[quote=Dori Schatell;11540]It’s not about the longer contact time with the dialysate, per se. The reason I suggested that you read the article about why more HD is better is because it explains the process of water shift inside the body. It takes time for wastes to move from inside the cells or in between the cells into the blood where they can be removed by dialysis. Yes, you need dialysate, and a higher gradient will result in more solute and water removal–but only from the blood. The blood only contains about 15% of total body water, and thus, presumably, only about 15% of total body excess water and wastes.
During an HD treatment, there is one gradient of the blood vs. the dialysate. But as wastes and water are removed from the blood, there is a second “gradient” of the cleaned blood vs. the still-“dirty” intracellular and extracellular fluid. As the blood becomes cleaner, wastes and water diffuse through the cell walls and into the bloodstream. If a treatment only lasts 3.5 hours, these newly-migrated wastes and water won’t be removed until the next treatment. With short daily, that next treatment may be tomorrow. So, at least you don’t wait too long to clean the blood again (plus, you’re building up MORE wastes and excess water each hour). But with nocturnal, you are actually removing more wastes and water during the treatment, because there is time for them to migrate into the bloodstream. It also takes much longer for middle and larger molecules to shift from one fluid space to another.
[QUOTE=bobeleanor;11337]HI Folks
Rich I can’t answer any of your question on nocturnal.
But I want to go noctunal ,I’m om nxstage now. My reason for wanting nocturnal are for time . I’m very happy to home but now I want my day light time for work.
So if anybody is on noctunal please give us any and all information that you can? I’m looking into the time saving that I hope it gives to let me get on with day time jobs.
bobeleanor[/QUOTE]
Bob;
My partner has been on Nocturnal for about 5 years… the first 4 yrs 8mos we were using the Fresenius 2008H. We have since the 2nd week of Sept switched to the NxStage System One… No there was no problems with the Fresenies machine. But after much web searching about the NxStage I convinced her to switch. Two reasons: We were invited to share our experiences doing Nocturnal at a National Kidney Fondation Symposium, while there we met and heard Gus Talk about how he was using NxStage for his treatments. Wow you can travel with the NxStage… And he was feelilng and looking as though he was like a normal person (Just like my partner). The second reason: It is so much easier to use the NxStage verses the Fresenius. With bagged dialysate I wouldn’t have to take care of the Reverse osmosis water system. Also running the RO 8+ hours 6 days a week really used a lot of water… At least I kept the city checking their water supply. If there were any changes I would contact them and tell them to check as I am getting a High chlorine reading…They would not give me a break on water usage even for medical… Now my Hall way is full of boxes with dialysate… But in the near future I should be getting a PureFlow system to have dialysate made form tap water… (The center is working out some kind of deal with NxStage).
When you switch from daily to Nocturnal… the amount of dialysate that we use if the same… The blood pump is lot slower… we run only at 200 pump rate… (It was the same on the Fresenius) While in training doing daily we had the blood pump rate of 350… we ran for a week with 15 ltrs being that my partner is rather small. (dry weight 49.0 Kilo). After blood work the center bumped it up to 20 ltrs… to get the same Numbers that we were getting on the Fresenius. I set the volume screen for dialysate at 19.6 (Suggested by NxStage) That way I get “000’s” yellow #5 at the end of the treatment. After 7 hours the amount of blood that is processed is 85+ ltrs on the NxStage and was only 80 max on the Freni. So with more blood being processed in the same 7 hours it must be doing something better for her.
She does not have any problems sleeping thru the night. Only problem is with nxstage she gets cold… Three blanket and still not comfortable… Refuses to use an electric blanket. What am I to do???
