Some months ago I posted our home nephrologist was going to start a home program for patients. They met with Aksys and thought it was going to be a go. Aksys just informed them this week they wouldn’t support a rural dialysis center with service on the machines. Tomorrow they will be meeting with Fresenius. For me this is good news because I want to transfer closer to home someday but wouldn’t do it if the Aksys was their choice. Not because I don’t like the machine just because too many patients have posted service complaints. When it’s a 2 hr drive to get dialysis in center, machine service becomes a big issue. I do think however it is bad new for patients who want the daily dialysis because the set up and tear down time on the Fresenius plus the RO = more work for short treatments. Maybe there is a flickering light of hope that some day our clinic visit won’t be 5 hrs. 1 way.
there goes another quarter for Aksys…I hope at least they can get the Fresenius for you, but I think the NxStage fo daily would save them headaches… :roll:
Gus, I agree with you 100% I tried to talk them into NxStage when they first started talking a daily program. If I were interested in daily I certainly would go NxStage it just has so many advantages over the Fresenius for short treatments. No special modification for water and electric. No water period. Short set up and tear down time. I think they thought the NxStage was a little to pricey and another concern they had was if a larger person would get enough dialysis with the NxStage. If they were going to start a program they didn’t want to limit patients because of their size. I wonder if other centers that offer NxStage have the concern with patient size.
Recent posts by other patients using NxStage said size don’t matter…its the ammount of time spent on machine…
Of all patients trained at my center I am the smallest guy here…hehehe :lol:
…All the other patients are BIG people… :oops:
Gus mentioned in a previous post that it takes 45 minutes to start a treatment. I’m a little puzzled as to what the time advantage is, because it only takes me 20 minutes more (15 if I don’t waste any time), and 15 of those are just waiting while I let the machine recirculate saline (and I can easily do other things during this time since I don’t have to be near the machine). So my question is, what uses up that 45 minutes? What happens once you’ve put the cartridge in, do you still have to run some processes (alarm tests, etc.), open and/or close some valves or clamps manually?
Pierre, The time advantage for me is in the tear down time. You are absolutely right when your doing an acid clean and heat disinfect or chemical rinse you can do other things. But there is still a commitment to be in the house to change from acid clean to heat disinfect when the time is done. Also we make bicarb there is another 6 minute to 7 minute commitment to rinsing the jug. I would like to have the treatment over and be able to walk out the door.
Yours is a 2008K right? Actual tear down, which I define as pulling the tubing off and throwing it into the trashcan, only takes less than a minute. Acid clean takes about 15, and I also have to wait around until it’s done so I can switch to heat disinfect. I usually put the coffee on and start cooking the bacon during the acid clean… and it’s not “low salt” either
Did you know that once it’s in heat disinfect, you can turn off the R/O and the water supply as soon as the Fresenius has reached its operating temperature (when the red graph starts on the screen). When you put it on heat, first it heats up to I think about 75 degrees or so (I forget as I haven’t been paying attention to it lately). This takes a few minutes. Then, once the actual disinfect cycle starts, you turn off the R/O and water (since the machine no longer needs water from that point on). If your machine isn’t set to turn itself off automatically once the heat disinfect cycle is finished, you can easily change that setting to auto. Doing this can save you a lot of that tear down time, because you no longer have to be there once you’ve turned off the R/O.
Now if I could only find a way to eliminate that 20 minute holding time to stop the bleeding
This is probably a wasted discussion anyway. The center has the choice of what machine they are going to use and if they have a daily or nocturnal program so what we think is pretty irrevelant. I don’t foresee any change on our part in the near future because I wouldn’t change from nocturnal to daily just to save myself 6hrs driving once a month. I do think however there is a possbility that once the center gets used to patients doing their own on the Fresenius daily they might have more confidence in expanding to nocturnal. Right now even though what their doing doesn’t fit my opinion of the best way to go I can’t deny just having a daily home program in our area is a blessing beyond words. However will save any celebrations until it can be officially listed on the list of home program here at Home Dialysis.
Pierre, during 2008K heat disinfect you can turn off the R/O as soon as the prerinse clock on the 2008K goes to zero (mine is set for seven minutes). This is way before the temperature goes up. I was trained the same as you, but a technician corrected me. You can test this by checking the 2008K drain hose and you’ll see nothing comes out after the rince clock gets to zero.