short daily home hemo vs. in-center nocturnal

[happyonhemo]

I need to know if in-center nocturnal would be as good for me as short daily home hemo. I started home hemo because I had DRA (dialysis related amyloidosis) and was told it would be better for me to do it more often but now it looks like I can't continue for several reasons. Does anyone know if in-center nocturnal would be as good?PLEASE anyone, any help at all?

[mcclane]

I don't know if this helps, but I did nocturnal home hemo.  Eventually I got fed up with no sleep at nights - due to the noise/alarm of the dialysis machine - that I did short daily hemo in the evenings.

Here are the pros of doing home hemo :
- it is at home, comfortable surroundings plus if the weather is bad (eg. heavy snowfall) you don't have to make the trek to the hospital.  Plus, you dictate when you start dialysis, you're not dependent on the hospital schedule, for example if the guy before you took longer it pushes your appointment back.
- depends on where you setup your machine, if it is bedside, you can sleep comfortably in your own bed.
- you're more independent, once you're comfortable self needling it is hard for anyone else to do it for you.

Cons :
- there is alot of trash to throw away
- you need alot of room to store supplies
- expect your electricity/water bill to increase
- if you do short runs, depending on the pump speed and flow, clearance may not be as good as a good long run.
- tanks for the dialysis machine require frequent changing
- if an emergency should happen, you maybe on your own

To me, whether you do the run in a hospital or at home is up to you, but I would think it would be more dependent on how long you go and the settings on the dialysis machine.  Someone correct me if I'm wrong on this one.

To me, if I had to do it all over again, I may choose in centre, as I couldn't deal with the frequent tank changes plus the required space for supplies.

[lmunchkin]

I read your other post & I give you props girl. To do this as long as you have and go through all that you have gone through. You remain so positive and very upbeat, yet you endure!  That is to be Admired without question!

I do home hemo on NxStage (short daily) as you did.  Given the dynamics of your situation, I do believe In-center Nocturnal would be a better fit probably!  If you have transportation to & from and can leave (without worry for others-inwhich you have done) then absolutely do it. You will get better dialysis on Nocturnal, no doubt!  Find a really good caring center to go to. Not all centers are bad, but don't settle for mediocer care.  You, my dear, deserve the best!

God Bless you for all that you & your family have endured.  So strong when needed. So sorry for the loss of your son.  That has got to weigh on you both.  I will Pray for you & your family!

Let us know what you decide and how it goes, okay?

God Bless,
lmunchkin

[happyonhemo]

Thanks so much for your help, kind words and prayers! I cried when I read it, thats how much it touched me. :thxi I guess I'm just emotionally fragile right now. I cry when people talk to me about my situation. But it'll work out one way or the other.

[noahvale]

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[ianch]

My experience is quite short - 1 year and 5 months.  As I came in as an emergency case and had a tunnel line for 6 months.

My in-centre experience was not great.  To get good clearance the 4-hour session had to be a 350 pump speed.  Because the state pays and its $200 per hour, we are limited to 12 hours a week (which is $100k per yr).

I was a candidate for HomeD so i took it with gusto. I have now been doing HomeD nocturnal for 6 months and its a huge improvement for me.  There was an adjustment period but i learned to control movement and limit machine alarms.  I use the Fresenius 4008b.  Its a little clunky but very reliable. 

I ran a 10 hour session (machine max) last Friday over night and it didn't alarm once.  I usually do 8 to 9 hours.

I find nocturnal fantastic.  For me i have to still control eight gain to get the best result, but i can get up and go to work most days with no problem. 

So i do recommend that if you can get onto nocturnal, in-center or out, you will get benefit from it. 

It costs US85,000 per year for 636 hours of treatment in-center.  I would cost US300,000 per year for 1600 hours if I did my home treatment in-center.  But it costs less than US20,000 and is better for me - win, win