incenter nocturnal or home nxstage

[tyefly]

Hello to all...   I am trying to make a decision on incenter nocturnal verses home short daily with nxstage.... My insurance (kaiser) does not allow nocturnal nxstage use or extended ... they only offer short daily at about 2.5 hourse per day.... That is what I was told when visiting the nxstage training center.  They told me that if I wanted to do nocturnal then I would have to go in center three days a week.... I am not on dialysis yet but I will be in a few months..... waiting for my fistula to mature (just got it last week).  I like the idea of doing a dialysis treatment that will be the best for my body.  I am thinking that slow speeds with my new fistula would be great.....  I think they said with the short daily they run speeds of 450.... I want my fistula to last and I want to feel good.... The feel good is the goal.. I am going to have to start with either incenter nocturnal or use the nexstage and would like some input from some of you.   

[kitkatz]

I am very happy with in center nocturnal dialysis.  They run you slower and longer. It can get more toxins out over time.  My Kt/v has gone way up and I feel better.

[del]

I'm in Canada and nx stage is not available.  My husband does nocturnal at home with a full size fresenius machine.  it is fantastic. he uses a pump speed of 250 for 7 hours 5 nights a week. his bloodwork is super!!!

[Hemodoc]

Kaiser in LA medical center will soon begin nocturnal dialysis trials.  Not sure how soon, but it is in the planning stage right now as a pilot program.  In addition, I am at the max short daily time of 4 hours per session which is already FDA approved.  I am in the process of advocating aggressively for longer duration at Kaiser as well as increased frequency.  It is an uphill battle that several have already fought for years before I came on the scene as an MD/patient.  Kaiser has many advocating in high positions for what you are looking for.

You will simply need to learn your way around the Kaiser system until you find the right folks who will listen to you.  They are there, but you have to look.

I run at 370 with a filtration fraction of 35%.  I need to repeat my labs, but it looks like my phosphorus really dropped with this regimen.  Keep learning, you are really picking up the issues quickly.

By the way, which NxStage training center did you visit?

[Rerun]

I do not understand why insurance companies won't pay for longer dialysis.  You are already hooked up.  The supplies have already been used.  Why not leave you on the machine a little longer at a slower speed if you will benefit.   

Having said that.... I think incenter nocturnal is better.  You don't have to set up you just go jump on.  You don't have to order supplies or store them and you leave the mess to someone else.  The bad thing is the staff.  You have to have good staff.  I was totally content with incenter nocturnal dialysis until they hired 2 bozos to do the Thursday night session.  Idiots!!!  Now I'm back on incenter days and I feel like crap most of the time.

                                             

[cherpep]

For me, I prefer home hemo with NxStage.  I was incenter nocturnal for about a year.  I am much happier at home.  For me, it works.  I work full time, and when I was in center, it seemed I rarely got to see my family.  They developed a routine without me, and it almost seemed like I was a visitor when I was home.   I love being able to dialyze at home - with my family around me, under my own control.  Love NxStage.

[tyefly]

   I think you are right..... I would be happier at home....  I love to stay at my beach house but I still need to live in my service plan area which I do have a house there too.....  at least with nxstage I will be able to bring in out here to the beach and work and play there instead of town.... I hate town.... too many people.....  I like my space.....dont we all...   I think the one think that  I wll miss with all of this is the back packing trips that I do usually once or twice in the summer... for several days.... just me and the huskies.....    I love to get lost in the woods..... 

[thegrammalady]

i am on incenter nocturnal, which works very well for me. i am off all blood pressure medication and no longer take binders. my labs are great. i didn't chose home treatments because i don't do needles and my daughter doesn't do blood. i'm concerned if i tried it at home i'd never leave the house. you never know though, i might change my mind.