Saturday, December 27, 2008

CAPD

Inilah jenis rawatan buah pinggang yang sedang dijalani Ammar sekarang.




Tiada yang berkuasa melainkan Allah. Yang mencipta, memelihara dan mentadbir sekalian makhluk. DitanganNya lah penguasaan langit dan bumi, dunia dan akhirat.

InsyaAllah Ammar boleh balik hari ni atau Selasa depan. Doa untuk Ammar dan umat.



Introduction

Current treatment options for patients with severe chronic kidney failure are dialysis and kidney transplantation. Dialysis is a treatment that removes substances such as water, salts, and waste products (from the body’s normal metabolism), which build up in patients with failing kidneys. There are two forms of dialysis. One is called hemodialysis (HD), where the blood is cleaned outside the body and then returned to the body. This treatment, done in a hospital, or a dialysis clinic, is normally done 3 times a week, where each session takes about 4 hours. In HD, a machine and a filter are required, as well as a system to get the blood out of the body, as well as returning the cleaned blood to the patient. In most patients, this so called access to the blood, is done by inserting two needles into blood vessels on the forearm. A few centers around the world can train patients for self- HD. In regard to transplantation, the new kidney can come from either a deceased person or a living donor.

Fun fact: in 1972, a law was passed that medical care had to cover dialysis and kidney transplants.


What is peritoneal dialysis (PD) and how does it work?

The other form of dialysis is called peritoneal dialysis (PD). More than 150,000 patients are currently receiving this lifesaving treatment around the world.

In PD, a dialysis fluid is entered into the patient’s abdominal (= peritoneal) cavity (the “belly”), which is covered by a thin membrane, containing many small blood vessels. This membrane, called the peritoneum, is like a big bag that keeps the stomach, intestines, liver, and other organs in place. The dialysis fluid will make water, salts, and the waste products move from the blood into the fluid (also called solution). This process is called dialysis, and means that the peritoneum works as a dialysis filter. As the fluid gets saturated after a while, the solution must be exchanged regularly (see below).


The solutions

The fluids contain either sugar (glucose), amino acids, which are building blocks for proteins, or a compound called icodextrin, to remove the water. The sugar solution is the one most commonly used. The glucose “strength” (1.5%, 2.5% or 4.25%) of the solution determines how much water is removed from the blood; the higher the concentration, the greater the water removal. The amino acid solution is used to improve a patient’s nutritional condition (as the amino acids are taken up by the body, i.e. they move from the solution to the blood), and/ or to reduce the uptake of glucose from the solution. The benefits of the icodextrin fluid is that it removes more water than the glucose solution for longer exchange intervals, and that it is glucose- free, which is advantageous both for the peritoneum and the body as a whole.

There are two types of glucose solutions. The main difference is the pH, and the type of substance added to reduce the acidity of the blood, which is common in patients with kidney disease.


How can the solution be exchanged?

A small plastic tube, called a catheter, which has been placed through the abdominal wall in a small operation done before starting PD, is used to let the fluid go in to, and out from, the abdomen. The place where the catheter comes out is called the “exit site”. The catheter can normally be used for many years if so needed. In most cases two liters of fluid is entered each time, and is exchanged 4 times per day. In the beginning the patient may feel some discomfort when the solution goes in, but this normally disappears after a while. The bags are delivered to the patient’s home at regular intervals.


Preparation for the exchange

The recommended procedure varies somewhat between centers, but in most cases the patient wears a disposable surgical mask, and scrubs the hands for 3 minutes using soap and water. The solution should be warmed to body temperature before use, for example by using a heating pad or a heating plate. Many centers will provide the patients with an appropriate heating device to be used at home.


Two methods for the solution exchange/ types of PD

There are two types of PD: CAPD and APD. The difference is that in CAPD the exchanges are done manually, and in APD automatically by a small machine.

CAPD means: Continuous Ambulatory Peritoneal Dialysis

C- continuous: dialysis solution is always inside the “belly” cleansing the blood in a continuous manner.

A- ambulatory: ambulatory means that between exchanges, one can move about freely and continue normal activities like going for a drive, walking, golfing, studying or sleeping. In CAPD the solution exchanges are done manually at home, normally with 4 exchanges daily, seven days a week, by the patient him/herself.

