This is what NxStage told me were the requirements for a UPS that would be needed to operate a NxStage System One machine if the power failed.
Oh ok thanks for clarifying, Beth. Well it is helpful to know that NxStage can be powered by either a generator or a UPS in the event of a power failure. Now it will be necessary to figure out which power source is more economical/affordable, how many hours of back up each type provides, eaze of use of the power sources…(can anyone think of any other concerns?) in order to decide which type is the best choice.
If anyone out there has purchased a power source for your NxStage we would appreciate hearing what you chose. Or if anyone can ask their rep for info. on what other patients have done we would like to know what you find out. We did ask our rep, but she was not forthcoming on this point for some reason.
Heather, If using a generator I would suggest that you have installed a transfer switch. Not all units might be compatibel so ask. Some of the smaller units are not. A transfer switch means that if in the midst of a tx. and the power goes off the generator will kick in automatically, otherwise you would have to do this yourself and it could be a problem. We have a freestanding generator without a transfer switch installed but are looking to upgrade when I begin home hemo… Our local power company has them available and even will do the installation, but I’m not sure how much the cost will be. Check with them anyway and tell them your situation. It’s my understanding that some provide a backup if your txs. are medically necessary, and I would guess they would consider dialysis such a treatment! Where I live they fix the power problems in the areas where there are such pts. first too if at all possible. Lin.
I think it’s very easy to get overly wrapped up about power failures. You’re dialyzing daily. Power failure – you just take yourself off and take up where you left off the next day (and it’s very easy to take yourself off with no power). It’s not a big deal. With daily hemo, it’s never a situation where you must dialyze on any given day or else. It’s a lot more important to have a battery-powered light source if you’re dialyzing at night or in the evening than it is to have a generator.
Pierre
Yes, that’s true.
But just a few months ago we had an ice storm in SC and went w/o power for three full days (Motorhome generator and a long extension cord did supply some light and heat.) Some areas near us went over a week. While in FL w/ my parents, hurricane Jeanne left us w/o power for almost a week.
My husband could easily move his NxStage into his motor home, where he’ll be using it when he travels, and use the generator (which is easily large enough to power it). BUT, w/ any generator there is a certain amount of power fluctuation as other appliances cycle off and on. Dialysis w/o heat or a/c is not really feasible for most of the year, so most of the time the NxStage will not be the only thing loading the generator.
When he starts dialysis we’ll have to contact NxStage directly to see if it has a “breaker” or fuse to shut it down if there is a power fluctuation and what the electrical tolerances are. When we find out I’ll post here.
Lorelle
I think the issue re: generators is the possibility of pandemic-related power outages that might last more than a day or two. If a pandemic caused either quarantines or people who work at the power company not showing up for work, power outages could last longer. I think this is highly unlikely, but if such a thing were to happen, you might want to have some sort of a generator that would take gasoline or preferably propane if such a thing is possible (safer to store in large quantities).
Well people, we’re on our way to preparedness on bird flu… :?
Read about it at FOX…
http://www.foxnews.com/story/0,2933,193924,00.html
I’d say we’re on our way to preparedness in the same sense that Neil Armstrong was on his way to the Moon on the day he was born.
Here is a statement from the Secretary of Health and Human Services http://www.pandemicflu.gov/plan/pdf/panflu20060313.pdf
Looking over the planning documents and incident tracking on the numerous web sites that are reporting on avian flu such as:
http://www.recombinomics.com/
http://www.flutrackers.com/forum/index.php
http://www.pandemicflu.gov/
the thing that is most clear is that we have a long way to go.
And the worst case scenario is far, far worse than what is commonly reported:
http://www.rms.com/NewsPress/Risk&Insurance_Avian2.pdf
I was at a the California Dialysis Council meeting last Friday and Saturday people are taking about preparedness – learning lessons from the hurricanes, thinking about earthquakes but they all acknowledging that a pandemic would be a disaster an order of magnitude greater than any other imagined event.
One thing that is continually reinforced: Preparedness begins with each individual. For dialyzors moving from incenter to home dialysis would be the most important preparedness measure.
Interesting! You have to love the “this may be comparable to a war–but don’t panic!” message. 