With the Freni we didn’t have many alarms… Mostly caused by human error… like forgetting to add acid to the container. One bad dialyzer and a blown fuse… Those machines are rock solid… as for the NxStage you have seen my problem with the 14 alarm… Air in the dialysate line… With the dialysate rate at 2.8 ltr/hr it doesn’t run fast enough to pull the bubbles thru the lines and collects there above the air sensor and eventually alarms… According to the spec on the cartridge dialysate flow rate should be 10-200ml/min…which is 0.6 to 12 ltr/hr…
Another thing that we are doing differently for most patients is… She uses a cathater rather than being stick with needles… Haven’t had a problem with infections or disconnects. They say that the cathater are for temp use… Well we have proved them wrong… 5 years and some on the cathater… Had to have it replaced once (moved from her left chest to her right chest… have problem with the clip getting brittle and breaking… So the tips were replaced once and since then i have found a way to install a larger clamp that works just fine… same cathater for about 18 months already…
Need to return to my other chores so hope this was helpful…
By they way… Her sex drive is and has always been there… since on Nocturnal…
When you switched from the Fresenius to NxStage did you get the feeling of having a lot more freedom being away from the end of treatment cleaning cycles and the RO?
When you switched from the Fresenius to NxStage did you get the feeling of having a lot more freedom being away from the end of treatment cleaning cycles and the RO?
Marty[/QUOTE]
Marty;
The NxStage is a walk in the park compared to the Fresenius… Yes, I don’t miss the water checks on the RO System, the disinfecting and the cultre of the water… And as far as the Fresenius the cleaning and disinfecting after every treatment. It also freed up a lot of floor space… In our loft area where we have set-up the dialyzing; it use to be full of equipment… Now all we have is NxStage sitting on a small table next to her bed… All the friends and family that come to check out this new machine and are blown away by its size… and when I tell them We can put it in our SUV and go in trips. Their response is WOW!!! NO WAY…
The NxStage is a walk in the park compared to the Fresenius… Yes, I don’t miss the water checks on the RO System, the disinfecting and the cultre of the water… And as far as the Fresenius the cleaning and disinfecting after every treatment. It also freed up a lot of floor space… In our loft area where we have set-up the dialyzing; it use to be full of equipment… Now all we have is NxStage sitting on a small table next to her bed… All the friends and family that come to check out this new machine and are blown away by its size… and when I tell them We can put it in our SUV and go in trips. Their response is WOW!!! NO WAY…
I don’t know how to attach the picture I just took… Need help…
I know how to send email and attach a picture so maybe I can email it to you and you can display it… any way it is just a loft area that is aprox 10’ X 12’. Her bed is set on one side and the machine is next to the bed (adjustable bed). On the other wall is my bed that I rest in. At the foot of her bed is a TV sitting on a stand so she can watch until she falls asleep. behind the TV is the open area above the living room downstairs. (yes, I have to lug those bags of dialysat up stairs…) can’t wait for the center to approve and get me a PUREFLOW water system. The Fresenius, RO water system and carbon tanks use to reside where I am now sleeping… I use to sleep in the Hallway leading to the loft on a camping cot…(Still using the cot got so use to it, I decided to continue to use it. Yes, I could be sleeping in the other bedroom and be more comfortable but… my partner would not be feeling safe and secure without having someone close by to take care of machine alarms… immediatly. The Fresenius dialyzer would clot if alarms were not cleared immedialtly…
I don’t know how to attach the picture I just took… Need help…
I know how to send email and attach a picture so maybe I can email it to you and you can display it… any way it is just a loft area that is aprox 10’ X 12’. Her bed is set on one side and the machine is next to the bed (adjustable bed). On the other wall is my bed that I rest in. At the foot of her bed is a TV sitting on a stand so she can watch until she falls asleep. behind the TV is the open area above the living room downstairs. (yes, I have to lug those bags of dialysat up stairs…) can’t wait for the center to approve and get me a PUREFLOW water system. The Fresenius, RO water system and carbon tanks use to reside where I am now sleeping… I use to sleep in the Hallway leading to the loft on a camping cot…(Still using the cot got so use to it, I decided to continue to use it. Yes, I could be sleeping in the other bedroom and be more comfortable but… my partner would not be feeling safe and secure without having someone close by to take care of machine alarms… immediatly. The Fresenius dialyzer would clot if alarms were not cleared immedialtly…
HemoHelper
HemoHelper[/quote]
Sure thing, you can email them to me. I sent a private message to you with my email address…just click on the “private messages” link on the top right corner of the forum header where your name is bold is at…
