Monday, August 20, 2012


Kidney failure has become a common disease. Just 10 years ago it was a rarity and mostly from complications of diabetes. But, now there are more and more otherwise healthy people having to go on dialysis and/or get a kidney transplant. We have had several people ask us about it and Kevin's nephrologist has Kevin talk to patients that are considering home dialysis. So, I thought it might be helpful to post a blog about the pros and cons of home dialysis from a patient and caregiver point of view. Chances are that you know someone that will have to go on dialysis, so please feel free to share this post with them.

There are different types of dialysis. Peritoneal is done through a port in the abdomen and usually done at night while the patient is sleeping. Since this is not the type that we do, I do not know much about it.  

Kevin does hemo-dialysis which is done by inserting 2 needles in the patient's arm, one needle pulls the blood out and runs the blood through a filter on the machine which cleans the blood and then the other line pushes the cleaned blood back to the patient. They say that hemo is the most efficient type. Hemo is done in dialysis clinics usually 4 hours a day 3 days a week. Or you can choose to to do it at home. 

1) The home machines are smaller and gentler than the clinic machines, therefore they are easier on the patients' bodies. 
2)  Does not leave the patient "wiped out" like the clinic machines do. 
3)  Since you are cleaning the blood 6 days a week instead of only 3, the patient feels much better. "Bad" feeling days are much less frequent. 
4)  Fluid buildup (swelling) is almost non-existent since you are pulling the excess fluid off 6 days a week instead of only 3. FYI - since their kidneys don't work, the fluid that normal kidneys get rid of everyday, just sits in their bodies and accumulates which could result in fluid building up around their heart and/or lungs which would lead to death. The machine takes the excess fluid off while it is cleaning the blood.
5)  Can be done anytime that you are home. Do not have to work around clinic hours, which is very beneficial if you continue to work.
6)  You can load up the machine & supplies and take them on vacation with you.

1)  Machine and medical supplies take up a LOT of room. You need to have a room just for your medical supplies. We had to turn our college son's room into the medical supply room.
2)  If the patient and caregiver work full time, as we both do, your free time is extremely limited. We get off at 5 & have to rush home to get him hooked up so that we can get in bed by a decent hour. It takes 30-45 minutes to get machine & supplies ready. Treatment time is anywhere from 2.5 to 3.5 hours. Then it takes about 20 minutes to unhook & tear down machine. You only get 1 day a week off of dialysis, so how you spend that time is so precious. No more spur of the moment dinners or movies or time with friends. If anyone wants to see us they have to come to our house & visit while Kevin is on machine. We only make it to one church service a week and we miss being with our church family so much. We have to miss a lot of our nieces' & others' ballgames, birthday parties, weddings, showers, etc.
3)  If you are a homeowner and work full time you know how hard it is  to keep up with maintenance, repairs, etc. It is almost impossible to take care of your home and yard when you work full time and do home dialysis.
4) Machines break down and have problems. Technical support for dialysis machines is just as bad as they are for cell phones & everything else. Except you have the added pressure of having a person hooked up to the machine with a pint of his blood hanging out there waiting for you to do something.
5)  Experience in nursing is very handy for the caregiver. Medical terminology, procedures, drawing blood, etc. are not normal to most people. I went to college to be a legal assistant and have worked in oil & gas for 25 years. I can tell you how to drill a well from start to finish. Division Order Title Opinions (DOTO), Joint Operating Agreements (JOA), assignments, deeds, drilling reports, etc. are my "normal" & I am very confident at what I do. I did not go to medical school & never had a desire to be a nurse. My brain is not "wired" that way. I have got it figured out now, but it does not come as easy to me as chains of title, legal descriptions & that type of thing does.
6)  Insurance and medicare will not approve for home health nurses to help a patient with dialysis in the patient's home. We have been told it is because dialysis is such a specific type of nursing that the nurses would have to be specially trained and since they would have to be in the home about 4 hours everyday it would be too expensive.

I could list more pros and cons, but I'm sure you get the idea. We are so thankful that we can do dialysis at home so that Kevin can continue to work and he feels so much better than he did when doing it in the clinic. However, we are so ready for him to get a new healthy kidney so that we can get our lives back. I told him that once he gets his kidney and feels good that we are not going to be home for a long time. I get so tired of staying home. I am ready to go have fun with our friends and family again. I look forward to the day when we can drive to Durant after work and have dinner with my precious son and daughter in law. It's only an hour away, but is impossible right now because of dialysis.

Of course, if the patient and caregiver do not work, then they do not have the time constraints and added stress. A patient is eligible for disability immediately upon starting dialysis. Kevin still feels good enough to work. He just tires more easily and has to be careful with his left arm because of the fistula. He is not supposed to lift anything over 50 pounds. He works for a great company that has been very supportive and he has a great co-worker that doesn't let him do the heavy stuff. Because he has such great insurance through his employer, medicare was going to cost us more than it was going to help, so he opted out of medicare and disability. We are so thankful that God has kept his hand upon him and allowed him to continue to work. All of the doctors say that he is the healthiest dialysis patient they have ever seen. They believe that once he gets a transplant that he will heal quickly and be back to his old self in record time. I can't wait to have a big party with all of the wonderful friends and family that have been so supportive throughout this journey.

I hope this post helps someone to better understand dialysis. If you know of anyone that needs someone to talk to about it, let me know. We would be glad to talk them. We believe that God allows us to go through things so that we can glorify Him and help others along the way.

Wishing you all many blessings and good health,

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