It is so interesting reading how this forum is changing in a matter of months to mainly talking about Nxstage. We even have Bill out there pioneering unchartered ground, going where noone has gone before with a machine for home and one for holidays and I am sitting looking at Freni who is keeping me very well on Nocturnal but starting to feel a wee bit dissatisfied that she is not the size of a laptop down here in Aussieland.
THEN i come back to earth and remind myself that we are all among the fortunate ones that can live full, happy and healthy lives thanks to any of these marvellous machines available to us for little cost at in our homes.
Spare a thought for our brothers and sisters in countries where home dialysis or in some cases any dialysis at all does not exist and thank your own lucky stars that we are living where we amongst those breaking new territory every day. Here’s to a brave new world.
Cheers 8)
this brings to mind a few things. First is when I was just starting dialysis. I was young and still not very worldly. I was at a clinic that was non profit. it was a great place in so many ways, but I always thought it could be better. The biggest problem was getting your full time on the machine. There were never empty chairs in this clinic. I remember seeing elderly asian people that couldn’t speak any english. I asked about them and was told that they were not citizens. Turns out they weren’t even legaly here. That made me mad as hell. I mean they are making it hard for me to get a full treatment and they are illegals. I voiced to a nurse one day and she told me that where they are from they would just be sent home to die. I then figured that I could handle missing some treatment time. Hell I didn’t mind feeling sick a few days a week if it was keeping someone else alive. In america we are very lucky. There is a bill that insures diaysis care for everyone with kidney failure. It may not pay for the rising cost of treatment, but there sure are a lot of people on government paid for dialysis here. That is a great thing. I am sure that if I were in china or many other countries I wouldn’t still be alive.
The other thing it brings to mind is the machine you choose to use. NxStage was not my first choice. There is no re-use of the filters. I used to get first time dialyzer syndrome every time I went on the machine. Even in-center with re-use. I was afraid I would have the same problems with NxStage. I haven’t and it is ok, but it was not my first choice. Also if you take a smell of the bags the cartridges are in. You will notice and almost intoxicating smell. Almost like glue of some kind. When the machine starts to run I taste the smell in my mouth. I am sure it is coming thru the lines. Maybe I am kooky, but it seems this is happening. People talk about being worried about pcb’s in their fish. What the hell is going into me every time I run on my NxStage machine? It’s a great little machine, but it is in no way the best a machine could be. Maybe when they realize the money to be made there will more competition in this market. Then companies will be trying to out do each other with even better technology. That’ll be the day.
LSB
Your positive attitude sure does give me a lift somedays. I am waiting for the machine that is small enough to travel and can do nocturnal or daily maybe NxStage will get there. One of Fresenius owned companies is working on the Allient Sorbent Machine. I’m intrigued by this machine and hope it gets FDA approved someday for home use.
But the truth is we should all be greatful that we can do home dialysis. It gives us much more control over our time.
Do you or Bear know why they were going to do away with the bibags in
Australia?
Hi Marty
Great to hear from you and to know you are still hanging in there! The bibag problem was a patent issue and is only a problem in Oz for a few years until patent runs out. Due to an agreement reached between Gambro and Fresenius existing home patients can continue with bibags (thank heavens!) but new patients have to be trained on liquid Part B which means alarms and changing bottles in the middle of Nocturnal runs. Cheers 8)
Due to an agreement reached between Gambro and Fresenius existing home patients can continue with bibags (thank heavens!) but new patients have to be trained on liquid Part B which means alarms and changing bottles in the middle of Nocturnal runs.
What do you suppose that will do to nocturnal home hemo in Australia? Does this ruling affect other countries, too?
Also, the best way to make sure that a variety of topics gets talked about on this forum is to bring up other topics!
Think it may knock Nocturnal on a Fresenius on the head for a while. Those , like Amba, who are trained with Gambro will continue to be okay. Apart from the alarms, the storage of all those extra bottles is a real pain. I would be asking to be retrained on a Gambro if they hadn’t allowed us to stay with the Bibags.
