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MooseMom
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« on: March 17, 2010, 07:47:23 PM »

My mom has been on in-center hemo for about 5 years now.  She is 81.  She is not doing too well these days.  She is retaining fluid that dialysis doesn't seem to be getting rid of.  She had a pacemaker put in a year or so ago, and while that made her feel better for a while, she is now having trouble with low BP and is always having to have oxygen while dialyzing.  She was telling me today that her clinic has started up a nocturnal unit; she happens to like all of the techs that have been moved to nocturnal.  I told her that data suggests that nocturnal hemo gives far better clinical results than in-center, and she has promised that she'll check it out.  I've told her about this forum, and I would be very grateful if any of you on nocturnal could give me some positive things that I could tell her.  I am really fearful for her health, and I am hoping that changing from the basic every other day modality to nocturnal will make her feel better.  Thanks so much!
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« Reply #1 on: March 18, 2010, 06:53:39 AM »

My Nocturnal is still only 3 nights a week.  I guess some have 5 nights a week.  But, I was having problems where day shift of 4 hours could not remove my fluid buildup.  The 8 hours at a slower blood pump speed got it.  The problem I see would be could she sit in that chair for 8 hours.  I guess some places have beds.

Best of luck.  Go Nocturnal if at all possible.
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kitkatz
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« Reply #2 on: March 19, 2010, 10:53:33 AM »

I have been on nocturnal ver a year now. I feel better and the fluid build up and toxins are better.
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MooseMom
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« Reply #3 on: May 04, 2010, 01:34:53 PM »

My mom has started wearing surgical hosiery to dialysis, and this seems to be helping remove more fluid by pushing it all upward, I guess.  She told me that when she asked about moving to nocturnal, the head nurse said, "Absolutely not."  I asked my mom why she was told this, but she doesn't remember.   What would prevent a dialysis patient from being a candidate for in-center nocturnal dialysis?
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« Reply #4 on: May 05, 2010, 09:03:19 PM »

Maybe the night shift crew aren't as skilled as the day shift.
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MooseMom
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« Reply #5 on: May 05, 2010, 11:40:34 PM »

My mom actually really likes the night crew as, before, they had been her day crew.  So I don't think that's it.
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« Reply #6 on: May 06, 2010, 04:31:53 AM »

She (or someone) should ask for details of their reasoning about this.
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M3Riddler
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« Reply #7 on: May 06, 2010, 12:01:29 PM »

My mom has started wearing surgical hosiery to dialysis, and this seems to be helping remove more fluid by pushing it all upward, I guess.  She told me that when she asked about moving to nocturnal, the head nurse said, "Absolutely not."  I asked my mom why she was told this, but she doesn't remember.   What would prevent a dialysis patient from being a candidate for in-center nocturnal dialysis?

MooseMom,

First it is not up to the head nurse to decide if your mom should be able to go on nocturnal. It is up to your mom and her nephrologist.
It is unethical for the medical professionals to withhold and discuss all treatment options to the person. Especially if your mom asked about it. 
Are you ever around when the nephrologists makes their rounds in the unit? iHow involved are you with your moms treatment? and has your mom signed the proper HIPAA paperwork for you to be incolved in her treatment to discuss along with her any questions she may have?
either yourself or you mom should bring it up to the Nephrologist that that she is interested in nocturnal and would like additional info on it. They must provide it to you and cannot deny you that.
Noctunal is much better and gentler on the body.
Whatever you do, dont give up and learn as much as you can and get involved as much as you can along with your mom. Information is knowledge and power.......
Here is some information on nocturnal dialysis you can look over:
Nocturnal Dialysis 
It may take a minute or so to load.....

///M3R
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MooseMom
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« Reply #8 on: May 06, 2010, 12:40:46 PM »

M3Riddler, my mom is in Houston and I am in Chicago, so no, I'm not around when her neph makes his rounds.  As I am headed for dialysis myself in the probably not too distant future, I have researched all modalities and understand the pros and cons of each.  I do understand that nocturnal is extremely good at delivering optimal dialysis, which if of course what I want for my mom.  I have asked her the reasons she was given that nocturnal was not good for her...I have asked her several times, but she does not seem to remember.  My mom is far from senile, but she is 81, and she has a lot on her plate, and I think she is happy just having the staff in clinic look after her.  She is not her own best advocate, unfortunately.  She doesn't really care about the hows and whys of dialysis as long as she can get out asap and continue her life.  For her, a modicum of ignorance is a modicum of bliss, I suppose.  This is why I posted this question here on IHD...I thought someone here might give me some insight into why nocturnal would be denied to anyone. 
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« Reply #9 on: May 06, 2010, 02:17:58 PM »

Lack of space in the night clinic would be the only rational reason I could think of - and even then, she should be put on a waiting list.
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MooseMom
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« Reply #10 on: May 06, 2010, 02:55:17 PM »

Nope...it's not lack of space, either.  My mom told me they are still looking for patients to do nocturnal.  I'm sure there is a reasonable explanation; I just don't know what it is.
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"Eggs are so inadequate, don't you think?  I mean, they ought to be able to become anything, but instead you always get a chicken.  Or a duck.  Or whatever they're programmed to be.  You never get anything interesting, like regret, or the middle of last week."
jamoman
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« Reply #11 on: May 11, 2010, 02:37:54 AM »

where in houston? spring, league city, omni.
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M3Riddler
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« Reply #12 on: May 11, 2010, 01:55:25 PM »

This is why I posted this question here on IHD...I thought someone here might give me some insight into why nocturnal would be denied to anyone.

If the person is willing and able to learn nocturnal, there should be no reason why they shouldnt be able to switch. If your mom did it at home, then someone would have to be there as her partner. If there is no one availablke, then this would be a legitimate reason why they would not let her switch.
But as to in center nocturnal, there is absolutely no reason why she shouldnt be able to switch. But again, this is a decision the nurse cannot make. If the nurse brings up age, that is hogwash. There are home dialyzors that do nocturnal in their late 80's if not early 90's at the clinic I belong to. They are doing just fine.

///M3R
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