases risk of developing a blood clot; a high INR result means your blood coagulates too slowly and increases the risk of bleeding
• warfarin:  (brand names: Coumadin, Jantoven) an anticoagulant drug that’s used to prevent or treat blood clots, including deep venous thrombosis or pulmonary embolism, also used for blood clots that may be caused by certain heart conditions. Other newer anticoagulants include dabigitran (Pradaxa), rivaroxaban (Xarelto),  edoxaban (Lixiana or Savaysa) or apixaban (Eliquis) – also used by heart patients who are at moderate-to-high risk of a stroke
• vitamin K:  a group of vitamins that your body needs for blood clotting and helping wounds to heal
• anti-platelet drugs:  a class of drugs that inhibit the platelets in your blood from clumping together. Platelets are small particles that can stick together to form blood clots, potentially leading to heart attack and to the sudden clotting of a coronary stent. Aspirin (ASA or acetylsalicylic acid) is the most common antiplatelet drug;  at a low dose, aspirin reduces inflammation in the arteries, which is why doctors recommend taking aspirin if you think you’re having a heart attack.

Resources: Heart and Stroke Foundation, Mayo Clinic, National Heart Lung & Blood Institute, American Heart Association

.

1. Gu ZC et al. “The Management of Heavy Menstrual Bleeding After Percutaneous Coronary Intervention in a Woman of Reproductive Age.” Front Pharmacol. 2019; 9:1573. 2019 Jan 15.

2. Maas AH et al. “Practice Points in Gyne-Cardiology: Abnormal Uterine Bleeding in Premenopausal Women Taking Oral Anticoagulant or Antiplatelet Therapy.” Maturitas. 2015 Dec; 82(4):355-9.

♥

Q: Have you experienced heavy periods associated with your anticoagulant meds?

.

NOTE FROM CAROLYN:  I wrote more about how cardiac medications affect women’s health in my book A Woman’s Guide to Living with Heart Disease (Johns Hopkins University Press). You can ask for this book at your local bookshop, or order it online (paperback, hardcover or e-book) at Amazon, or order it directly from Johns Hopkins University Press.  Save 30% by ordering this book directly from Johns Hopkins University Press, using their code HTWN .  

See also:

-Visit Sara Wyen’s site Blood Clot Recovery Network

–A rock drummer’s take on atrial fibrillation

–Why are women with atrial fibrillation treated differently?

–What you need to know about your heart medications

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Living with chronic kidney disease

Daily life and some general concerns

You can’t change your diagnosis, but there are many things you can do to adapt to your treatment and live as normal as possible.

During this journey, it may be helpful for you to talk about how you feel and any uncertainties or fears. The team of doctors at Diaverum can play an important role in helping you adjust to dialysis and possibly plan your kidney transplant.

The goal of your treatment is to enable you to live as normal a life as possible, having dialysis as a necessary factor, but without letting it take over your life. But we also know that the inevitable life changes that come with kidney failure can be hard to accept and deal with, and that it can be hard for you to talk about your feelings. But try not to keep everything to yourself.

The staff of the Diaverum clinic is very experienced and there are few situations that they have not seen before. Share your concerns with the clinic staff, as more detailed information will make it easier for you to understand the situation. There may also be small changes in your treatment that can change your experience and outlook.

Common problems faced by dialysis patients

Anxiety: can have a significant impact on your daily life. You may feel anxious about coming to dialysis, not being able to predict the future, or that you are losing control. Physical symptoms may include heart palpitations during dialysis treatment.

Difficulty sleeping : can be for many reasons, most often anxiety. In addition, it may be due to bad sleep habits and unhealthy lifestyles such as lack of exercise.

Depression: can vary in severity and affect your life in many ways. It includes a group of symptoms such as persistent low mood, lack of interest in activities, changes in sleep and appetite habits, poor concentration, and fatigue.

Sexual problems : Many dialysis patients experience decreased sex drive. This may occur as a physical side effect of kidney failure or may be associated with changes in body image, depression and anxiety.

Never hesitate to talk to us about any problems you may have – we are always happy to help you. As a first step to optimizing your health during dialysis, we offer the following tips: control what you eat, what you drink, your medications, stay active, talk to other people and seek their support.

Diet control

There is no diet that is suitable for all patients with kidney failure at any time, we recommend that you seek advice from the Diaverum Clinic team. You may feel tired and have a decreased appetite, but it is important to continue to eat well and follow a generally healthy diet. There are also some specific tips for certain types of food:

proteins help maintain muscle and repair tissue. It is important to eat high-quality protein, such as meat, fish, poultry, and eggs. Proper nutrition will help you stay generally healthy and fight infections.

Phosphorus is a mineral found in many foods and on dialysis one must be careful not to eat too much of it. Foods such as milk and cheese, dried beans, sunflower seeds, flaxseeds, cola, nuts, and peanut butter are high in phosphorus. If your blood phosphorus levels are too high, this can lead to calcium buildup in tissues and organs, a process called calcification. Phosphorus can cause itchy skin and affect blood vessels.

