John

About John

Treatment Type Nocturnal Home Hemodialysis
Gender Male
Age 80s
Marital Status Married
Kids No / Not at Home
Work Status Retired
Race White
Pets No
Cause Unknown
Travel No
Poor Vision No

"I guess you can teach an old dog new tricks," laughs John, "because I started training to do my own dialysis at 81!" Today, John is still going strong and may be the oldest person in the U.S. doing home hemodialysis (HD).

Unplanned start

In late 2002, John's doctor told him his kidneys were failing. He and his wife, Sarah, of Lynchburg, VA, talked to their nephrologist, Dr. Robert Lockridge, about training to do dialysis at home. Their plans were put on hold when John had a heart attack.

"I went into the hospital for the heart attack," said John, "and started dialysis there—much earlier than planned." The heart problems, fluid overload, and low kidney function sent John into kidney failure. "Before my kidneys failed, they tried to put a stent into one of my kidneys to help keep it working," recounts John. "But, it didn't work."

John did his treatments at Lynchburg Dialysis Center when he got out of the hospital. He dialyzed 3 days a week for 4 hours at a time, but didn't much like it. "The schedule messed up everything," he says. His wife, Sarah, agrees: "The only time the center had open was at 5 pm. So, our dinner time was interrupted and we didn't get home on dialysis days until 10:30 or 11:00 pm." And, John didn't feel very well. "He was cold all the time, and very tired," adds Sarah, "and he was itching like mad."

A better way

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As soon as they could, John began to train for home HD, encouraged by Dr. Lockridge. The knowledge that there were other people doing home HD convinced them to give it a chance. Notes Sarah, "If other people could do it, we could do it, too."

"We went to training classes 5 days a week for 6 weeks," recalls Sarah. As dialysis partners, they both needed to learn all about dialysis, the machine, the alarms, the blood tests, catheter care, and more. "At the center, they have a huge workbook for training," says Sarah. "There's so much to learn."

Despite their ages (John was 81; Sarah was 74), they chose to take on the challenge of home HD and all the training because they believed it would make their lives better. "You get more dialysis," says John. "So, it is more like having a kidney." All that HD lets John eat almost anything he wants. And, he likes having fewer limits. Plus, he feels a lot better. "I feel like I'm 75!" John jokes.

On their own

Even though the training was thorough, John and Sarah were a little nervous about going solo. "During training there was always a nurse close by," comments John. "If you had a problem, you'd ring a bell and they'd be there in a second."

Now, if they need help, they call one of the home dialysis nurses. "You can call anytime, day or night," notes John, "and they will call you back in 2 or 3 minutes." Nerves were not the only problem that John had when they first went home—they also had equipment troubles. "We had a bad computer on our first machine," explains Sarah. "We had a lot of alarms until they replaced it. Since then we've hardly ever had an alarm."

They have had some scary moments, though. Like the night John complained that his "head was hot." Sarah got up to check and found that the dialyzer was leaking. John's blood pressure had dropped to a dangerously low level. "I gave him some saline and called the nurse," relates Sarah. "When they called, they told me I had done the right thing and I should watch John carefully. If his pressure dropped any more, we were going to go to the hospital, but it didn't and we were fine." That episode convinced Sarah and John to put a moisture sensing pad (used as a bed-wetting alarm) under the machine. If the dialyzer leaks even a drop, the alarm goes off to prevent major blood loss.

Comfortable routine

At home, they have settled into a comfortable routine. John sets up the machine (a Fresenius 2008K), primes it, and runs the tests. He also takes his blood pressure and weight. Sarah prepares the syringes that are used to flush John's catheter. "We start getting ready a little after 10 pm," says John, "and I'm on by 11 o'clock."

The machine runs for 8 hours at the night while John and Sarah are sleeping. "In the morning, you disconnect and flush the catheter," says John. There are also a few steps needed to cleanse the machine after a run. "It's pretty easy for us now," claims Sarah, "and we've even tried to show our grandchildren how to do some of the steps."

John and Sarah do a treatment 5 nights a week. They take Wednesdays and Saturdays off. "It gives you a little break," notes Sarah. "And we can use those days to travel to visit our relatives who don't live too far away."

Making adjustments

John and Sarah have made adjustments to fit in home HD. For one thing, they've added a room on the first floor. "We have a 2-story house and our bedroom was upstairs," explains John. "Sarah designed a 'dialysis room' on the first floor so we can keep the equipment and supplies downstairs and still have a closet big enough for our clothes." They also put a bathroom and a laundry tub in the room for convenience.

They put the dialysis machine on a 4 x 8 sheet of plywood covered with linoleum. "We occasionally have a little leak," John comments, "but it's easier to see and clean up on this type of flooring." Though their water comes from a well, they had no problems with their water supply. Their electrical system was fine for the machine, too.

Once a month, they take a blood sample and water sample into their center for testing. Then, John goes back to the center later in the week to meet with Dr. Lockridge and his staff to go over the test results and discuss any concerns or needed changes.

The right decision

"I had my doubts about all this at first," remembers Sarah. "Three weeks into it, when we were having all those equipment alarms, I asked myself 'Should we have done this?'" But now she and John are happy they stayed with it. Adds John, "This [home dialysis] is the way to go."

A 2013 update from John

"Seven years ago you spoke with me and wrote an article on my story. I am now 91 and have been on dialysis for 10 years. I'm still doing okay. I have some aging problems with my legs and use a walker for balance, but am dialyzing every other night. My pressure is good, my appetite is great, and I am on no new medicines except prednizone because of an incidenct last June. This was the only hospital stay I have had except for the occasional block in my catheter.

"I still cut some of my four acres of grass and leaves and attend church each Sunday and a meeting each Tuesday. I am probably not quite as active as in 2005—but, after all, I am 91 now!

"I am still on the Fresenius 2008K machine and am happy with its performance. My wife and I start hooking up at 10:30 and run 7 hours. Our day is ours to enjoy and after almost 10 years on home I still feel it is the way to go for dialysis treatment!"

John passed away in 2013 at the age of 91.