The most useful advice is probably to avoid crowds (or any place where people congregate together) if a pandemic comes around. The Internet and video- and audioconferencing make it easier for people to work from home and still be in touch with people. Shopping malls, grocery stores (one of our local stores will deliver, which would be good), airports & especially airplanes, churches, schools, daycare centers are all going to be places to avoid. And, of course, hospitals and dialysis centers.
I saw an article that said employers should be prepared to set up the workplace so people can be “at least 3 feet apart.” Um, yeah. Because air doesn’t travel. Right. Nice thought, anyway. Since people shed respiratory viruses for 24 hours before they have symptoms themselves, that’s probably not going to help much.
The article Gus just pointed us to suggested having 5-7 days worth of food on hand in case of quarantines, which is MUCH more doable than having 4-6 weeks worth. I just might go ahead and do that myself.
Lorelle, I don’t know if this will help you or not but this is what I can tell you from experience and it relates to the Fresenius not the NxStage. Just about 2 weeks ago we had a real short power outage something like 2 minutes. We have a backup generator which will come on by itself in 1minute and 15 seconds and it did. It will run for 20 minutes before shuting itself off to make sure the electric stays on. What I had not anticipated was the Fresenius blowing a fuse because of the “low voltage” prior to the electric going off. So even with the generator until the fuse was changed the dialysis machine wouldn’t run. Since then we bought a voltage regulator that will not only handle spikes in electric but also low voltage and shut the power off to the machine before the low voltage can cause the fuse to blow.
Hi y’all,
Some good news for a change…
GlaxoSmithKline Plc’s vaccine against a bird flu virus that may spark a pandemic was effective in about 80% of people who received it in tests, indicating the shot is more effective than those of rivals.
The shot was effective at a small dose using a new additive to boost effectiveness, the London-based drugmaker said in an e- mailed statement today. Paris-based Sanofi-Aventis SA has said its experimental vaccine was only 50% effective.
Glaxo, Europe’s biggest drugmaker, is testing two bird flu inoculations in people, including one with a standard additive. About 30 companies worldwide including Novartis AG’s Chiron unit are working on such products as world health officials track the lethal H5N1 strain of avian flu. Earlier this year, Chiron asked European Union regulators to approve a pandemic flu vaccine, following Glaxo’s application in December 2005.
The avian flu circling the globe and infecting birds may mutate into a form that can kill millions of people, according to the World Health Organization. At least 133 of the 231 people known to be infected with H5N1 have died, according to the World Health Organization in Geneva.
Vaccines produced each year for seasonal flu won’t protect against a pandemic strain, the WHO has said. No pandemic shot is ready for commercial production and no vaccines are expected to be widely available until several months after the start of a worldwide outbreak, the WHO said.
Well it is some good news, a step in the right direction, but they haven’t solved the problem.
- They still don’t know if it will provide protection against the pandemic strain.
- They still haven’t said how long it will take to produce the vaccine in mass quantities.
- They still don’t know if it will provide protection against the second and third waves.
Don’t forget, there will be some vaccines available to some people.
The big problem is that there are over 6 billion people in the world, the virus takes a couple of months to spread around the world and the vaccine production is slower than the virus.
We have always known that there will be limited availability of different types of vaccines.
We still have the same problems, but possibly another bullet in our gun against H5N1.
On the pandemic discussion boards the main disagreements seem to be whether 2006 is just like 1914 or is 2006 more like 1916 … in other words is a pandemic like 1918 two or four years off.
http://www.bangkokpost.com/News/30Jul2006_news04.php
If the news in the above link is true then it would seem we are moving from Stage 4 to Stage 5 (at least going by the pre2006 definition). That would make it 1916.
I started this thread over two years ago, about the time I started keeping track of Pandemic Flu reporting. I’ve tried to research and understand the issue as best I can. This is some of what I’ve concluded.
There are three important unknowns. When will this virus (H5N1, the virus active now in SE Asia) or some other virus start to pass easily from human to human? What percentage of the population will catch the virus once it can pass easily among people? Of the people who catch the virus, what percentage will die?
When will this virus start to pass easily from human to human? It could be in a month or in ten years, there is no way of knowing but we can assume that it will happen, one year or twenty years this will happen.
