Nocturnal training

Pat wrote:

As for going to the bathroom once your on for the night- I have a trick I use- when I canulate Ralph I put an extra piece of tape on the Arterial line so that when I have to take him off to recirculate, I know which line is which and I do not have to undo everything. This really works well.
I have also learned that the first thing I do when he has to go to the bathroom is take the UF of and than proceed. This way there is no alarming to contend with. When he returns from the bathroom I just reverse everything.
I am so use to doing this I probably can do it in my sleep.

This sounds like a smart idea, Pat.

We have a porta potty which we have used about 3 times in 6 years. Don’t keep it in the bedroom though. Its in a storage room at the house. I just go get it put in a little bleach and water then take it into the bedroom for dad to use. When he’s back in bed I get it and take it to the bathroom for emptying.
Kind of gross but its faster than disconnecting from machine.

Heather,

You don’t need to add phosphorus or calcium for short daily. These are the same as ordinary in-centre treatments. The only difference is that they are shorter because you do them daily instead of every 3 days. I have great sympathy for you guys who have to run 3 or more hour treatments every day. That’s a long time. 2 hours is plenty for me when I do short daily!

For a nocturnal treatment, I have to add phosphorus into my bicarbonate jug. It’s just a simple Fleet enema, the whole bottle. I used to add some calcium powder to my acid jug, but I don’t have to at present.

For a short daily, I prepare 5ml of heparin and for nocturnal, it’s 10 ml - in a 10 ml syringe which mounts on the machine. I get a 1 ml bolus and then 1 ml per hour until one hour before the end. It stops automatically. But that’s my prescription. Some people need more or less.

Pierre

We were trained at the center dialysing 4-5 hours during the day, then we did it twice during the day at home with our nurse present and then started nocturnal on our own the next night. Like a first solo flight in an airplane your are bound to be apprehensive the first few times no matter what plan you follow. Like pilots I find it very useful to come up with a one page checklist which is much easier to use than a manual and helps assure you don’t make mistakes when your are feeling the pressure that comes with inexperience. Our home nurse works only two days a week so we have no local support at night, but I have found both Fresenius and NxStage support to be generally excellent – a cordless phone with a speaker is very handy when you are trying to follow their instructions.

We have been doing 6x nocturnal for almost four years on a Fresenius 2008K except when we travel and do SDD on a NxStage machine. We have a strong preference for nocturnal over SDD which is reinforced every time we switch back and forth. The difference is not in the machines but a consequence of long, slow, gentle dialysis with no need for phosphate binders plus getting our days and evenings back for things that are more fun than dialysis. With nocturnal we don’t start setting up until 9:30 and are all finished and cleaned up by 8:00 the next morning.

Rather than disconnect and recirculate we have found a better solution to the bathroom problem is to get a light weight portable commode that can easily be moved to bedside when the need arises.

Mel

If you need to disconnect during a treatment, we are told not to go longer than 15 minutes. So you have ample time to go to the toilet. Its best to avoid it, but the option is there if you need too. If you go longer than that, well you wont be able to hook back up as you dont want un-oxygenated blood going back into you.
As for adding things to dialysate, you need to take this up with whoever is looking after you, as everyone is different, regardless of what type of dialysis it is. It depends what type of dialysate you are using to start with.

Re porta potti, thought maybe a plastic trash bag could be used as a liner for easier disposal.

Mel wrote:

We have been doing 6x nocturnal for almost four years on a Fresenius 2008K except when we travel and do SDD on a NxStage machine
.

Never heard of someone who has FR 2008K for home txs and NxStage for travel :?: Is this something your unit offers?

Does anyone know, medically speaking, what the timing is for food to make it through one’s system?

I think its about 8 hours? I try to only have a light meal before Dx, otherwise its too hard to get a correct pre Dx weight. I have dinner early too, and if Im still hungry ill make some crackers to have once Im hooked up, and my usual cup of tea.