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DrHoellering
DrHoellering, Doctor
Category: Medical
Satisfied Customers: 22987
Experience:  Doctor of internal and general medicine self employed
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Sir

Customer Question

Hi sir
Submitted: 11 months ago.
Category: Medical
Expert:  DrHoellering replied 11 months ago.

Or madam... How can I help you? Good morning!

Customer: replied 11 months ago.
Posted by JustAnswer at customer's request) Hello. I would like to request the following Expert Service(s) from you: Live Phone Call. Let me know if you need more information, or send me the service offer(s) so we can proceed.
Customer: replied 11 months ago.
Can we rather talk?
Expert:  DrHoellering replied 11 months ago.

Since I am not in the U.K. I will open the question for other experts.

Customer: replied 11 months ago.
Should I write my question here
Expert:  DrHoellering replied 11 months ago.

Yes please!

Customer: replied 11 months ago.
My brother has Ckd 4 from many years and last 2-3 months creatinine has started to increase
Expert:  DrHoellering replied 11 months ago.

Sorry to read this.

Customer: replied 11 months ago.
His blood sugars and blood pressure is being managed at the moment but given Creatinine is in the rise from last consective 3 months -- we are worried
Expert:  DrHoellering replied 11 months ago.

I understand. What's your question? How is the creatinine now?

Customer: replied 11 months ago.
He has been managing this on 3.8 but last three monthly readings are 4.18 , 4.62 and now 5.18 ....Similarly egfr 15, 13 and now 11
Customer: replied 11 months ago.
the question is , can we do something to bring this down?
Expert:  DrHoellering replied 11 months ago.

You can't, I am afraid. He will need dialysis, and sometimes the kidneys recover after some of them so they work a littel better for a while after. As you noiced blood pressure and sugar are important parameters to be taken care of. He should drink enough, but not too much.

Customer: replied 11 months ago.
One time dialysis or on regular basis to be started now?
Expert:  DrHoellering replied 11 months ago.

Depends on the creatinine. He will at least need a couple of them.

Customer: replied 11 months ago.
I have heard once you start dialysis -- you have to keep doing that. Can you please explain that
Expert:  DrHoellering replied 11 months ago.

I can't, because this is definitely wrong!

Customer: replied 11 months ago.
I am happy to call you in US
Expert:  DrHoellering replied 11 months ago.

I am in Germany. Shall I send you an offer?

Customer: replied 11 months ago.
Whatsapp?
Expert:  DrHoellering replied 11 months ago.

Skype?

Customer: replied 11 months ago.
mahadmian
Expert:  DrHoellering replied 11 months ago.

I send you an offer. This is an extra premium service.

Customer: replied 11 months ago.
Do you mean I have to pay more
Expert:  DrHoellering replied 11 months ago.

Yes, its not included.

Customer: replied 11 months ago.
See the attached
Expert:  DrHoellering replied 11 months ago.

Nothing new. He needs dialysis.

Customer: replied 11 months ago.
Not Skype then please
Customer: replied 11 months ago.
What should we expect from dialysis
Expert:  DrHoellering replied 11 months ago.

Prolongation of your brother's life.

Customer: replied 11 months ago.
Thanks I mean in terms of creatinine values
Expert:  DrHoellering replied 11 months ago.

That depends on his underlying issue. Anyhow the machine will do the work the kidneys can't.

Customer: replied 11 months ago.
How much creatinine would be lower from 2 rounds of dialysis ? Also how much water he should drink? What are the optimum values he need to maintain for blood sugar and blood pressure ?
Expert:  DrHoellering replied 11 months ago.

I wish your brother all the luck he neerds and thank you for a positive rating for this long consultation.

Customer: replied 11 months ago.
Ok thanks - understand water and bp and sugars. Really need to understand more about dialysis. So far his egfr was between 13-17 and doctor suggested that as long the values remains stable he can avoid dialysis. This is the first time creatinine crossed 5 and egfr touched 11 ... So really I want to understand if we put on the dialysis and assuming values goes back on again around Creatinine being 4 and egfr around 15 and stays there .... Can we avoid dialysis further if LFT stays around these numbers ? Or this is confirmed now that dialysis can't be avoided as he has reached the tipping point? Apologies if I am repeating myself
Expert:  DrHoellering replied 11 months ago.

I understand your point, but I can't tell tell since I don't know his underlying condition! You will have to wait and see, hoping that he won't need dialysis forever.

Customer: replied 11 months ago.
What do you mean by wait and see? Can you please explain this bit? At what values or conditions generally you go for further dialysis or not? Happy to share if you need to understand more about the history
Expert:  DrHoellering replied 11 months ago.

I did this already. You have to ask this your brother's doctors, because only THEY know what issue made your brother's kidneys sick. You go for further dialysis when the kidneys don't recover to do the job themselves. This is what you have to see.

I have been attending you vor 45 minutes already, much more than you initially requested and paid for. If you need more informations, please accept a permium service. Thank you for your understanding!

Customer: replied 11 months ago.
Thanks - I thought I have paid already but the extent of my question is not fully understood maybe. I can go and talk to HIS doctor but point was really to take a second opinion and understand our options going forward. Sorry but you keep sending me offers to pay more. I don't know what time was allocated to me and how can I have exhausted my time limit already. ūüôÉ
Expert:  DrHoellering replied 11 months ago.

Ok, you might understand that expert's time is precious, especially on weekends, and I can't stay with you for an hour ore more . Let's summarize then: I told you that dialysis is necessary. Maybe his kidneys recover, that depends on the underlying condition. Maybe not, then dialysis will save his life until he might get a new kidney. This is your brother's only option except taking care of fluid, blood pressure and sugar.

Is this quite clear?

Customer: replied 11 months ago.
Ok thanks.
Expert:  DrHoellering replied 11 months ago.

You are very welcome. I thank you for clicking a positive rating for my help and wish your brother all the luck he needs!

Expert:  DrHoellering replied 11 months ago.

And you, too.

Expert:  DrHoellering replied 11 months ago.

Hi again,

The only way I am paid here by the website and the money that you have deposited is released is when you rate me.
Therefore, I would appreciate a rating.

If something is still not clear: Just feel free to ask! I want you to be happy with me and Justanswer.

Thank you!