What percentage of the population will catch the virus once it can pass easily among people? This “clinical rate” is a key number and there is not a lot of data on how many people in a normal flu season catch the flu and there isn’t any data on what percentage caught the flu the last time a pandemic occurred. In my reading the usual number is 30 to 50% of the overall population will catch the flu. A 50% clinical rate is used by most of the planning models that I have seen.
Of the people who catch the virus, what percentage will die? To date the case fatality rate (CFR) for H5N1 is 50% overall, however, most experts think this number will come down if the virus recombines into a version that can pass easily among humans. The low end of the range of CFRs is 2 to 5%.
The pandemic would hit in three waves, it is thought that the second wave would be the worst. I think a very optimistic prognostication about the worst wave would be for 30% of the population to get sick and a CFR of 2%. This is, as near as I can tell, the best case scenario.
King County, where I live: population ~ 1.8 million, would suffer over 600,000 cases of illness and over 12,000 deaths in an 8 to 12 week period. That in itself is horrible, but beyond that my concern is that with that many sick – far beyond the surge capacity of our public health facilities – dialysis personnel would be pulled from dialysis units and assigned to surge medical facilities.
Looking at renal industry specific information on the Web – mostly information from the Network websites (here is an NKF resource list) – there is no discussion about what people expect to happen. All the Network sites do is link to the various State pandemic plans (other than Network 14, with a PDF newletterthat includes an ESRD Pandemic Checklist). These State plans all warn that people must anticipate being self sufficient for 2 to 4 weeks, but how is that suppose to work for someone on dialysis?
Reading the plans they all indicate that surge capacity would be created – in schools for instance but who will staff these facilities? If the choice is between staffing a flu ward for hundreds or keeping a dialysis unit open for dozens … well, I think the ethical choice may be to staff the flu ward. Am I missing something? If following our State pandemic plan means that dialysis units will be closed then this must be communicated bluntly to those on incenter dialysis.
I believe if you plan on living for another 20 years then you must plan on surviving a pandemic. If you are on dialysis then you will have unique challenges and the only way I can imagine getting through it is by being able to dialyze at home. I don’t know how else to say it. I wish it wasn’t true but I believe that the implications of what is coming must be understood and addressed now by the renal community, this would give people some time to come to grips and find a way to get home.
I will continue to post to this thread, if you don’t want to think about this then skip the thread but I think there are things we can do to be ready, I’ll share what I am doing and what I find out as I continue to ask questions.
I thought I wold bump this thread - it was interesting reading under the current circumstances. I made some sloppy word choices but all 'n all this lead to some planning that is helping today.
Web tool helps advise when flu needs a doctor
(AP) – 1 hour ago
http://www.google.com/hostednews/ap/article/ALeqM5hleDaUzrketr8vaIyQxI58ybeCIwD9B685VO1
WASHINGTON — Wondering if swine flu’s bad enough to require a doctor’s attention? An interactive Web site may help you decide, using the same type of triage calculations that doctors at Emory University use.
Microsoft Corp. unveiled the site Wednesday at http://www.h1n1responsecenter.com Type in your age — it’s only for people over 12 — and answer questions about fever, other symptoms and your underlying health.
The program may conclude you’ve probably got swine flu — known as the 2009 H1N1 strain — but that rest and fluids should be enough care, or that you need a non-emergency call to your own doctor.
But answer that you’ve been short of breath — or that you felt better but then the fever came back with a worse cough — and the program flashes: “You might be very sick! Call your doctor now.”
It’s part of efforts, including local hot lines, to keep people who aren’t that sick from flooding already crowded emergency rooms.
Microsoft licensed the self-assessment tool from Emory, which based it on what the Centers for Disease Control and Prevention has determined are key risks factors for a bad flu outcome. A large insurer tested the tool against more than 2,500 records of patient visits for flulike symptoms in Colorado, and only two people deemed low-risk were hospitalized within the following two weeks.
“It reflects the best available science,” said Emory emergency medicine specialist Dr. Arthur Kellermann.
The CDC also posts lists of signs to seek emergency flu care, including for children, at http://www.flu.gov.
