Hi Marty,
From what I have read so far I think the Australian model is very similar to our friends in Canada. I don’t want to sound too parochial or political but… what you US folk have to go through is quite distressing to contemplate at times. Particularly this mire which seems to be your very complicated Medicare system and fight to get into home training such as Jane is experiencing. Everything seems so much more difficult when it shouldn’t and doesn’t have to be. (I hope someone high up in your health system reads this and pulls their fingers out)! LOL
Beachy, I hope someone reads this board also. In the US it is quite distressing and complicated at times and in the world of dialysis things aren’t equal at all. What you get totally depends on where you live in the US and the attitude of the center. I don’t know but if I had to make a guess I would bet over 50% of the dialysis population in the US can’t even get into a home hemo program because they simply aren’t available.
Sad but true Marty; You know what troubles I had getting into a program just because I have a well and septic and yet in other areas of the US plenty of pts. are on homehemo who have their own wells and septics. Too, I called centers that were listed as offering home hemo and when I told them where I live and that I have own utilities they turned me down. As you know I live in NW NJ… I tried leaving a post last night but I guess it didn’t go through. I’ve since met other pts. who were turned down for the same reason I was. Hopefully the Nxstage machine will solve the roadblocks for me. Lin.
Unfortunately, where dialysis is provided by private sector for-profit corporations, these companies are not going to go out of their way for patients if it increases their costs too much. When dialysis is a public service, they tend to take a more egalitarian view in which everyone has equal access, as much as possible. In terms of water supply, where there’s a will, there’s a way. But in your case Lin, NxStage should be a pretty good solution. Since you don’t have to take fluid off, short daily will be plenty, while not having to worry about keeping your UF rate down to a reasonable number. I’m not sure how NxStage handles this. Most high-flux dialyzers need a minimum UF rate in order to work properly. How this is usually handled is that if you don’t have any fluid to remove, they give you some in the form of saline so they can remove it, bringing the UF rate up to the minimum (often, that’s about 300 ml/hr) – or they use a lower flux dialyzer which doesn’t have that requirement). If that’s the case for you, then short daily should be ideal.
Here’s a question for the NxStage users: does NxStage make provision for different dialyzers, or do they have only one which everyone must use?
Hi Pierre, We could’ve installed the equipment but the costs for recharging and maintenance would be very expensive and not affordable for us. In other areas of the country pts are doing home hemo with wells and septics and pay no extra but those I’ve spoken to were on Medicare primary so there may be different rules I’m not aware of. The company was not a small not for profit co… I decline to mention the name as they are a sponsor and in the past that has gotten me into the dog house so to speak. I speak the truth but…
Yes, I need no fluid removal at present time; giving back saline doesn’t work with me. I’m at a stage with the pkd where I don’t concentrate urine (the other concentration is slowing down lol). During tx. I actually give up more than the machine is set for and some days they must disconnect me so that I can go to the ladies room.
(Note to self :- I must check the flow rate when I switch on tonight…supposed to be 300 :? )
Well I was on 2884 on daytime H.H.D., Beachy, but we all got changed to A412 to go nocturnal & they gave us a plastic ‘Jerry can’ to put the 2 lots into. THere’s a liter or more left when finished & we were advised to leave it in there until next dx, swill it around as kind of antiseptic & then chuck it before refill. There’s also a once-a-month disinfect procedure for the jerry can. I also went ‘back’ to a 170H dialyser, after being on a 210H. So I dunno…maybe this will change in future, depending on clearances etc. ?? :?
Just realised, I didn’t come back to here, after 1:checking the machine & 2:then checking with the unit. It was on 500 & I subsequently 1:ran at 300 for 2 nights, then 2: switched back to 500 when the staff there told me that was the setting for me (don’t forget Beachy, I weigh twice as much as you!! :shock: :lol: ), as I need as much as I can get !
Anyway, I don’t seem to be having as much trouble now.
On the gambro machines for nocturnal we get an 1150g bicart cartridge that is more than enough to last me 10 hours.
When I bleached the jerry can, I find I have to rinse it about 10 times more than what the instructions say, to get the negative chlorine result :shock:
:- I must check the flow rate when I switch on tonight…supposed to be 300 :? )