Time line for starting NxStage

[MooseMom]

This is probably not the best time for me to be asking this; y'all know how I overthink things, but confusion makes me more fearful, so I'll ask, anyway...
Looking at my latest labs, I'm probably going to be on D sooner rather than later.  I am getting my fistula on Monday.  I want to use NxStage but I am confused about whether or not people usually start in clinic and then start training for NxStage asap.  My surgeon and the SW at the clinic I'll be using say that it is best to start in clinic just so that I will have support in the beginning and will have people to help me learn to stick, etc.  My transplant coordinator, who was a dialysis nurse for years, says that I can start NxStage immediately and don't really have to start in clinic.  On the one hand, I know all about the benefits of NxStage, which is why I want to do it.  On the other hand, if I'm honest, I don't know if right now, my brain is going to absorb any new information while I am in the process of starting dialysis what at the same time I'm going through all the tests to get on the transplant list.  I don't know how much time I have.  I thought I might have more time, but everything now seems sort of rushed.  I am getting my fistula as soon as humanly possible, but I have this suspicion that despite my speedy attention to this matter, I may wind up on D before it matures.  So, my question is...is it more common to start in clinic and then transition to NxStage, or do most people (who have fair warning) go right to NxStage?  Thanks.

[monrein]

My opinion is that it would be best to start in center so that you can adjust to all aspects of what actually happens and also so that your fistula can mature.  Get comfortable first, then go home with the machine.  You can use your time in center to watch, learn and observe so that you'll be primed and ready, so to speak, to start training with a vengeance.   

[M3Riddler]

Hi Moosemom,

As long as your fistula is mature before you start dialysis, there is no reason why I see you should have to start in center. When you train on Nxstage, they will not let you leave and start at home until you feel comfortable and they think you are able.
Do you know approx how much time you have until you will need to start?
If your fistula does not mature before you need dialysis, you will be required to have a cathetar. This is a different story. Then I recommend you go in-center.

Other than that, I would highly recommend staying away from the in-center setting. You are in much better care at home with your caregiver. In many centers, but not all, it is my knowldege that many of the techs are there for just a job and it is like a rotating door with new employees. Like I said, not all centers are like this.

If you know that you would like to use NxStage, try to get on the training schedule as soon as you know when your fistula will be mature so you do not have to wait for a spot and therefore go in-center.

Remember, as i said before, they will not let you take yoru machine home until you are fully comfortable using it.

///M3Riddler

[jbeany]

Check with the dialysis center you are going to use.  Mine has a policy that you must have at least one month in center before they will train you.

[cookie2008]

You need to do what ever you are comfortable with.   

[Zog]

You can use the NxStage machine at home with a catheter if you have to.  My advice is to start in a center for a least a week or two so you will know how being on dialysis feels then you can better understand your NxStage training and why you don't want to be incenter so you don't ever think it would be a good idea to quit NxStage. 

While you are doing your NxStage training you will be doing dialysis with a NxStage machine in a center surrounded by nurses most likely.  In that way you are incenter, but at our center at least, home training is done in small private rooms instead of on the main, wide open, dialysis clinic floor (rows of machines spaced 8' apart).

Jenn has never had the luxury (or anxiety) of sliding into a dialysis treatment regimen.  She has always started back on the D after a traumatic hospital trip and wham bam boom she has a catheter and is on dialysis.  I don't know if that will happen to you, but this decision may be made for you, if that helps.