Angel went to a local center 3 times a week for hemodialysis for three years. Then, he started doing CAPD at home.

Watching and waiting

The onset of kidney failure was slow but relentless for Angel. After 30 years of diabetes, he began to have complications. He slowly lost his vision, and had to give up his business running a snack truck in his hometown of San Juan, Puerto Rico. Then, his kidneys began to fail. "He was going to the nephrologist for 2 years before he needed to start dialysis," said Angel's wife, Rose. About 18 months before his kidneys failed, his doctor said it was "time to start setting up for dialysis." So, Angel went to the surgeon for a fistula.

"We watched his progress every month," noted Rose. "We got lab reports, did 24-hour urine tests, and we went to the dialysis center and the hospital to see what hemo would be like." Because they were so prepared, Angel never really felt any symptoms of kidney failure and started dialysis earlier than most. "We didn't want to wait for a crisis," noted Rose, "so we went by the lab reports, not the symptoms."

Starting at the center

Angel and Rose did not want to do home dialysis at first. They thought there was "too much involved," and were intimidated by the thought. Besides, the clinic was close to their home, and the staff was terrific. "It seemed like it would be convenient," explains Rose. "Just go over there and they handle it all for you."

Angel chose the 4-8 pm shift so he could go in for his treatment and then come home and go right to sleep. "The treatment really does drain you," Rose observed. But aside from being tired after his sessions, Angel did pretty well for 3 years. He didn't like the needles, and had a problem with his fistula once, but he felt pretty good.

Need for a change

Then, Angel began to have liver problems. His belly would fill with fluid on the days between treatments, and he had fluid in his lungs. Angel went to the gastroenterologist twice a week, so the doctor could draw out the fluid with a large needle.

Week in and week out, this process took a toll on Angel. He lost his appetite—and 30 pounds. "He was down to 98 pounds," reports Rose. "He felt awful and looked awful, too. He hardly had the strength to walk."

Then, the gastroenterologist suggested that Angel try CAPD. Rose quickly followed up with the nephrologist, and Angel had a PD catheter placed. The couple received 2 weeks of PD training.

Because Angel cannot see well enough, Rose took on the task of doing his exchanges. "You have to keep your mind on what you're doing," Rose reports, "but it is not hard to learn."

Seeing progress

The switch to CAPD is working very well for Angel. "People who saw Angel six months ago can't believe the progress he's made," claims Rose. Angel has gained back the 30 pounds he'd lost, and has started to take an interest in life again. "He was resigned to dying," recalls Rose, "but now he is feeling better and is joining into our family life more."

The PD nurses have been very helpful and supportive, too. "They told him they wanted to see him get out of his wheelchair and walk in for his clinic visits," said Rose. And, he did! With the help of a cane, Angel can now walk into the clinic on his own.

Rose notes that even the nephrologists are amazed at Angel's progress. "They tell him he's one for the history books," Rose points out, "because he's doing so well in spite of the liver problems."

Getting into a routine

Rose and Angel have fit the four daily CAPD exchanges into a routine. They have a bedroom just for exchanges so all the supplies are handy and it is easy to keep clean. When the door is closed, it means Rose is helping Angel with an exchange, and "grandchildren and other family members know they shouldn't disturb us."

Rose has worked out a schedule that suits her and Angel, and she has come up with a some time saving techniques. She likes the fact that she can move an exchange around a bit so she can run errands, like taking her granddaughter to a karate class.

Angel feels well enough to lend a hand, too. "He wasn't too cooperative at the start," Rose recalls, "but now he feels better and helps with some of the prep, the blood pressure, and clamping." She and Angel are getting so good at CAPD that they are thinking about taking a little trip. "You don't have to take all the boxes with you," said Rose, "you can have your supplies shipped to the place you want to visit."

Worth a try

Both Rose and Angel have come to value doing PD at home. "It is very flexible," Rose describes, "so you have more time to do other things." Rose and Angel also like the fact that with CAPD, Angel can eat more of the foods he likes. "The other diet was so limited," Rose complained. "Everything was 'no.' Now he can eat more of the things he wants."

They didn't want to "do it themselves" at first, but Rose has changed her mind about home dialysis. "It's a good option, and people should try it," she asserts. She believes home treatments make good sense, especially for young people and people who work. "If you can do it, give it a try!"