want to do nocturnal home hemo but clinic only offers daily home hemo!

[happyonhemo]

  I started nocturnal in-center hemo just over 3 months ago after 10 years+ of in-center 3x week hemo and I love it!I love how much better I feel in every way and I love that my labs are better and I love going at night and dialysing while I sleep.The only bad thing about it is that the closest clinic that offers it is a 25 min. drive away and I'm not driving now so that means my husband has to take me at night and then pick me up early in the morning.When I started he'd drop me off at 8PM and pick me up between 4:30 and 5AM and that was fine but since then they changed the time to an hour earlier so now he has to get up at 3AM to pick me up between 3:30 and 4:00.Just that one hour is making life miserable for the whole family.He doesn't seem to get any sleep on the nights when he has to get up at 3:00 and then he's tired all day and can't get anything done and he's grouchy and when he's grouchy we're all walking on eggshells.I think the best solution is home hemo which I'm interested in anyway just because I like to be involved in my own treatment but the center that I was referred to for training in home hemo doesn't do nocturnal,they only train for daily with the NxStage and it seems to me that going from nocturnal to daily is taking a step backwards.Am I wrong?Nocturnal is 8 hrs,3x a week so thats 24 hrs a week and daily is 3 hrs,5 or 6x a week so thats 15 or 18 hrs a week.Would I notice the difference?The nurse who does the training says not to worry cuz all her patients end up with a Kt/v of about 2.5 but mine is already 2.76!I'd love to get some feedback on this as I have to make a decision asap.Also,I'm currently with Davita and I'm in the Tampa Bay area of Florida but I would gladly switch to another clinic if it would make it possible to do nocturnal at home so if anyone knows of one, please let me know.Thanks to you all for any help in this matter!

[Wallyz]

Get the home training, then push for nocturnal.  It's coming, and you can help pave the path at your clinic.

[jbeany]

I haven't done nocturnal, so I don't know about the difference, but I do know that I felt fabulous on 5 days a week with NxStage.  I had to switch back to regular in-center, and I can certainly tell the difference!
I think that you'll probably feel as good on 5 day as you do on nocturnal.  Home has the advantage of clearing the toxins more often, so they don't build up.  I never got that washed out, tired feeling. Many centers are starting to offer nocturnal on the nxstage - although they can't officially call it that - it's "extended" treatments. 

Remember - if you start NxStage, and decide the nocturnal in-center worked better for you, there's nothing to stop you from changing back.

[del]

Hubby tried doing short daily first when he started home hemo. He was having trouble sleeping so he thought it would be better to do short daily.  When he had blood work done all the readings were about the same as nocturnal except for phosphorus!!  He would have had to go back to taking binders.  He decided to go back to nocturnal. 

I think you should train for the home hemo and then push for nocturnal. At least you will have the training done and be able to change if it became available.

[aharris2]

Happy,

We also live in the Tampa Bay area,tampa to be specific. I am caregiver to my brother who dialyzes at DaVita, Temple Terrace (day only).

I understand that DaVita, Plant City has in-center nocturnal. Is that where you go?

I have been told that there is a Fresenius unit on 46th Street in Tampa that offers in-center nocturnal.

Alene

[happyonhemo]

 Thanx for all the great replies! Every one of them was helpful information! I guess I'm gonna go ahead with home training and then try for the nocturnal (extended) treatments.Thanx again.Will keep you posted.