The journey · Step 2
Getting ready: your access, your plan, and the needle nobody wants to discuss
The weeks before your first session are practical. Here is exactly what gets arranged, in what order, and how the part you are dreading really feels.
Dialysis access
The machine needs a way in and out
Blood has to leave your body and return quickly and safely. That needs a dedicated access point — and there are two common kinds.
An AV fistula
The long-term option, usually in your arm
- A small operation joins an artery to a vein, making the vein strong enough for dialysis.
- It needs weeks to mature before it can be used, which is why it is created early.
- It sits under your own skin, with nothing outside the body — the lowest infection risk.
- You may be shown gentle exercises to help it develop.
A central venous catheter
The option when treatment must start soon
- A soft tube is placed into a large vein, usually in the neck or upper chest.
- It can be used straight away, so dialysis need not wait.
- Part of it stays outside the skin, so it must be kept clean and dry.
- Often a bridge while a fistula matures.
Which one suits you depends on your veins, your general health and how soon treatment needs to begin. Your nephrologist will explain the reasoning for your own case — ask them to draw it if that helps you picture it.
The fear, addressed
Most people are not afraid of dialysis. They are afraid of the needle.
It is one of the most common things people admit to us, often quietly, and it deserves a straight answer rather than reassurance that skips over it.
Two needles are used. They sting going in — comparable to a blood test, held a little longer — and then the sensation fades. Numbing cream helps. Looking away helps. Being told exactly what is happening, in the moment, helps most of all.
Tell your nurse you are frightened. They have heard it hundreds of times and they will slow down for you. Within a few weeks, the majority of our patients barely think about it.
What to have ready before you start
- Your ID document and medical aid card
- A written list of all medication and doses, including anything herbal
- Recent blood results or referral letters from your doctor
- Your nephrologist's and next of kin's contact numbers
- Comfortable clothing with sleeves that roll up easily
- A jersey or blanket — you may feel cool during treatment
- Something to pass the time: headphones, a book, a charger
- Any questions written down before you forget them
From decision to first session
Week one
Consultation with your nephrologist, blood tests and a plan for access.
Weeks one to two
Access created — a fistula operation, or a catheter placed if treatment is urgent.
Before you start
A newly diagnosed training session at the clinic, with your family welcome.
Your first session
You are welcomed, weighed, settled in and connected, with a nurse beside you.
Timings vary from person to person — this is the usual shape of it, not a promise.
Our newly diagnosed training session
Before you begin treatment, we sit down with you — and whoever you would like to bring — and go through the machine, the access, the diet, the medication and the schedule. You will see the unit, meet the nurses and be able to ask anything at all.
People leave these sessions visibly lighter. Knowing what will happen is the single biggest thing that lowers the fear.
Honest answers
This is general information and does not replace professional medical advice. Please speak to your doctor or our team about your own situation.
Take the first step, whenever you are ready
You can ask us anything — a question about a session, a medical aid, or simply what happens next. There is no pressure and no appointment needed to talk to us.