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Dialysis Discussion => Dialysis: Home Dialysis => Topic started by: katieking1981 on December 05, 2012, 09:38:39 AM

Title: Home hemo and no heparin?
Post by: katieking1981 on December 05, 2012, 09:38:39 AM
John has been bruising easily since starting a daily aspirin regimen. His nurse suggested that we try dialysis with out giving heparin to see if it makes a difference with the bruising. I'm going to talk to het more about it as I'm nervous. Does anyone here not use heparin?

Thanks,
Katie
Title: Re: Home hemo and no heparin?
Post by: stringbandbeth on December 07, 2012, 06:40:03 AM
 Hubby is on kumadin (a blood thinner, as is asprin)  We run with only one bolus of only 1500u in the beginning of treatment. He has done many treatments w/o it too.
Title: Re: Home hemo and no heparin?
Post by: bevvy5 on December 07, 2012, 09:17:21 AM
When DD started hemo, he was on warfarin to dissolve some clots on his non-fistula arm due to an intravenous that went awry.  Personally I wouldn't agree to trying cold turkey without heparin.  Maybe they can tweak the running dose a bit.

I can't imgine now trying to get through a run without heparin.  He always has marks that looks like bruises on his arms, his neph has said it's not unusual so we don't worry about it.
Title: Re: Home hemo and no heparin?
Post by: boswife on December 07, 2012, 03:11:10 PM
once again.. IMHO.. :) . it's going to be a 'personal' thing... Unfortunatly, (or fortunatly) everyons different.  Hubby doesnt take asprin, kumadin, or use heperan.  We run at 300 for 3 1/2 to 4 hours.  Dont know what would need to be done if he went nocturnal though.  But for now, thats what he 'can' do.  I wouldnt want someone whos been on hep to go cold turkey either.  It would scare me a bit i think.
Title: Re: Home hemo and no heparin?
Post by: M3Riddler on December 21, 2012, 10:38:03 PM
John has been bruising easily since starting a daily aspirin regimen. His nurse suggested that we try dialysis with out giving heparin to see if it makes a difference with the bruising. I'm going to talk to het more about it as I'm nervous. Does anyone here not use heparin?

Thanks,
Katie

Katie,

How long are Johns treatments ?  Heparin has a half life of approx 4 hours..  Many that dialyze 3 hours and under to not use heparin.   You can also perform saline flushes every so often to flush the filter to insure it doesnt clot.

There may also be other reasons for the bruising... how are your platelets ?   Also, the aspirin can cause bruising.. You may want to request a blood test that measures bleeding times.. It is called an   InR.  You can google it for more info.  If the InR is on the higher side, this will cause the bruising...more than likely from asprin if it just started after that..   Did  John have issues with just heparin ?
Title: Re: Home hemo and no heparin?
Post by: M3Riddler on January 11, 2013, 06:51:50 PM
John has been bruising easily since starting a daily aspirin regimen. His nurse suggested that we try dialysis with out giving heparin to see if it makes a difference with the bruising. I'm going to talk to het more about it as I'm nervous. Does anyone here not use heparin?

Thanks,
Katie

Katie,

How long are Johns Treatments?  Many who dialyze the 2.5 hour "out of box" prescription often do not use heparin. Heparin has a half life of 4 hours.   Some people will use saline flushes every so often to clean the dialyzor out and make sure its not clotting.
Title: Re: Home hemo and no heparin?
Post by: highway61 on January 11, 2013, 08:14:15 PM
I have to admit that i don't totally understand the situation. As to the use of heparin, all I can say is that that while I was on home PD, and this was both manual and machine PD. I used to use heparin anytime my my drains started to get slower or yielded lower amounts. I used to shoot it directly into my feed bag and it tended to fix the problem.
I don't know it this helps.
Title: Re: Home hemo and no heparin?
Post by: Adam_W on January 12, 2013, 07:48:01 AM
Most of the time I was on home hemo I didn't need heparin. In fact I've been back on in-centre for almost a year and I still don't use it.
Title: Re: Home hemo and no heparin?
Post by: CebuShan on January 12, 2013, 08:25:21 AM
I tend to clot VERY fast so I use heparin every time. I usually run about 500/2.25 hours.