I am 42 years old and I have been on dialysis since January 14, 2002. Initially, after going into kidney failure, I was started on hemodialysis at the clinic. After some time, it was suggested to me by my nephrologist to do peritoneal dialysis. This worked well for me for a time, but unfortunately I got peritonitis on two occasions (at this time I was very immune compromised). The second time, there was a lot of scarring and I had gotten very sick, so I was unable to do peritoneal dialysis again and I returned to hemodialysis at the clinic three times a week. At some point, I changed doctors and Dr. King, my new doctor, suggested that I try home dialysis. Now I have been on home dialysis for about 6 years.
My first preference, and by far the easiest modality for dialysis, is peritoneal. I found it extremely convenient and portable. Although I did hook up to a machine during the night, if I needed to, I could be completely portable and do all manual exchanges. With peritoneal, you almost always are carrying around extra fluid in your abdomen and I thought this would bother me, but it really did not. Also, as with any dialysis treatment option at home, there will be a lot of boxes of fluid and supplies and you are responsible for learning the process and the safety concerns. But, overall, peritoneal is the simplest to learn and to do and the easiest to travel with.
My least favorite treatment option is hemodialysis at the clinic three times a week. First of all, there is the inconvenience of having to do dialysis at a specific time and you really cannot miss a day because you are already going every other day, so it would not be tolerable (or healthy). I found the clinic to be a very depressing environment. One of the worst things there was that I was always extremely cold. They would not allow electric blankets and no matter how many regular blankets I brought, I was frequently shivering uncontrollably. At my home, I have a space heater and I am never cold. I can also adjust the heater settings on my dialysis fluid if it seems to be a little cold.
Another thing that came up at the clinic was when I would cramp, I sometimes had to wait for the nurse to be able to attend to me because she has several patients. At home, I can immediately administer saline and stop the fluid removal. Cramps during dialysis come on very quickly and can be extremely painful, so dealing with them immediately is important.
My experience with home dialysis has been fantastic! Yes, it is work and, yes, you will have to learn a lot about how to access and care for your graft or catheter and how to set up, run and troubleshoot the dialysis machine… but it is very worth it. I was told at the beginning of dialysis that this would be my part-time job, and so it is. But given the option of the clinic three days a week and at home 6 days a week, I would absolutely always choose home dialysis.
I cannot overstate the convenience and health benefits of being able to dialyze every day (I do six days a week) in my home when I decide to do it. If I need to rearrange my dialysis schedule, I can. If I need to do dialysis early or late or in the middle of the night, I can. I can also dialyze for longer, or if I have to, stop short and do extra another day (not the best idea, but I can). If I need to do an extra day, I can. I feel almost normal when dialyzing every day. I can drink more fluid and have a little more leeway on the dialysis diet when I am dialyzing every day.
So being able to do dialysis on your schedule is the number one advantage, but being in your own environment is next. I have a comfortable chair and I have my own TV and computer I can use, and I am in my own room! I can adjust the temperature so that I am comfortable and I am in a room by the window and I can look out. Learning the machine initially can be overwhelming, but I promise it gets more routine. My treatment on the machine takes about 2 hours. It takes about 15-20 minutes to setup (really only five, but the cartridge has to prime for 15 minutes). It takes about five minutes for take-down each day. In between, there are other responsibilities such as inventory and ordering of supplies once a month, and a few routine maintenance things if you have a pure flow. There are a lot of boxes and supplies and you will need to find a room to store these.
The company that provides my hemodialysis machine and supplies, Nextstage, has a fantastic customer support service for any technical issues. I have called them in the middle of treatment with a problem and they walk you through the problem very clearly step by step.
Home Dialysis Therapies of San Diego really stands out! Individual attention is given to each patient by all members of the team (doctor, nurse, social worker, and dietician) and they have a wealth of experience and knowledge so that I know I am in good hands. It shows that they care about me and are also invested in making my health and my dialysis experience the best it can be. It is like night and day dealing with HDT versus the traditional dialysis clinics. I really enjoy my appointments. They can be both informative and entertaining from time to time!
I have been at HDT since January 17, 2007, and I am very grateful to be there. As a result, I don’t dread dialysis. I look forward to my appointments and my health has greatly improved so that I rarely have hospital visits. I am willing to speak to anyone who might want to talk to me regarding my experiences and the process and HDT.