Some dialysis patients need to take a medication called a phosphate binder to prevent dietary phosphate from getting into their blood.

Potassium is a mineral found in almost all foods, especially some fruits and vegetables. Healthy kidneys keep the right amount of potassium in the blood: potassium levels in the blood can vary and can rise between dialysis sessions. High potassium levels can affect your heart rate, and it’s important to follow the advice you’re given on how best to control your potassium intake. Foods rich in potassium include apricots, bananas, dried fruits, fruit juice, melon, nuts, plum juice, raisins, tomato juice and sauce, artichokes, avocados, dried beans, carrot juice, baked potatoes, chocolate, honey, milk, potato chips, lentils and spinach.

Sodium (Salt) is found naturally in most foods and is also used to add flavor. Too much salt in the diet can make you thirsty and lead to fluid retention. Therefore, it is important to carefully check the amount of salt you consume.

Fluid control

If you are on dialysis, it is very important to control how much you drink, especially if you are not passing urine. Hemodialysis patients generally have to manage their fluid intake more carefully than peritoneal dialysis patients.

Control your thirst

The best way to reduce your fluid intake is to reduce your thirst, and you can do this in part by controlling how much salt you eat in your diet. Dialysis patients should aim to eat half as much salt as other people.

Most canned, prepared or frozen meals are high in salt, as are chips. Try to avoid them, or choose foods low in sodium, and don’t add salt to your food while cooking or eating.

Control your fluid intake

Any food that is liquid at room temperature contains water, and eating something like this adds fluid to you. These foods include soups, milk, yogurt, jellies, and ice cream. Many fruits and vegetables are also high in water, including melons, watermelons, grapes, apples, oranges, tomatoes, lettuce, and celery. Along with limiting the amount of these foods, you can also lower your fluid levels by drinking from smaller glasses or dishes.

Hemodialysis Fluid Management

Between hemodialysis sessions, fluid can accumulate in the body, causing swelling and weight gain. The extra fluid affects blood pressure and can make the heart beat faster. Between treatments, you should aim for a maximum weight gain of 4% of your prescribed “dry weight” (see next paragraph).

Your dry weight is your body weight without additional fluids. This is usually the lowest weight you can tolerate without developing low blood pressure. Your dialysis prescription will determine the amount of fluid that needs to be removed during treatment in order to restore your estimated dry weight. Typically, the prescribed dry weight is slightly lower than a healthy person’s weight without supplemental fluids.

If you develop too much fluid between treatments (because you drink too much or eat too many water-rich foods), it will be harder for you to reach your prescribed dry weight during your dialysis session. This increases the risk of dialysis side effects such as low blood pressure or seizures. Your lean weight can change over time as your lean body weight changes.

Peritoneal dialysis fluid monitoring

Fluid intake is not as restricted for those on peritoneal dialysis as it is for hemodialysis patients, but it is still important to watch for any signs of fluid retention such as swelling or weight gain.

Medication control

Many of the medicines you need when you start dialysis are the same as those you took before you started treatment. Some medications will need to be adjusted and medical supervision will be required. The most common medications dialysis patients take are:

ESAs

Your kidneys are the main source of a hormone called erythropoietin, which stimulates the production of red blood cells. In chronic kidney failure, the levels of this hormone can be reduced, which can cause low red blood cell production and lead to anemia. Erythropoiesis-stimulating agents (ESAs), which stimulate the production of red blood cells, may be given intravenously.

Iron

Iron is essential for the production of red blood cells and hemoglobin, which carries oxygen to your body. You may need iron supplements, which will be given intravenously.

Vitamin D

Vitamin D is partially activated by the kidneys and its production may reduce chronic kidney failure. Vitamin D is essential for the absorption of calcium from the diet and for healthy bones. A lack of active vitamin D can cause bone disease, characterized by bone pain and weakness. Active vitamin D can be given orally or intravenously.

Phosphate binders

Phosphate comes from food and is normally excreted by the kidneys. In kidney failure, phosphate can build up in your body as your kidneys can’t get rid of it normally. Too much phosphate can form bone deposits in your tissues and cause calcium to build up in your blood vessels. Phosphate astringents taken with every meal reduce the absorption of phosphate in the intestines and the amount of phosphate in the blood.

Blood pressure medications

Since your kidneys are involved in controlling blood pressure, patients with kidney failure often need medications to control their blood pressure. High blood pressure is a risk factor for heart disease and should be carefully monitored. The good news is that once dialysis is started, these medications may no longer be needed at the dose they were previously used, or may not be needed at all.

Blood thinners (anticoagulants)

If you are on hemodialysis, blood thinners will be given at the beginning and during each treatment to prevent blood clotting in the lines and dialyzer.

Other medicines

People on dialysis may have conditions other than CKD that require medicines to treat. These include heart disease, diabetes, hyperlipidemia (abnormally high levels of lipids, especially cholesterol), depression, sexual dysfunction, or pain.

Live an active life

As with many other illnesses, positive thinking can make a big difference in how you feel and help you maintain a good quality of life. Your Diaverum Clinic team will do their best to help you enjoy life to the best of your ability.

