"I've tried every kind of dialysis there is—and a transplant," says Joyce. "For me, this (nocturnal home hemodialysis (HD)) works better than anything."

Voice of experience

Joyce started dialysis when her kidneys failed in 1989. Since 1997, she has been doing home HD at night. "I was one of the first to try it here in Lynchburg (Virginia)," she says, "and now they tell me I've been doing it longer than anyone else in the U.S."

Joyce was not doing well with in-center HD treatments. Dr. Robert Lockridge, her nephrologist at the Lynchburg Dialysis center, offered her a chance to try a "new" type of dialysis that was being tested in Canada. "I thought about it for a few months," says Joyce. "It was very new. But, the Canadian patients were reporting such good lab results—and I was having so many problems—that I gave it a try."

Do-it-yourself routine

Joyce learned how to do her home HD during 5 weeks of intense training. "In the last week, they put me in a room with a phone and I had to do the treatment by myself," she says. "If I needed help, I had to call!"

Even with the training, Joyce admits she was nervous the first few days at home. "It's human nature to watch the machine," she says. "Now I know it's safe and the alarm will wake me up if there's a problem." She avoids daytime naps to make sure that she is tired and ready to sleep at bedtime.

After all these years, of course, Joyce has her HD routine down pat. Five nights a week, she sets up her machine and does about 7.5 hours of treatment while she sleeps. "The machine set-up used to take me an hour," she says. "Now I can do it in 40 minutes." To make it more convenient, Joyce breaks her set-up into segments: 20 minutes at about 7 pm, and the last 20 minutes just before she goes to bed. "The morning clean-up doesn't take long at all," she says. "I just unhook and turn my machine on heat disinfect." Because her Fresenius 2008H dialysis machine uses a resin bag water purification system, she doesn't need to disinfect any reverse osmosis (RO) water treatment equipment. "My husband helps with lifting supplies," she says. "Everything else I do by myself."

Better health

"With home HD at night, I feel good," Joyce says. She no longer has the problems with nausea, cramping, or loss of appetite that she had with other types of dialysis. She also enjoys the freedom to eat and drink fluids with very few limits. "Every aspect of my health has improved," she says. "My color is good. Most people don't even know I'm on dialysis."

Feeling good has made it easier for Joyce to stay on the job as a tax preparer and office manager at H&R Block. Although she never quit during her first 8 years on dialysis, she often had to take sick leave. Since she's been home on HD, she's only taken a few days off.

"Every person is different when it comes to dialysis," says Joyce, "so it's hard to be an expert." And, she still has problems with allergies—mostly to the skin cleaners she uses on her catheter exit site. Still, Joyce feels so good with her home HD that she would tell any new patient who has the chance to "take advantage of it!"