P- peritoneal: this type of dialysis makes use of the peritoneal membrane that covers the peritoneal cavity in order to cleanse the blood of waste products and water.

D- dialysis: dialysis is the process of removing all wastes and excess water from the blood, in PD using the peritoneal membrane as a filter.


Steps in CAPD are

Step 1) Attach the new bag

Step 2) Drain: this means letting the solution go from the peritoneal cavity (by gravity) to the so-called drain bag, which takes 15-20 minutes

Step 3) Flush: this is when the system is ‘flushed’ with unused solution for approximately 10 seconds. This ensures your system is made clear of bacteria that may have entered the system when the new bag was connected

Step 4) Fill: this means filling the new solution into the peritoneal cavity. This normally takes less than 10 minutes

Step 5) Dwell time: this is when the dialysis solution is inside the peritoneal cavity


APD means: Automated Peritoneal Dialysis

A- Automated: automated means that the fluid exchanges are done automatically by a machine. In APD, the treatment is done at home at night while sleeping. Most patients are prescribed a continuous (see above) treatment, but in some cases it may be possible to have no dialysis during the day, which means no fluid in “the belly” at daytime.

The steps in APD are

Step 1) Start the machine

Step 2) Connect the new bags

Step 3) Connect to machine

Step 4) The fluid exchanges are done by the machine during the night

Step 5) Disconnect from the machine


Travel

Travel is possible with both CAPD and APD, as the bags can be delivered to the visiting areas. In APD the small size of the machine (such as HomeChoice, manufactured by Baxter) makes it easy to travel despite the PD treatment.


Disposing of the drained fluid

Patients can empty the bags containing the drained fluid into the toilet.


Advantages and disadvantages of peritoneal dialysis

Advantages

A. Compared to HD

* Treatment at home, which means no travel to a HD unit 3 times a week.
* Self control of the therapy
* No needles required
* Facilitates employment
* Easy travel
* Better preservation of the remaining kidney function, which is very important because it helps removing the water and the waste products. This reduces the need for a high dose of dialysis, and also improves patients’ survival and their quality of life.
* Lower doses of medication needed to treat anemia
* Lower risk for hepatitis B and C (liver infections caused by virus)
* Better results after kidney transplantation
* The removal of water is more gentle

B. General

* Easy to learn (3-5 days)
* High level of patient satisfaction and well-being

Disadvantages

* Peritonitis is an infection in the peritoneal cavity. This is in most cases caused by bacteria entering the fluid pass at a solution exchange procedure. The risk for such an infection is nowadays low (on average one episode every 3-5 years) due to improvements in the design of the products used. Also, following the instructions about how to exchange the fluids will further reduce the risk. Usually, a patient with peritonitis has fever, abdominal pain and a cloudy appearance of drained dialysis fluid. Peritonitis is treated, and normally cured, by using antibiotics. Sometimes a change of the catheter or a change of dialysis therapy (temporarily or permanently) may be necessary.

* Exit site infection is an infection of the “exit site” (=where the catheter comes out through the skin) and normally caused by bacteria. Common signs of such an infection are redness and secretion at the exit site. Antibiotics are given to cure the infection. There are also simple ways to prevent the occurrence of exit site infection, such as changing clothes daily, and always wash and dry hands before touching the catheter and exit site.

* Membrane function With time on PD, the peritoneal membrane may change its capability to remove enough water and wastes, which can require a need to change the prescription. In some cases, mainly after many years of PD (more than 5 years), this may not be sufficient, and a change to HD may be needed.


Summary

PD is a home- based therapy and widely used around the world. In general, it is easy, convenient, safe and effective for most patients with failing kidneys.

Saturday, December 20, 2008

Depression vs Contentment

Talk by Sheikh Sulaiman Mulla.

Most Islamic scholars and pious Muslims of the early generations of Islam were poor; needless it is to say, then, that they did not have beautiful houses or nice cars. Yet, despite these disadvantages, they led fruitful lives, and they benefited mankind, not by some miracle, but because they used all that they were given, and spent their time in the correct way. Hence they were blessed in their lives, their time, and their talents.

On the contrary, there are many people who have been bestowed with wealth, children, and all forms of blessings, yet these blessings have been the very reason for their misery and ruin.