That is so cool, Bill! Thanks for finding it, and don’t be too surprised when you find it on my Facebook page. 
I just found this on the NYT site. The big fear re: pandemic is something like the 1918 flu epidemic, which preferentially killed young, healthy people–and scariest of all, it caused a severe pneumonia that basically caused people to drown.
Turns out, it might not have been the VIRUS that caused this problem after all, but the TREATMENT: high dose aspirin. That’s actually good news for all of us today. Here’s the article:
In 1918 Pandemic, Another Possible Killer: Aspirin
By NICHOLAS BAKALAR
Published: October 12, 2009
The 1918 flu epidemic was probably the deadliest plague in human history, killing more than 50 million people worldwide. Now it appears that a small number of the deaths may have been caused not by the virus, but by a drug used to treat it: aspirin.
Dr. Karen M. Starko, author of one of the earliest papers connecting aspirin use with Reye’s syndrome, has published an article suggesting that overdoses of the relatively new “wonder drug” could have been deadly.
What raised Dr. Starko’s suspicions is that high doses of aspirin, amounts considered unsafe today, were commonly used to treat the illness, and the symptoms of aspirin overdose may have been difficult to distinguish from those of the flu, especially among those who died soon after they became ill.
Some doubts were raised even at the time. At least one contemporary pathologist working for the Public Health Service thought that the amount of lung damage seen during autopsies in early deaths was too little to attribute to viral pneumonia, and that the large amounts of bloody, watery liquid in the lungs must have had some other cause.
Dr. Starko acknowledged that she did not have autopsy reports or other documents that could prove that aspirin was the problem. “There was a lot of chaos in these places,” she said, “and I’m not sure if there are good records anywhere.”
But of the many factors that might have influenced the outcome in any particular case, Dr. Starko wrote, aspirin overdose stands out for several reasons, including a confluence of historical events.
In February 1917, Bayer lost its American patent on aspirin, opening a lucrative drug market to many manufacturers. Bayer fought back with copious advertising, celebrating the brand’s purity just as the epidemic was reaching its peak.
Aspirin packages were produced containing no warnings about toxicity and few instructions about use. In the fall of 1918, facing a widespread deadly disease with no known cure, the surgeon general and the United States Navy recommended aspirin as a symptomatic treatment, and the military bought large quantities of the drug.
The Journal of the American Medical Association suggested a dose of 1,000 milligrams every three hours, the equivalent of almost 25 standard 325-milligram aspirin tablets in 24 hours. This is about twice the daily dosage generally considered safe today.
Dr. Starko’s paper, published in the Nov. 1 issue of Clinical Infectious Diseases, has stirred some interest, if not enthusiastic endorsement, among other experts.
“I think the paper is creative and asking good questions,” said John M. Barry, author of a book on the 1918 flu titled “The Great Influenza.” “But we don’t know how many people actually took the doses of aspirin discussed in the article.”
The pharmacology of aspirin is complex and was not fully understood until the 1960s, but dosage is crucial. Doubling the dose given at six-hour intervals can cause a 400 percent increase in the amount of the medicine that remains in the body. Even quite low daily doses — six to nine standard aspirin pills a day for several days — can lead to dangerously high blood levels of the drug in some people.
Peter A. Chyka, a professor of pharmacy at the University of Tennessee, said he found Dr. Starko’s theory “intriguing.” Little was known about safe dosages at the time, he said, and doctors often simply raised the amount until they saw signs of toxicity.
“In the context of what we know today about aspirin and aspirinlike products, Starko has made an interesting effort to put this together,” Dr. Chyka said. “There are things other than flu that can complicate a disease like this.”
Although he doubted that more than a small number of deaths could be attributed to aspirin overdose, Dr. David M. Morens, an epidemiologist with the National Institutes of Health, said the paper was valuable in that “it makes an attempt to look at environmental or host factors that may be involved.” He said, “We haven’t been able to explain all the deaths in young adults with the virus itself.”
Dr. Starko was hesitant to estimate how many deaths aspirin overdose could have caused, but suggested that military archives might be one place to look. “I’m hoping others will follow up,” she said, “by examining available treatment records.”