Hospital Hemo or Home Hemo?

[MattyBoy100]

I am fed up of rushing around between work and hospital for my dialysis three times a week.  I feel like it is taking up a large part of my life.  My centre offers machines for use at home if we want it.  Can those of you who do hemo at home tell me what the pros and cons are and does there have to be big changes made to the house?   My room is fairly small and I understand that I will need a water supply to the room used for dialysis.  I also have the following questions:

1) If I dialyze at home, do I have to do it every night?

2) Does someone else have to be present while I am dialyzing?

3) Will it mean storing a lot of dialysis supplies in the house?

I realise, I will have to self - cannulate so I am just asking questions at the moment.  I have set myself a target of 6 weeks to self - cannulate and will make the decision about home - hemo based on how I get on with self - cannulation.

[Epoman]

I am fed up of rushing around between work and hospital for my dialysis three times a week.  I feel like it is taking up a large part of my life.  My centre offers machines for use at home if we want it.  Can those of you who do hemo at home tell me what the pros and cons are and does there have to be big changes made to the house?   My room is fairly small and I understand that I will need a water supply to the room used for dialysis.  I also have the following questions:

1) If I dialyze at home, do I have to do it every night?

2) Does someone else have to be present while I am dialyzing?

3) Will it mean storing a lot of dialysis supplies in the house?

I realise, I will have to self - cannulate so I am just asking questions at the moment.  I have set myself a target of 6 weeks to self - cannulate and will make the decision about home - hemo based on how I get on with self - cannulation.

1) Depending on the type of home-hemo, as there as a few kinds. Nocturnal is nightly, traditional home-hemo is 3 x a week, NxStage is 5 or 6 days a week. You need to find out what machine they offer. I have heard even some traditional home-hemo patients do 4 or even 5 days a week.

2) Again it all depends on the training center, I sometimes dialyize alone, which is a big NO NO from my clinic, but others I know do traditional and nxstage by themselves all the time. Some home programs will not even train you unless you have a partner. For example it is a requirement to have a partner for the NxStage machine however people do dialyze alone all the time.

3) Traditional Home Hemo, HELL YEAH. You will have a TON of supplies and it will be a pain in the ass, with the plumbing and filters. I have heard of some very unhappy people after a while. With NxStage there are very little supplies. Except for my Dialysate bags which they are about 40-48 a month (you can see the size of those boxes at http://www.ilovenxstage.com in the pictures section.) all my supplies fit in a 6 foot by 3 foot cabinet. And soon I will be using the "PureFlow" and I won't be needing the bags. Again you can read more about the PureFlow over at http://www.ilovenxstage.com

With traditional home-hemo you will indeed need plumbing modifications to your home. I live in a apartment and have done no plumbing mods to my apartment using the NxStage System One. It will not take you 6 weeks to learn to canulate, however since your fistula is smaller because it is still new, it will take a little longer. But since you want to maintain the "vanity" factor, I highly recommend you learn to stick yourself ASAP and use the buttonhole method. It just takes a tech or a nurse to be having a very bad day and next thing you know your arm has this big lump and is black and blue. I hope this info helps.

- Epoman

[AlasdairUK]

In the UK NXstage is not available and you will need to use a machine similar to the one used in-centre, this will will mean having the plumbing done. This will however be installed by your trust as home haemo saves them money.

As far as I know you will not be allowed to do more than 3 times a week haemo at home unless you pay for the extra supplies. You can run longer sessions if you would like to increase your time on the machine as your saving time not traveling.
It is advised to have someone present with you have dialysis, but since you are at home you can cheat the system. The downside is if you go flat and need someone to give you saline.

[Panda_9]

Every country seems to have different rules and regs about home dialysis, but ill tell you how it works here...

First of all, there is no time limit on learning. On average it takes about 3 months to learn how to cannulate, learn the machine, and the machine maintenance. You are not sent home until you are 100% comfortable.
When you first go home, you are generally on 5-6hrs every second day or 4 days a week. If you wish, you are later on given the option of doing nocturnal home hemo once you are settled in at home. Nocturnal is 8-10hrs every second night, or 4 nights a week. Some patients choose to do 3 nights a week and one short (5-6hrs) day time run on the weekend. 
It is not advisable to dialyse at home alone. There are people who do it, and I used to do it, but after having a couple of heavy bleeds (thankfully my partner was home), I now no longer will dialyse alone. My partner is home at night anyway which is good.
I use the smallest room in the house for dialysis and only that. That way once Im off the machine I can shut the door and forget about it until the next time. Ive just got a single bed, the machine, a big chest for my TV, and I store everything in the wardrobe except the bottles of dialysate and bicarb which are stacked against the wall. It is alot of stock, so you do need some room to store it. I have to get delivery every 2 weeks as I dont have the room to store a months supply.
Its up to your unit what hours you will be doing. If you are only offered 3xweek then I would increase the hrs of those days for as long as your supplied dialysate and bicarb will last. Depends what sort of machine you have. Extending the hours wont cost any more as you are only using solution that would otherwise be thrown out.

[del]

Hubby started nocturnal home hemo in Oct. and loves it.  It seems as if different centers and countries have different policies.  He had a choice to do it how he wanted,  He could have done short daily, regular 3x a week, every second day or nocturnal..  He chose nocturnal because of the better (more normal) lifestyle.  The only time he loses is night time when he would be in bed anyway.  You can eat and drink more normally.  Nothing is really restricted but you can't be unlimited either (eat a whole dozen tim horton doughnuts!!)  He has a beer or 2 most every night which he couldn't do before.  Fluid gain is not a big problem for most people.  We do 5 nights a week for 8 hours.  He usually does Sun., Mon., Tues. No treatment Wed.  Thurs., Fri., no treatment Sat.  But that is flexable because you are at home and in control.. If we are going somewhere or something comes up he can take any night off as long as he doesn't miss more than 2 nights in a row.  Also if we have company and he has a little extra to drink he can hook up for a couple of hours just to get the fluid off.  Supplies are usually ordered once a month becaiuse of room to store it.  We are lucky we have a big bedroom with lots of room for RO and machine.  Doesn't bother either one of us to see it in the room.  We have accepted dialysis as part of our life and realize that it is the lifeline that is keeping him alive.  Most people who come to the house want to see the machines and know how they work.  It is just routine now to hook up to the machine when he goes to bed.  He still appreciates his nights off!!  He figures it is two nights for relations whether you want it or not!!