Continue to work or study

Starting dialysis does not mean you have to stop working unless you have an extremely hard job and you can continue your studies at school or college. Continuing such activities would be a welcome distraction; most employers understand and help and make any necessary adjustments so you can keep working.

Be in good shape

You should always seek the advice of a doctor before choosing a particular type of physical activity, but the general rule is to do as much exercise as comfortably as possible. This improves your health and wellness.

Continue to drive

Most dialysis patients can continue to drive, but you should be checked by a doctor. During the first two months of hemodialysis, it is recommended not to drive immediately after treatment. If you drive in your profession, such as a truck, taxi, train or bus driver, you should discuss with your doctor whether you can continue to drive as usual.

Do not smoke

Smoking is dangerous for everyone and is an additional health risk that you should try to avoid if you are on dialysis. If you’re considering a kidney transplant, it’s even more important not to smoke or stop smoking, as this damages your blood vessels and can affect the success of your kidney transplant.

A little alcohol…

…permitted, provided it is in accordance with your total fluid intake and dietary intake. Ask your clinical team for advice.

Leisure

Everyone should be able to enjoy their holidays and we help make that possible for you. Talk to your clinical team about how best to organize your holiday. They can advise where to go and how to take care of your dialysis while you are away. With over 400 Diaverum clinics around the world, our d.HOLIDAY program will help you travel and make sure you get expert kidney care while you’re away from home.

Talk to others about your situation

Everyone reacts differently to their situation, both physically and mentally, but you may feel anxiety, stress, or anger and resentment about what happened to you and about your treatment. It is very important to find people to talk to.

Diaverum Clinic Team

The doctors and nurses at your clinic are always ready to help you. Ask questions and discuss your feelings and concerns with them. Share your concerns. Often, a little extra information will help get things in order. You may also find it helpful to talk to other dialysis patients, as they have firsthand experience of what you are going through. Do not hide your feelings: there are many people around you who are ready to listen to you and help. By engaging them, you will start building the support you need.

Be open about your situation

Sometimes it can be difficult for you to talk about what you are going through, even or especially with those closest to you. But keep trying. It can be very helpful to encourage your family or close friends to learn more about chronic kidney disease and your treatment so that it is easier to talk about your situation. Everyone will benefit from this. The effect of chronic kidney failure is felt not only by the patient. Openness with family, relatives, friends and colleagues can make life easier for all of you. Knowledge, understanding and encouragement are essential elements to help you make the most of your situation.

The concept of venous thromboembolism (venous thromboembolism)

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Venous thromboembolism is when a blood clot forms in a vein. The term refers to two related conditions: deep vein thrombosis (DVT) and pulmonary embolism (PE). If you have DVT, a blood clot has formed in a deep vein. It often happens in the foot. Sometimes this clot can break out and travel to the lungs. Once there, it can block the blood flow. This is called a pulmonary embolism or PE. This condition is a medical emergency.

How to pronounce it

Ve-noz-na-ya trom-bo-em-bo-li-ya

What causes venous thromboembolism?

A blood clot can form in a vein for many reasons. Your genes may be part of the reason. For example, you may have a protein deficiency or a bleeding disorder. Your history may also make you more prone to this problem.

Other factors may increase the chance of a blood clot forming in a vein. They include the following:

• major surgeries such as joint replacement;

• an injury such as a broken leg or injury to the spinal cord;

• cancer;

• heart failure;

• old age;

• obesity;

• smoking;

• certain medicines such as birth control pills or hormone replacement therapy;

• pregnancy;

• long periods of insufficient movement, such as after surgery or during a long flight.

Symptoms of venous thromboembolism

You may not have symptoms. But if there are symptoms, they can develop quickly. Symptoms of DVT are:

A pulmonary embolism is when a blood clot travels to the lungs. This condition is a medical emergency. It can cause breathing problems, chest pain, coughing up blood, and an irregular heartbeat. The symptoms may be similar to those of a heart attack. This can lead to sudden death.

Treatment of venous thromboembolism

The goal of treatment is to break up blood clots and prevent new ones from forming. This reduces the risk of pulmonary embolism. Treatment includes:

• Blood thinners. These medicines can be given by injection, intravenously, or as a tablet. You may need to take them for several months or longer. It depends on the cause of the blood clot.

• Walking. Once your symptoms are under control, your doctor may recommend that you walk. At first, for example, after surgery, you won’t be able to walk too much. But it will prevent new blood clots from forming and help you feel better.

• Compression socks. These socks or similar devices may reduce the risk of blood clots. They gently apply pressure to the lower leg. This can reduce pain and swelling.

• Inferior vena cava filter. This small metal device is inserted into the inferior vena cava. This is the main vein that runs from the legs to the heart and lungs. The device catches large clots before they reach these organs. This can stop a pulmonary embolism. You may need this treatment if you cannot take blood thinners.

• Operation. In some cases, surgery may be required to remove the clot, especially if it has already reached the lungs.

Possible complications of venous thromboembolism

When to call your doctor

Call your doctor right away if you experience the following symptoms:

• temperature 38°C (100.