I Hate Dialysis Message Board
Dialysis Discussion => Dialysis: Home Dialysis - NxStage Users => Topic started by: Neo on September 16, 2008, 02:47:26 PM
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I do in-center Nocturnal Hemodialysis and the only thing that gets me through the treatments is my benadryl that I get injected into the line during the treatment becasue it knocks me out and I can sleep. Does the Nxstage line have a port where you can inject meds straight into the line???You guys know what im talking about??
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Neo I think once you start Nxstage you won't need Benadryl, Otto stays busy on the Computer while he's on.
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Neo, I'm pre-dialysis but should start any time now. My Neph. wants me to do incenter nocturnal and I really think that would be best for me. Tell me, is it difficult for you to sleep at all without the Benadryl? Is it the sounds or the fact you can't move that make it difficult? Do they turn the lights way down or not at all? Rerun and Kitkatz seem to like nocturnal so much better than regular session dialysis and my Neph really recommends it. Also, how has doing nocturnal dialysis affected your diet? Do you eat more "normal" and drink more "normal"? Sorry for hijacking your thread with all these questions.
I hope someone can answer your questions. :thx;
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Most lines do have a port for injections. If not, you center can make sure you get the right ones.
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The entire time Marvin was in-center hemo, he always took three Benadryl pre-treatment (over twelve years). Since he's been on home hemo, no Benadryl AT ALL.
His NxStage machine does NOT have a port for injections.
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If IV meds are absolutely needed on NxStage, there is a port on top of the dialyzer that can be used to inject meds. That's not what it's actually for (it's a port for removing air from the system), but it can be used for that. Most NxStage patients end up not needing any IV meds during treatment, unless the centre's protocol involves giving IV EPO or iron.
Adam
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You can use the port for IV meds, but sleeping during your NxStage run isn't really practical - you have to record readings every half an hour. Your run time will likely be about 2 and a half hours, not the 4 you do in-center. NxStage is supposed to be changing the tubing system to include a port sometime soon.
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I do extended therapy on the nxstage, and so I sleep with it. I sleep better with it than without it. You can use the air bleed valve to inject meds if you want. If you are doing Nxstage, and are used to nocturnal, I would encourage you to look at extended therapy.
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Neo Otto said to let you know when he falls asleep(he tries not to) he wakes up feeling like :puke; he has to record his readings every half hour so that helps not to fall asleep.
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well I'm going to be doing 7 hour treatments which is what I do now.. I absolutely need the benadryl injections to sleep. I have a partner that will be monitoring me so I'll be able to sleep but I absolutely need he bnadryl injections because it gets me through the treatment.. Isn't there a port in the line that you can inject directly into the fistula like my in center? It's a no go for me if it doesn't have that.. Can someone post a pic ofthe lines connected to the needle? Thanks
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Can't you just take it orally a half an hour before you start?
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NxStage is presently working on installing a port for medicine but Davita doesn't "allow" us to use any of the existing ports for medication. I have to self inject my EPO and have to go to the clinic for Iron etc. I don't know about NxStage that is used by NON Davita but I am checking into that next week after my day today.
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I'm using mine for Hectorol right now. NxStage itself doesn't encourage the use of the air valve for meds injection, but I'm thru a private clinic that gives more leeway on a case by case basis. It's also possible to inject some meds directly into the cannulation lines before connecting to the machine. Iron is more complicated - very few insurance companies will cover it for home use. I had to go to the infusion center for mine.
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I gotta find batteriess for my camera, but I will try to get pics up later.
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Neo- Here is the port on the outflow end of the filter
(http://i95.photobucket.com/albums/l155/jespeachy/DSC01334.jpg)
The port can accept a standard 3 or 10 cc Syringe. If you inject benadryl into the system after starting the pump, it will hit your system before the first blood starts back.
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I inject Rob's Epo and Iron treatments into that port, his dialysis nurse told us to do it that way. Just make sure you flush after each injection. He has been doing this for over 1 1/2 years and has no issues at all.
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does that go directly into the vein or through the machine and then into the vein? I get mine in the port nearest to my fistula so the benadryl doesn't dilute on it's way into my body.. I know I sound difficult but I have such restless legs and sleeping problems that it's the only thing that gets me through my treatments.. Oh and thanks for all the info your all a huge help as usual... Oh, and no benadryl in pill form is way different than IV form. I'm sure some of you have had IV benadryl and may understand why I can't do without it while I'm waiting for my transplant during treatments... You all are great thanks so much for your effort in figuring this out for me.. My dialysis is avprivate company not davita by the way..
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Anything that goes into that port will not be diluted, because at that point, the blood has already passed through the dialyzer and is on the way back to your access. It only goes through a pressure sensor and an air detector, but those have no effect on any meds that may be injected into the port. And like skyedogrocks said, make sure you flush the port with a little bit of saline after the benadryl is injected, otherwise it will just sit there in the port and the top of the dialyzer and not go anywhere.
Adam
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What he said. It's on the outflow side, so it is not diluted much at all.
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AWESOME !! Thank you so much for that info!! Benadryl IV is the only thing that calms my legs during treatments... I think ill try it out now, starting next month...
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Just stick to your guns and get pushy if they say they can't let you inject meds that way. Plenty of us are doing it!
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I think it depends on who trains you...but when I did home for a year they told me they didn't want me sleeping. I had to be able to respond to any alarms or problems that my arise during treatment. But if you have to have it make sure they are aware of that before you start training.
Also, I'm kind of shocked they have you doing 7 hour treatments...is that 3 days a week or what?
I was doing 2:30-2:40 depending on how much I put on in between treatments...3X a week.
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It's the extended therapy option. You use the same amount of dialysis, but run the pump and the dialyisate at a slower rate. what this does is slow the process to pull everything out of the body more gently and more slowly, so that your body can move toxins out of the tissues and into the blood where it can be filtered out.
There is a heparin pump that attaches to the system so that clotting is less of an issue, and when you pull water off more slowly, you have less issues with cramping, restless leg, and other issues.
I run 7 to 7 1/2 hours overnight, six days a week. I have normalized my diet, do not take binders, and was able to climb Mt Pilchuck (http://www.parks.wa.gov/mtpilchuck.asp) a couple weeks ago. If you are looking to feel close to healthy again, I would encourage you to look into it.
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I know this is an old thread but I am new here so it's new to me :waving; I am interested in the nocturnal dialysis. I was told that Davita doesn't train for that but perhaps another center does. Is it covered by insurance without any problems?
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Medicare covers it just like normal dialysis at a center.