Preparing to go on NXStage at Home and have questions

[dkerr]

When I started dialysis back the end of December the nephro that watches over the clinic immediately encouraged me to look down the road to start home hemo.  They started my buttonhole about 5 weeks ago and started today with dull needles.  Why the difference in needles?

I was told my center was going to support home hemo but they haven't found a nurse yet. If I go for training, then I'll have to go to a center about an hour away.  Would it be better for me to wait until they have someone at the center I've been using?

When they set you up for home dialysis, what supplies do they provide you with?

Cannulating myself isn't a problem for me.  I'm not afraid of it at all.  Maybe because of poking my fingers for years.   




Edited: Fixed error in Subject Line - okarol/admin

[jbeany]

When I went on NxStage, I had to provide my own chair, big trash bin, trash bags, heavy duty storage shelving, an egg timer for counting down the 3 minute wait for the heparin, bleach, paper towels and a tubbie to store the bleach water for cleaning the machine after a run, and a rolling cart to store supplies in.  I also bought walkie-talkies to make it easier for my partner to move around the house and yard.  My center or NxStage provided the scale, thermometer, bp cuff, plumbing connections, and every medical supply I needed to run the machine, like gloves, bandaids, gauze pads, etc.

[Wallyz]

Go to the training as soon as possible, and try to get on the extended therapy.

Ask your center what they provide,and what you will need to provide.  These are good questions, but you need to ask your trainer.

[willowtreewren]

an egg timer for counting down the 3 minute wait for the heparin

Huh? My center has never said anything about a 3 minute wait.

We also got a dialysis chair to use at home. The rest of the stuff you mentioned, Jbeany, is pretty much what we have to supply.
Aleta

[monrein]

When I started dialysis back the end of December the nephro that watches over the clinic immediately encouraged me to look down the road to start home hemo.  They started my buttonhole about 5 weeks ago and started today with dull needles.  Why the difference in needles?

I was told my center was going to support home hemo but they haven't found a nurse yet. If I go for training, then I'll have to go to a center about an hour away.  Would it be better for me to wait until they have someone at the center I've been using?

When they set you up for home dialysis, what supplies do they provide you with?

Cannulating myself isn't a problem for me.  I'm not afraid of it at all.  Maybe because of poking my fingers for years.   



Edited: Fixed error in Subject Line - okarol/admin

The "blunt" needles, are pointy sharp but not slicing sharp, so you wiggle them into the exact same tunnels each time (kind of like a pierced earring hole) and it doesn't cut new skin or new holes in the vein which would end up causing aneurysms (weak spots) in the fistula vein.  The blunt punches into the vein rather than cuts into it and that's why you can use the same hole over and over.  Some people do have to use a sharp in the buttonhole from time to time but this is to be avoided or minimized as much as possible so that these weakened areas don't develop.  I never  had to use a sharp again once my buttonholes were established but I dialysed 5 times a week and that can make a real difference.  People who use only sharps should ladder up the fistula vein in a very consistent way so that the vein develops evenly all along its length rather than get all lumpy and bumpy with aneurysms.  Unfortunately, many centres are not so vigilant about this technique and because they have time constraints, they often needle in the "easier", better developed spots which can lead to real problems down the road.



Edited: Fixed quote tag error - okarol/admin

[jbeany]

an egg timer for counting down the 3 minute wait for the heparin

Huh? My center has never said anything about a 3 minute wait.

Protocol at my center was cannulate, inject heparin in the venous, wait 3 minutes (connect lines while waiting), and then start the pump.

[willowtreewren]

That's interesting. We cannulate the arterial first, then the venous. Once the venous is cannualted we inject the heparin then connect the lines and start.

They did add that I am to take the readings at 200 level (including BP), then increase to 400.

I find all the different protocols interesting.
Aleta

[dkerr]

Thanks.  It looks like I will have lots to learn.

[skyedogrocks]

We chose not to do PureFlow, we didn't want to do any extra plumbing in our family room.  Rob uses the bags and they work for us.  The good thing was, we were able to work with the Wearhouse and get on a bi-weekly delivery schedule.  NxStage doesn't like it, because it costs extra, but we don't have a ton of closet space to work with. 

I say go to the training.  Rob has been on NxStage over 2 years and his center was about 40 mins away.  It's a PITA when he had to get monthlys and supplies, but he just dealt with it.  Now his center is his old dialysis center that is 5-10 mins from our house.  His nurse is SOOO much nicer and knowledgeable!

When I went on NxStage, I had to provide my own chair, big trash bin, trash bags, heavy duty storage shelving, an egg timer for counting down the 3 minute wait for the heparin, bleach, paper towels and a tubbie to store the bleach water for cleaning the machine after a run, and a rolling cart to store supplies in.  I also bought walkie-talkies to make it easier for my partner to move around the house and yard.  My center or NxStage provided the scale, thermometer, bp cuff, plumbing connections, and every medical supply I needed to run the machine, like gloves, bandaids, gauze pads, etc.

Wow, you were supplied with a lot more than we were.  We had to buy a scale, bp machine and have to buy our own band aids.  The medical supplies are the only things that our center gives Rob.

We also do not have to wait 3 mins after heparin. 

[willowtreewren]

We are going in for Pureflow training in a couple weeks. Our machine sits just on the other side of a wall from a sink, so we'll put a line through the wall. We drilled a hole in the wall for the drain line already.

Skydog, you're fortunate that the warehouse will work with you. We have plenty of room in our garage for the supplies, but our center wants to use us for Guinea pigs for the Pureflow training. They have not supported it until now and since they consider us their stellar NxStage users (the competition isn't too tough, they say!). Once we are trained and have worked out the kinks for them, they will start training others.

I feel really fortunate to have our clinic. Not only do they supply all the things we need for dialysis, from the bandages to the pillow covers, but they gave me a huge box of disposable aprons to use.

Aleta

[M3Riddler]

When you first start training, it can be very nerve racking. Especially when you hear that first alarm sound. After the training is over and you get the hang of things, you will feel soo relieved but always have to be on watch.
If you go to www.nxstageusers.com/forum  they have a section dedicated for questions about new dialysis users and those preparing to take that step to nxstage. It is very informational along with this site.

HH