* Part 1/2


* Part 2/2

Friday, December 19, 2008

Hospital Selayang

Firman Allah dalam surah Al Baqarah, mafhumnya;

[155]
Demi sesungguhnya! Kami akan menguji kamu dengan sedikit perasaan takut (kepada musuh) dan (dengan merasai) kelaparan, dan (dengan berlakunya) kekurangan dari harta benda dan jiwa serta hasil tanaman. Dan berilah khabar gembira kepada orang-orang yang sabar:
[156]
(Iaitu) orang-orang yang apabila mereka ditimpa oleh sesuatu kesusahan, mereka berkata: “Sesungguhnya kami adalah kepunyaan Allah dan kepada Allah jualah kami kembali.”
[157]
Mereka itu ialah orang-orang yang dilimpahi dengan berbagai-bagai kebaikan dari Tuhan mereka serta rahmatNya; dan mereka itulah orang-orang yang dapat petunjuk hidayahNya.


Aku & family semenjak Ammar masuk hospital pada 5hb Nov 2008.

Hari-hari awal Ammar di hospital tak dapat tidur baring sebab susah bernafas bila paru-paru berair.
(kegagalan buah pinggang berfungsi menyebabkan air memenuhi badan, darah tinggi naik dan tekanan jantung jadi lemah. Hebat engkau Ya Allah!)

Bapak misali (ceh, ceh..)

Ada aktiviti pulak pada satu hari 22 Nov 2008.

Hasil karya Ammar.

Ammar yang ceria selepas melalui proses cuci darah melalui lehernya.

Majlis taklim (bacaan hadis fadhail) selepas Isya'.

Amir yang balik cuti pada raya Haji lepas.

Mu'az tido.

Mardhiah pun tido.

Ammar dan rakan-rakan.

Doa untuk Ammar dan umat.

Syukuri lah nikmat iman, Islam dan kesihatan yang Allah bagi kat kita.



*Posting berkaitan.

Sunday, December 14, 2008

Our Imaan


Its indeed necessary [not optional] for us to think deeply about the exact condition of our Imaan. Now at the present situations, Muslim Ummah are putting hard and soul efforts for developing their careers but are they really giving equal time for thinking about Imaan?

Our Rasool Muhammad [Sallallahu Alayhi Wasallam] passed nights after nights awaking, crying, giving da'wah, fasting during hot summer, performing Salaths at nights, making Du'aa for Ummah and we, the follower of Muhammad [ Sallallahu Alayhi Wasallam] sleeping in Air Conditioning rooms without even neglecting Salath? How can we stand in front of Allah Taa'la in the day of Qiyamah!

Allah Taa'la said in Quran [059:19]
"And be not like those who forgot Allah and He caused them to forget their ownselves. Those are the Fâsiqûn (rebellious, disobedient to Allah)."

One Muslim philosopher [Rohmatullah] used to ask Allah Taa'la like "Ya Allah, eyes are in our control but we can't control our eyes. Hands are in our control but we can't resist hands of doing wrong works. Legs are in our control but we even can't control our legs of going bad places but Imaan is not in our control then how can we guard our Imaan. So Allah, please secure our Imaan with your blessings and mercy."

SubhanAllah!


So my brothers n sisters we need to be very careful to guard our Imaan from all evil works. The most evil crime is forgetting Allah Taa'la. We also need to make du'aa all time so that Allah Taa'la helps us to guard our Imaan with His own rahmat.

Saturday, December 13, 2008

Allah Maha Pencipta

Artikel di bawah diambil dari http://atehfaisal.blogspot.com

****************************************

Syukur...
maha suci Allah, pentadbir seluruh alam dan seisinya. Ilmu Allah amat hebat dan segalanya tidak mustahil terjadi. Inilah bukti kekuasaan Allah SWT untuk hamba-hambanya melihat, dan berfikir tentang kebesaran dan kekuasaan Allah yg tidak terhingga.

Saksikan gambar di bawah. Musytari (Jupiter), Kejora (Venus) dan Bulan kelihatan harmoni dan dekat antara satu sama lain (seolah sedang tersenyum) sedangkan pada hakikat sebenar, 3 makhluk Allah itu adalah berbilion-bilion tahun cahaya jaraknya antara satu sama lain. MasyaAllah...





kejadian Allah yg mengagumkan aku malam ni...

