Originally posted on IHD: http://ihatedialysis.com/forum/index.php?topic=2477.0
MY PureFlow review - The Good, The Bad, and the Ugly.
Well I finally went for my training for my PureFlow and you can’t tell by the pictures you see on the net but it has a lot of connections. But it is all very easy to understand and my training literally just took a couple of hours and those 2 hours included friendly conversation. The PureFlow was very simple to hook up and the nice thing is that NxStage took the time to include MANY different types of hookups for the water supply and all are clearly labeled and have instructions. I literally attached the water supply to the main water supply hose under my sink in less than a couple of minutes. There are some things that you don’t hear about the PureFlow, don’t get me wrong, I don’t have a problem with them but I wanted to make it known here. First off the NxStage says a “batch” will last for 72 hours, but what they don’t tell you is that includes the 7-8 hours it takes to create a batch. So you are really looking at 64 hours, less than 3 days. What I am talking about is… A batch is enough dialysate for up to 3 treatments, if you use 20 liters each treatment. However those 3 treatments must be done within 64 hours. Also the “Pak” must be replaced every 12 weeks, and in some cities it must be changed sooner. From what I am hearing from others is that the “Pak” lasts more like 6 weeks. It all depends on how “hard” your cities water is. But it is not a big deal because it’s not hard to change and is very easy to “prime”. Priming the “pak” takes 2-3 hours all by itself before you can even create a batch. Also there is a sediment filter that needs to be changed once a year and that is very simple and just requires unscrewing the filter and screwing in a new one. The main benefit of the PureFlow is not having to hang those bags, boy that gets old after a while and I would use 4 bags every treatment. I just wish that a batch would be usable until it was ALL used up. if you don’t you may end up have to wait while a new batch is created and that takes 7-8 hours. Another thing I like about the PureFlow is the waste line is permanent and does not have to be replaced weekly like the old waste line. I do wish that the water line was more of a hose and not plastic, since it can be damaged easily, if bent, but so far so good, just be sure to put it in a place that it will be safe. I also CUT the waste line AND water line so there wouldn’t be to much extra unneeded length, I just used scissors, again very simple. I also like the look of the PureFlow, it blends in nicely with the surroundings.
After I got everything set up, it was time to Prime the “Purification Pak” remember I said it takes a little over 2 hours. So I slide the pak into the pureflow, connected a few cables and hit go. Very simple indeed. There is one connection that is a little difficult for some, you need to connect it at an angle and unless you get on the ground on your knees (not possible for me, wheelchair) it is very difficult to see, you need to attach it by “feeling” it, not seeing it. But after that it’s relatively simple. You wait a couple to a few hours and it is all ready. Now the next step is to make a “Batch” The batch comes 2 per box and comes folded and when you place in it the PureFlow metal tub you unfold it partially. You have to unkink a couple of tubes and open the door on the control unit and place the tubes sort of like how you set up the NxStage Cycler, everything just pops in place. It really is user friendly. Then you attach a couple of more tubes, one to the purification pak and the other to the control unit. You see the “control unit” slides out of the PureFlow chassis, I guess to make it easier to transport, when the unit first came on the market it was one piece. Then you hit go and it will make some strange noises, really strange noises and do some self tests and then if everything is hooked up properly it will say “Making Batch…” then it is just a matter of waiting 7 to 8 hours. At the end of the 8 hours it will do a “conductivity” test and then it will prompt you to take a sample of the fluid for a Chloramines test, it is very easy to do. You just undo a tube from the control panel and squeeze a little drop of fluid on to a test strip and if it is clear (passes) you are good to go. Then you get your Nxstage Cycler primed and ready to go, and hook it to your Nxstage, You hit “GO” on your pureflow first, then press the “treatment” button on your NxStage. It’s important to hit Go on the pureflow first before the nxstage cycler to avoid air detection alarms.
So how did my first treatments go? Well I primed my first purification pak and had no problem, I made my first batch and no problems. I went through my first batch pretty much alarm free. I did have one alarm, number “54” on my 2nd treatment, which means I had a leak in my purification pak and after several tries the alarm would not clear. I called NxStage and they said take the pak out and wipe up any water underneath the pak, well it turns out I had not connected the waste line tight enough and it had been dripping and caused a puddle under the pak and set off the alarm. Once we tightened the waste line connection and dried under the pak, all was fine. So on my first batch (3 treatments) I got one alarm but that was my mistake because I didn’t tighten the waste line enough. Over all a very pleasant experience.
What about batch number 2? Well that’s when things take a turn for the worse. Ok so I did my 3 days in a row and I took Saturday off and in the morning I taught my wife how to make a batch, I knew but I followed the manual exactly since I had only done it once before. We set it up and waited the 7+ hours for it to get ready. It passed the conductivity test and got to the point where I needed to check for Chloramines. Again that passed and we were good to go. Then I set up my NxStage cycler and got everything ready. I turned the pump on and then I went to prime the line, some people from NxStage call it the “Chicken Foot” because it is a line that has 3 lines sticking out, one for each treatment per batch. The line would not prime, I could see it pulsating in the line half way thanks to the pump but it would not get to the top. I checked for kinks and what ever else I could think of but nothing worked. So I called NxStage and basically the support person said she had never heard of such a thing before. Of course I am thinking to myself, just my luck. So after trying a few things she told me I had no choice but to go into “Drain” mode, which means I must drain the whole 60 liters and must start over. Damn I did not want to hear that, so I went into drain mode and I asked my wife to hang 4 bags the old way so I could at least dialyze, this taught me a valuable lesson to always have the dialysate bags just in case something happens to the batch that I made using the pureflow, so I dialyzed the old way since it would take another 8 hours to try and create a new batch. So while I was dialyzing, my pureflow was draining. After dialyzing about 2 and half hours later, my pureflow was done draining, well almost but it was light enough where we could remove the bag even though it had some dialysate left over. So I showed my wife how to create a new batch over again, I walked her through the steps and we followed everything to the letter. It was now after 2:00am so we went to bed. Well the next morning I awoke to an alarm, I thought it was just finished so I got up and checked it, but nope it was alarming “43” which is a conductivity test fail. Oh great I thought now what, so I check the manual and followed the directions, which states to hit “stop” to acknowledge the alarm and hit “go” to re-test. So I figured it just hit a glitch or something and I sat there while it re-tested. It started the timer at 15 minutes then when it got down to 5 minutes it went back to 15. I guess it had failed and was trying again. This happened two more times and finally it stopped and got an alarm again. So I called NxStage again. So as I called this time in the middle of the day and not in the middle of the night and having to wake up a tech support person from a deep sleep. I told the support person the issue I was having and the problem that had happened last night and he had no idea either what was going on. We tried a few things and still nothing, he had told me eventually after so many self test retries the machine will automatically kick into “drain” mode. Oh great another 60L of water and 8 more hours down the drain, literally. So he had asked me to disconnect the “orange” tube and see if it is pumping fluid through and viola it was not. So he told me he would call me back, he needed to go talk to one of the engineers. Remember it’s the day time now so the engineers are at work. So while I was waiting for his call back I tried shaking the bag hoping that would mix the bags solution better but that didn’t work it was still failing conductivity check. So the support person called me back and told me to try to place a clamp on the tube between the blue check valve and the tube going into the control unit door. Well as soon as I did that all hell broke loose.
continued in NEXT post.