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...everything you need to know about doing dialysis at home.
When John first learned that he had kidney problems, he and his doctor came up with a game plan: John would get a transplant before his kidneys failed. Unfortunately, his kidney disease progressed faster than expected, and in August 2009, John was faced with the need to start dialysis right away.
John’s nephrologist talked with him about a transplant and referred him to an education class informing participants about different types of dialysis and how each type works.
John used what he learned to come up with Plan B when his kidneys began to fail. “I had two main objectives,” said John. “I wanted to keep working (as a financial analyst) and I wanted to keep my lifestyle as much as I could. I didn’t want my life to change too dramatically.” With those goals in mind, John decided to opt for peritoneal dialysis (PD) treatments that he could do at home. “It seemed like the best choice,” he explained. His nephrologist agreed.
The sudden onset of kidney failure did not give John enough time to prepare to start PD immediately. So, he did two weeks of in-center hemodialysis treatments while he had a PD catheter placed and waited for it to heal. As soon as he could, John began training to do his own PD treatments at home through his clinic, Fresenius Medical Care Central Ohio East.
John and his wife, Becky, learned how to safely do PD treatments in one week. “Kathy Nolen, our PD training nurse, was an excellent teacher,” said John. “She spent a lot of time explaining what to do and why, and she answered all my questions.” The training also included lots of hands-on practice doing actual PD exchanges with the same equipment and supplies that John and Becky would use at home. “We are trained to do both manual and cycler-assisted exchanges,” noted John, “but I knew from the start that I wanted to use the cycler so I could dialyze while I was sleeping.”
John felt he was very well prepared when it was time to go home and do the treatments on his own. “It was a seamless transition,” he recalls. “The repetition and consistency made home dialysis feel exactly like what we’d already done in training.” John also acknowledges the support he gets from his dialysis clinic. “I never felt like I was out there without a net. I have an emergency beeper number and know I can call anytime if there is a problem.”
Seven months after going home, John has settled into a regular PD routine. “My wife actually sets up the machine for me while I’m at work. Then, after dinner, I connect and do one exchange and disconnect. With that exchange, I have a 1–2 hour dwell. At bedtime, I reconnect, drain, and then let the cycler do the rest of my exchanges while I sleep.”
In the morning, John disconnects, takes his vitals and gets ready to head off to work. “The total time on dialysis is about 10 hours and includes 7 dwells,” he explained. John does leave some fluid in-dwelling as he goes about his day.
PD makes it possible for John to continue working. It also gives him time to spend with his wife and three daughters. “I have a young family,” said John, “and don’t want to miss any more family time than necessary. With PD, I can work and still have several good hours at home each day.” He uses some of that time to help his wife home-school their girls.
The rest of the family has also adjusted to dad’s PD routine. “Becky was nervous at first,” John admitted. “She didn’t want to be responsible if there was an emergency or something went wrong.” The training sessions helped Becky overcome her fears, and now she is as comfortable as John with the treatments. Even his daughters, who were a bit “skittish and scared” at first, now take his nightly treatments in stride. “My 4-year-old daughter likes to come in and check on me when I connect every night,” John said.
For John, PD has been a good choice. “Everyone has different demands on their time, “but from the perspective of lifestyle, PD does not disrupt what you normally do.” John readily admits that doing PD at home requires discipline and attention to detail, but considers it his best treatment option for right now. He remains on the list for a transplant, and hopes that staying as healthy as possible with PD will improve the likelihood of a good outcome.
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