Bulan bersama-sama dengan Mustytari (jupiter) dan Kejora (venus)berhimpun di dalam kawasan yang sama dan membentuk sebuah segitiga! seperti sedang tersenyum.

Bayangkan, walaupun ketiga-tiga objek ini dilihat seolah-olah hampir antara satu sama lain, tetapi dari segi hakikatnya tidak.

Cahaya dari Bulan mengambil masa 1.3 saat untuk sampai ke mata kita. Cahaya dari Kejora (objek sebelah kiri), mengambil masa lebih kurang 8 minit untuk sampai. Manakala Musytari yang dilihat itu ialah keadaannya 48 minit terdahulu!

1-12-2008 ~ Conjunction Pics Around Globe

conjunction as seen by peoples of East Asia & Oceania.


conjunction as seen by viewers from Central & West Asia Regions & East part of Europe


conjunction as seen by viewers from Western Europe.


conjunction as seen by viewers from South American Regions.

Sunday, December 07, 2008

Pengorbanan Nabi Ibahim

Selamat Aidil Adha.

Kisah Nabi Ibrahim dan keluarga yang buat pengorbanan untuk agama. Sifat ni yang kita kena ikut dalam buat ‘korban.’ Walaupun hati rasa berat tapi hanya kerana perintah Allah dan nak sukakan Allah, mereka taat. Nabi Ibrahim tinggalkan anak isteri di tanah Mekah yang tandus. Tiada asbab kehidupan. Yang ada hanya asbab kematian.

Berkat pengorbanan mereka Allah beri keberkatan. Dari tanah yang tandus Allah keluarkan air zam-zam yang tak kering sampai hari ini. Jutaan manusia datang berhaji setiap tahun dan bawa balik air zam-zam ke negara mereka. Bila Nabi Ibrahim balik ke Mekah, Allah perintahkan pulak sembelih anak. Kerana pengorbanan Nabi Ibrahim, anak dan isteri baginda Allah tarbiah dan jadi orang yang taat kepada Allah. Mereka rela untuk ikut apa sahaja perintah Allah.

Cerita bukan sekadar cerita. Hari ini kita di perintah Allah untuk sambung kerja Nabi. Bawa agama ke seluruh dunia. Janji Allah, akan beri keberkatan dan tarbiah kita dan keluarga seperti Allah buat kepada Nabi Ibrahim dan keluarga.

Selamat berkorban untuk agama.

Wednesday, December 03, 2008

Kekal Selamanya


Dunia tak dapat sempurnakan segala hajat manusia tetapi di akhirat segala hajat akan disempurnakan. Allah cipta manusia untuk kekal selamanya. Manusia yang cinta dunia takut untuk mati dan bimbang didatangi kematian. Orang beriman cinta untuk mati untuk kekal hidup di akhirat. Orang yang impikan syurga perlu mati dalam keadaan beriman kepada Allah.

Di syurga manusia akan dapat isteri banyak, makan banyak, harta banyak. Di syurga ada sungai susu, sungai madu dan sungai arak. Makanan di dunia akan jadi tahi tetapi makanan di syurga akan jadi peluh yang harum. Makan di dalam syurga tak akan kenyang tetapi makanan yang dimakan bertambah sedap.


Allah hantar para Nabi untuk tunjuk kepada manusia cara mengamalkan agama. Oleh itu kena buat usaha untuk mati di dalam iman dan amal yang sempurna kepada Allah. Usaha yang dibuat perlulah bertepatan dengan cara Nabi. Kena ikut cara Nabi 100% walaupun akal tak dapat terima.


Oleh itu kita kena lapangkan masa untuk buat usaha sempurnakan iman dan amal sebelum mati. Masalahnya kita dah mula usaha ke belum? Atau sekurang-kurangnya ada fikir untuk buat usaha? Untuk dunia yang akan ditinggalkan kita dah banyak buat pengorbanan. Saat kematian semakin hampir. Semua harta benda dan anak pinak yang kita usaha akan jadi milik orang lain sejurus nyawa tercabut dari badan. Apa yang tinggal sebagai bekalan? Iman dan amal soleh... yang sempurna!