Home hemo partner

[Stoday]

Why is a partner necessary for home hemo? What do they do?

I'm pre-dialysis and cannot have PD, so I shall have to go in centre, initially at least. I'm intending to go the home hemo route eventually.

[Bill Peckham]

I don't think they are - I dialyze alone at home. NxStage, when they applied to the FDA for approval to market their medical device - their new dialysis machine - indicated it was meant to be used with a trained partner. I don't know what their thinking was but that's what they did; I assume they regret that decision but changing your FDA application - resubmitting for reapproval - is expensive so it has not been changed.

The experience in Australia and in Toronto to take two examples is that by requiring a trained partner you double the chance of burnout and can strain an existing relationship. It is far better to have the person on dialysis do as much as possible.

If there is a significant risk from dialyzing alone (and I don't think there is) it is far outweighed by the improved clinical outcomes from dialyzing more frequently at home. Dialysis isn't dangerous -  stage 5 CKD is dangerous. More dialysis is a healthier treatment for the dangerous disease CKD5. Home more frequent overnight dialysis is the safest modality of all. Alone or otherwise.

[tyefly]

      Bill     when are you releasing your new video of your self cannulation techniques showing us your antegrade/antegrade positioning......  we are all eagerly awaiting for the new video.....

             

[Bill Peckham]

      Bill     when are you releasing your new video of your self cannulation techniques showing us your antegrade/antegrade positioning......  we are all eagerly awaiting for the new video.....

I'm looking to buy a new camera this weekend - hopefully it'll have a decent video ability

[tyefly]

   Sounds great Bill.....  keep us all posted.....

     

[Hanify]

Here in NZ people are allowed to do home haemo dialysis alone too.

[Meinuk]

If a person had the desire & ability to dialyize at home, alone, they should be able to do so.  I understand people's concerns, but each case should be evaluated on its individual merit. To set blanket guidelines, or make blanket judgments in the name of perceived safety - is wrong, and does so much damage.  Optimal renal replacement should be the goal of every person in CKD5.  Optimal for each situation.  I am very lucky that my medical teams all put my health first, and "regulations" last.

I trained for NxStage alone and never looked back.  When I was on NxStage, the only time I dialyized with anyone with me was when my Nurse and her assistant came for my first at home session (and they left before my run was over); and a month later, I dialyized in front of a reporter and photographer in my living room.

When my unit was suddenly closed by the State of New York (hepatitis/cleanliness scandal), there was a big kerfuffle - the unit I was assigned to would not  support my home dialysis - I fought it. 

For a month, I was dialyzing without a unit and then a few units decided to accept me as a solo at home patient (even though the laws in NY are sketchy about solo home hemo dialysis). Medical professionals, peers, companies, state and national agencies all intervened on my behalf - for that I will always be grateful.

Here are the links to my solo home hemodialysis journey:

My daily training here:  http://ihatedialysis.com/forum/index.php?topic=5229.0

The article about me dialyzing alone posted here:  http://ihatedialysis.com/forum/index.php?topic=7332.0

My Unit being closed (and commentary on solo optimal dialysis) on DSEN:

Here:  http://www.billpeckham.com/from_the_sharp_end_of_the/2008/08/dumped-by-your.html

Here:  http://www.billpeckham.com/from_the_sharp_end_of_the/2008/08/where-the-ball.html

and here:  http://www.billpeckham.com/from_the_sharp_end_of_the/2008/09/restoring-my-fa.html

[Stoday]

Thanks, guys, that's helpful. Especially Meinuk, for all the detail. I'm determined to get there when the time comes so the more I can learn from people here the better.

Thanks again.