Dialysis at home

Dialysis at home

By Shirley Wentworth
Tuesday, January 29

Twenty years ago, a verdict for dialysis was practically a death sentence.

Doctors were forced to act much like a panel of judges, granting dialysis to patients with the best chances of improvement or survival.

When Bill Taylor learned he’d have to have dialysis, he did think of it as a death sentence — or at best — a sentence meaning life was at an end because he’d never be able to do anything again.

“One of the worst things is the shock of realizing you have to have dialysis,” he said. “It’s worse than the dialysis.”

Dialysis is the process of cleaning the blood by passing it through a special machine. It’s a necessary procedure when the kidney aren’t able to filter waste out of the blood.

For Taylor, dialysis meant driving down to Pasco three times a week with his wife, Lela, for a three and a half hour treatment. Many times they wouldn’t return home until 10 p.m. Both Taylors said their employers were very accommodating about working with their schedules so they could make those trips.

At one point, he was going to switch to Moses Lake because it would cut the drive in half, but found there were no openings at the center there. In June, he learned he has the option of having the dialysis at home. The DaVita Center, where he’d been going, has a portable dialysis machine which can be set up at home.

“You have to have a willing partner to do this,” he said.

Lela Taylor had to train with the nurses to be able to provide the attention he needs while undergoing treatment. She went down to Pasco for three weeks and spent four or five hours a day learning how to set up the machine and the tubing, insert the needle into his arm, monitor the tubing to ensure there’s no air inside and monitor his blood pressure, which she notes in a chart every half hour and faxes to the nurses the next day.

The machine itself is very sensitive, she said, and alerts her to anything that might be going wrong. She has a manual that tells her what all the possible errors could be and if she doesn’t find it there, the nurses are only a phone call away.

His nurses, Tricia Richmond and Stephanie Sanchez, make a home visit once a month to check in and see how everything is going. They also test the blood each month to make sure it is getting clean.

With at-home dialysis, Taylor has treatment six days a week instead of three, which he said feels much better because on the three-day-a-week regime, there’s ups and downs — the downs coming on the off days. He also said the dietary restrictions aren’t as heavy when you have dialysis every day.

“It’s much gentler doing it every day because toxins are leaving at a steady rate and don’t build up,” said Richmond.

Taylor also said it’s so much nicer to be in your own environment while having dialysis. On his day off from the machine, he said he feels good. Another advantage of using the portable machine is that if he wanted to drive somewhere for a visit, he could take the machine with him.

In fact, nurse Sanchez said she heard about a man who went hunting and took his machine with him on a pack horse and ran it on a generator.

Taylor laughed when he heard that. “Knowing my luck, the biggest elk would come around and look at me like ‘What are you going to do about it?’ “ he said.

Although nurses are on call 24 hours a day, the Taylors have never had any life-threatening situations. There is, however, a little sign on the machine that says “Did you remember the waste line (yellow)?”

That’s a reference to two occasions when Lela Taylor didn’t have that line hooked up and fluid backed up into the saline bag until it burst. It’s a common oversight, Stephanie said.

“The first time it happened, we were watching the (West side) flooding,” said Taylor, chuckling.

Then they found themselves coping with their own mini-flood.

There’s about 18 people in Othello who need (or are taking) dialysis. And people in Othello don’t really know there’s an option of at-home dialysis, Richmond said.

Hospital Commissioner Bill Briggs said there have been efforts to bring a dialysis center to Othello. Opening a dialysis center requires a state-approved certificate of need. The Moses Lake Dialysis Center, owned by Fresenius Medical Care, started a year ago with the certificate process and has been turned down twice.

Briggs said area residents are working toward collecting 2,000 signatures in petitions to legislators such as state Rep. Mark Schoesler, R-Ritzville, Steve Hailey, R-Mesa, state Rep. Joe Schmick, R- Colfax, state Rep. Bill Hinkel, R-Ellensburg, and to Mary Selecky, secretary of the Washington State Department of Health. He said bringing Fresenius to Othello would not raise anyone’s taxes because it is a private company.

“You can’t get in at Moses Lake unless someone moves, quits or dies,” he said.
Marylou Krautscheid, nurse and facility manager of the Moses Lake Dialysis Center, said the state somehow rationalizes that there is only eight people from Othello going to Moses Lake for treatment. She said there is 18 and that does not count the people in outlying Othello or areas like Warden.

“This facility is bulging at the seams with three shifts a day,” she said.

She said the facility started in 1996 with five chairs and was full two years later, running with four shifts, meaning that were having to come for treatment on the graveyard shift. That was problematic because there’s no transportation in the middle of the night and people would have to find family members to take them. It’s now a facility with 18 stations on three shifts.

Krautscheid said she tried to get all the legislators to the facility last year so they’d understand the problem, but only state Sen. Janea Holmquist came. She said a lot of legislators don’t understand that dialysis is not like a trip to the doctor or the dentist.

“If they stop treatment, they die,” she said.

Holmquist, she said, is planning to introduce a bill that eliminates the need for a certificate of need because it is a long, tedious process.

She said she has no doubt that Othello can support a center, and that unfortunately it will likely have a greater need in the future because of the high population of Hispanics who have a higher rate of diabetes, and oftentimes, no access to preventive care. She also said that in the past, she’s been able to take in people who come to visit family or come for recreation.

“I won’t be able to take visitors this summer — we will be too full,” she said. “I’ll have a whole lot of unhappy people who’ve been here every summer.”

Briggs is also seeking volunteers to help with the petitions. Anyone interested can reach him at 488-2316 or billbriggs28@nctv.com.

More Information:

• The kidneys function to remove waste products, including salt and excess fluids; maintain a safe level of blood chemical in the body, such as potassium, sodium and chloride; and control blood pressure.

• Kidney failure occurs when a person’s own kidneys can no long perform those functions.

• More than 100,000 individuals in the U.S. are undergoing dialysis to stay alive.

• Risk factors include having a family member who has kidney disease, having diabetes or high blood pressure.

• Symptoms include feeling tired and week, loss of appetite, insomnia, diminishing mental clarity and swelling of the feet and ankles.

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