9:30 pm. CLICK - Turn on the dialysis machine. Wash hands with antibacterial soap. RIP RIP - Tear open the two outer bag covers and check integrity of the inner six-liter dialysis bags. RIP - Open the cassette and tube bag. SNAP SNAP SNAP SNAP SNAP SNAP - Close six tube clamps. Press GO, BEEP - To Start. Load the cassette and place the drain line. BEEP - Press GO for self test.

9:40 pm. Face mask on. Connect the bags, SNAP SNAP SNAP - Open three clamps. Press GO, BEEP - for priming. Take a shower, clean the body catheter exit site and get ready for bed.

10:00 pm. Face mask on. Uncap body catheter and connect to the machine, press GO and go to bed. Read for an hour and one half or watch TV. Sleep for eight hours while the machine is doing its job, draining the peritoneal cavity, refilling it with fresh dialysate and holding for about an hour and one half, and then repeating the process three more times. Wake up about 7:30 am when the machine is at END OF THERAPY.

7:30 am. Face mask on, antibacterial hand wipe, close clamps, SNAP SNAP SNAP, disconnect body catheter from the machine line and cap it off. Record data: blood pressure, temperature and fluid quantities. Remove cassette, tubing, the empty bags, and place it all in the waste basket. CLICK - Turn off the machine. Put two new bags on the machine to be ready for the next night session.

7:40 am. Get dressed eat breakfast and I am ready for the new day. Sound complicated? It was for a few days four years ago when I started dialysis. Now after having done this well over one thousand times it is all automatic and I don’t even have to think about it. The antiseptic procedure is built into my brain and I do not make mistakes. But I always remember I must do this each and every day, seven days a week until I die or get a kidney transplant. I do this entirely on my own and the total extra time each day is about twenty five minutes, not bad for good quality life saving treatment. I feel fine. No pain and lots of gain!

I have always been a “loner” and like to do everything for myself. Thus this is the best dialysis therapy for me. Also the diet and fluid restrictions are much less onerous than with hemo dialysis. To help with diet analysis for kidney patients, my wife and I developed a computer program five years ago available for no cost and which is widely used.

In addition to the twenty-five minutes per day set-up time, I go to the dialysis center for blood tests and examination once each month. Being retired, I don’t have to work. But shortly after starting dialysis, I did do some substitute teaching to fill in for another faculty member and had no problems with the work. Traveling is also relatively simple. I have flown across the country four times and driven across once carrying enough boxes of fluids for the trip in the Jeep. Long vacation trips only require having the dialysis fluids delivered to the destination, which is easy to arrange.

When the need for dialysis is drawing near it is a particularly stressful time for the patient and good advice, information and help should be furnished. With the strong support from my nephrologist and nursing/training staff it was easy for me to select and prepare for the modality (peritoneal dialysis) best for me. Several years into dialysis, we relocated to a different city and dialysis center. I continue to be responsible for my own treatment, which is the way I like it, but it is great to be supported by the high quality, friendly, and caring medical and nursing staff at the new clinic. I appreciate how well off I am when on my clinic visits I see many patients in wheelchairs unloading from the health transportation system for their hemo dialysis sessions.

It is time to go outside and do some trimming and weed whacking to get ready for flower planting. Then do some reading and prepare and eat my supper. Watch TV.

CLICK - Turn on the machine and start all over again.