A Poem to Commemorate Our Home Hemodialysis Learning curves
![A Poem to Commemorate Our Home Hemodialysis Learning curves](https://hdc-image-uploads-prod.s3.amazonaws.com/uploads/post/featured_image/629/hdc-blog-jan-23-2025.jpeg)
![Poem about Home Dialysis.](/images/blog/1-23-25/image2.png)
From the day my husband Steve was hospitalized for kidney failure, we have been on many learning curves. First, adjusting to the shocker that his kidneys had failed. Then, being told he needed dialysis immediately, and a catheter would be surgically implanted in his neck. Lots of tears on my part, but he handled it stoically.
After his discharge two weeks later, we were scheduled at a dialysis center 30 minutes away from our rural home. Three days a week, I dropped him off at the center, and while he was in treatment, I either ran errands or walked at a park behind a library near the dialysis center. Lab results indicated his potassium was slightly high, and a binder was recommended. I said, “Give me two weeks.” I researched potassium levels in produce and we adjusted our diet. Follow-up labs showed he was within range – and has been ever since.
When we were offered home dialysis, we jumped at it – to spare us the drive and gas, and give us more flexibility in our daily schedules!
We began training four days a week at a clinic only 10 minutes away. We were assigned to an incredibly experienced, and very patient nurse-trainer Jorge. At first, I just watched, wrote down each step he demonstrated, and typed them up afterward. Initially I found the process very intimidating and had moments when I doubted I could do it. But Jorge kept encouraging and reassuring me that I would get it. One complication was the neck catheter, requiring protocols of dressing changes, and saline and heparin flushes of the ports.
With each new step, we practiced what we had learned, with Jorge coaching us along. As we became more familiar with the process, he supervised me as Steve read each step from the booklet I had typed up. Four and half weeks later, Jorge was satisfied that we had it down and could begin dialysis at home. Machine and supplies arrived. It was daunting. Jorge came to our house, set up the Wifi-iPad connection and supervised our first home treatment.
On our own, we made a few beginner mistakes, causing alarms to go off, but quickly learned to resolve them, and swear never to make them again! Instead, we made other mistakes. But I no longer panic when I hear the coffee pot beeping as it turns off, or the oven beeping when it reaches temperature.
The choreography of our routine has evolved. Steve places a bag on the warmer and hangs four more on the machine. Meanwhile, I gather beginning treatment supplies – heparin, flushing syringes, neck-cath dressing, hemaclip, alcohol pads, and run the waste line to the kitchen sink. While he takes his vitals and enters the data into the Ipad, I attach the lines to the dialysate bags, break the cones and prime “the short green line.” Then I insert the cartridge into the machine, hang the saline bag, spike it to the multi-lines, attach the clear plug to the machine and start the 23-minute run time. During the run time, I change his neck-cath dressing and he talks me through the steps for the heparin pull, saline flushes, and heparin flush.
When the machine is ready, he guides me through Snap and Tap, setting volumes and speed on machine, and final connections. (Perhaps someday I’ll be able to perform without his recitation but for now his recitations are our “security blanket.”)
During treatment, as bags empty, I hang the additional bags, and finally the warmer bag. I gather supplies for the disconnect, and when treatment is completed, he takes me through the disconnection process. While he records and submits his vitals, I remove cartridge, saline bag, and waste line. Then he removes the empty dialysate bags - and we’re done!
We are now able to fit dialysis sessions around appointments and activities and we have a reliable support system with staff at the clinic, especially our trainer-nurse Jorge.
After I read this to Steve, I said, “It looks like I do more than you.” He responded, “Yes, you do!”
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