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Doobay Medical Centre set for 18 more fistulas this weekend
Eighteen fistulas are scheduled to be conducted at the Doobay Medical and Research Centre this weekend. The Annandale, East Coast Demerara facility is arguably the only entity that has been offering this service for the past decade.
Dr. Budhendranauth Doobay
At least this is according to founder and head of the facility, Budhendranauth Doobay.
“We have done over 50 fistulas and our complication rate has been less than one percent,” he shared doing an interview with this publication yesterday.
Dr. Doobay, a Vascular Surgeon based in Canada, is a Guyanese, who has been giving back to the land of his birth, by offering regular dialysis services to many at a subsidised rate at his not for profit organisation.
But it was in an attempt to improve its delivery of renal care service that the Medical Centre started offering to its patients Arteriovenous (AV) fistula which is recognised as the gold standard hemodialysis access.
Dr. Doobay had explained that with the AV fistula a renal failure patient cannot be dialysed with natural tissues. This, he explained, is due to the fact that the catheter used to facilitate dialysis is usually inserted in the region of the upper chest or neck which is in fact a foreign body.
And, according to him, a foreign body can in no way last forever in the body of a patient.
“It can get infected and an infected patient can even lose his/her life…When there is an infection it can be really bad and we would have to take the catheter out,” Dr. Doobay said as he admitted that offering renal care is not without a few challenges.
When he spoke about this procedure a few years ago, Dr. Doobay explained that all good dialysis centres are opting to do away with catheters and are now embracing the AV fistula procedure.
The service which costs a few hundred thousand dollars is to date still being offered free of cost at the Medical Centre, Dr. Doobay assured yesterday.
“We take a vein and connect it to the artery and it becomes big…It is an expensive operation and we are doing it free…We bring in our own people, our own gowns and everything we do for free,” said Dr. Doobay.
It has been medically proven that once kidney function goes below 10 to 15 per cent of its normal operation, dialysis treatments or kidney transplants are necessary to sustain life. There are two types of dialysis: hemodialysis and peritoneal dialysis. Both dialysis treatments are able to replace the kidney function of cleaning the blood of toxins and removing extra fluids for people with kidney failure.
Hemodialysis is done to clean a patient’s blood by removing it from the body and passing it through a dialyzer or artificial kidney. The dialyser is a filter with two parts one for blood and another for dialysis fluid called dialysate.
Usually for dialysis, a catheter is inserted into a large vein in either the neck or chest. However the catheter is usually a short-term option but there have been instances when it is used as a permanent access.
With most dialysis catheters, a cuff is placed under the skin to help hold the catheter in place. The blood flow rate from the catheter to the dialyzer may not be as fast as the AV fistula.
Added to this, catheters have a greater tendency to become infected than the other access types because the device is both inside and outside of the body.
A catheter therefore must always be kept clean and dry thus swimming or bathing are usually restricted. Getting dressed may disturb the catheter at the exit site, so care needs to be taken.
However, an AV fistula is created by connecting a vein to an artery using a soft plastic tube. After the graft has healed, hemodialysis is performed by placing two needles; one in the arterial side and one in the venous side of the graft.
The graft allows for increased blood flow. Grafts tend to need attention and upkeep. As such patients at the Renal centre will be exposed to sensitisation sessions on how to ensure that theirs are well cared for in order to ensure that the optimum result is maintained.
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