While obviously not great circumstances, you have definitely stumbled upon a very supportive bunch of people. It is a great resource as there are many very knowledgeable folks here. I have found it to be very helpful over the years.
Let me start by saying that I do not do nocturnal, I do conventional (3 txts a week) however… the process overall, is very similar, so I will speak to your specific questions as best I can.
A little bit about myself, so that you can relate… I am 30, have been on hemodialysis for 5 years since the birth of my daughter… she is 5. I did hospital base txt first (for about a year), and have been home since then (going on 4 years).
Dialysis itself, is a lot to handle at first. In my opinion, a lot depends on how interested you/fiancee are, in being in the ‘drivers seat’, and knowing all that you can know, to live the healthiest life possible. That said, I would imagine that your fiancee is likely not feeling particularly well, and ‘absorbing’, never mind understanding everything that comes will the new diet, caring for his fistula, home training and cannulating (putting the needles in his fistula) will be very overwhelming for you both.
I have to agree with Dr. Laird, that my strongest advice (though quite contrary to the belief of MANY), is to get your feet wet in the dialysis unit first. Watch… Learn… Observe… Ask Questions… Determine what your fiancee’s blood pressure is (when it gets too low/what he can tolerate)… his ideal weight… and how much volume he can tolerate removing… Get comfortable with the needles… All of this is much better done in a controlled environment, while everybody adjusts, and your fiance starts to get back on his feet, and starts to feel better. Again, not medically proven, just my opinion, having been there.
Your situation is slightly more complicated with a 6 year old at home. Don’t let me discourage you, it can be done, and YOU WILL DO IT, but it is important that you are both as comfortable as you can be, especially with a child involved. As a mom of a 5 year old, it is really important that we (husband and I) are calm, cool and collected… so that our child is not afraid of dialysis, and things related, when an Emergency arises (power failure etc). Being well trained is important, and not rushing through the training is crucial. For us, I did the bulk of the training myself… and my husband came in for ‘emergency’ training. It is quite a time committment - perhaps your local center could work something out through the evening for you? (Though that would be an extremely long day for you). It does depend on the type of machine you will be using, and how comfortable you both are with needles that will determine your training.
I think I am rambling… anyhow, please post as often as you need too, and try, as difficult as it is, to take some time for yourself.
This process can be very overwhelming to say the least. I wish you both all the best!