In one of the home programs here in the states they use the bottles. But the patients don’t have to get up to change the bottle for nocturnal treatments. They pour the bottles into a jug that holds enough to run an entire treatment.
I have been trying to get our unit to get away from us making the bicarb. It’s time consuming. They looked into the bibag but said it wasn’t being used in the states. This has me somewhat confused as I went to another center and saw with my own eyes the bibag. Or at least I think that is what it was. It looked like there was a box on the side of the machine. You hung a bag on it and the dialysate was made into the bag.
I have been trying to get our unit to get away from us making the bicarb. It’s time consuming. They looked into the bibag but said it wasn’t being used in the states. This has me somewhat confused as I went to another center and saw with my own eyes the bibag. Or at least I think that is what it was. It looked like there was a box on the side of the machine. You hung a bag on it and the dialysate was made into the bag.
I’d never heard of a Bibag until the folks from Australia started posting. But years ago, a product called BiCart was introduced–it’s a dry cartridge that you put on-line on a dialysis machine and it makes bicarbonate solution, eliminating the need for mixing and the risk of bacterial contamination. From my very brief search, it seems to be a Gambro product–but Gambro doesn’t have any home hemo machines in the US; only overseas. I think the BiCart can be used with other machines, but don’t know for sure. Marty, I’m posting a picture–is this maybe what you saw?
Here’s a picture of the Fresenius AG Bibag. On the Fresenius AG website it says: Bibag
Dry bicarbonate concentrate – a powder for the production of liquid bicarbonate concentrate used in bicarbonate hemodialysis.
Unfortunately, in January 2006, the FDA put an import ban on 3 of Gambro’s machines, including the Phoenix which uses the BiCart system. Here’s the FDA alert. I couldn’t find anything more recent about whether the company has resolved the problems identified by the FDA. http://www.fda.gov/foi/warning_letters/g5687d.htm
It didn’t look like either one of those. The bag was much bigger and didn’t have any labeling so obvious. Next time I get to that center, I’ll see if I can poke around and get some more information. It was used in private room where they run dialysis patients not actually in the center itself.
All I really know is I asked the nurse if they bought the bicarb that way and she said no. Then pointed to a box on the side of the machine and said she hangs the bag on the box and the machine makes the bicarb. Whether or not she dumps one of those containers into the box I don’t know. I asked her how long it took to make the bag and she said she really didn’t know as she hadn’t ever really paid any attention.
Think it may knock Nocturnal on a Fresenius on the head for a while… .[/quote]
Yes. They were basically saying at the unit that if they could not get BIBags for the Fressies, they would just train/retrain all patients on Gambro beasties. Our Home Unit uses a mix of the 2 (altho the in-center unit is all Fres’) & I think it is largely ‘pot luck’ which one you get. So if the agreement only covers us current ones, they’ll be all Gambro for a while. I stocked up just in case, when it was all ‘up in the air’, so I have boxes everywhere!! :lol:
…back as the ‘real’ me.
…my wife was complaining about the extra BiBag boxes I have in the garage - she hit them with her car My indoor stock no longer reaches the ceiling, so I guess I can move the others in now. :roll:
I like to think I’m as positive as Beachy and I’m looking forward to a ‘profusion’ of portable, take-home machines in the not-too-distant future. The meet-ups between dialyzors may mushroom. Maybe even take up the slack left when business travel plummeted after ‘911’
The bibag problem was a patent issue and is only a problem in Oz for a few years until patent runs out. Due to an agreement reached between Gambro and Fresenius existing home patients can continue with bibags (thank heavens!) but new patients have to be trained on liquid Part B which means alarms and changing bottles in the middle of Nocturnal runs. Cheers 8)
My indoor stock no longer reaches the ceiling, so I guess I can move the others in now. :roll: