Hi Karen,
I’m not a dialysis patient either, but worked as a social worker with dialysis patients, including home hemo and PD patients, for 18 years. As one of my friends on dialysis once said, it’s important to dialyze to live, not live to dialyze. Hopefully you’ll find a way to make kayaking work for you or, if not, you’ll find a new sport that gives you as much pleasure.
If you’re unsure about whether home hemo or PD would work best for you, I’d suggest that you call the clinics in your area (see Find a Center from the Home Dialysis Central home page) to see if there is a waiting list for training for PD and home hemo, what days and times training is offered, how long training lasts, what you would need to do it, and what might be covered and what you might owe. You want to visit clinics and talk with staff and patients if possible. There may even be classes in your area where you can learn more about your options.
Most (but not all machines) require a reverse osmosis water treatment system for home hemo. This is to remove things from the water that might get into your blood and make you sick. Contact your health insurer and ask what it covers for home hemo and home PD so far as set up and maintenance. Insurance companies often look at what Medicare covers when deciding whether to pay for something or not. Medicare covers 80% of the allowed charge for installation of the equipment needed to do home hemo and home PD, even some of the cost to hook the home hemodialysis machine and water treatment system into plumbing and the existing electrical system, as well as follow-up care.
Having pets and riding horses should be OK no matter whether you’re on either hemodialysis or PD. If you do PD, your training nurse will probably suggest that you keep your pets out of the room when you’re doing a CAPD (manual peritoneal dialysis) exchange or when you’re connecting to the machine for CCPD. Once you’ve made the connections and the system is closed, there should be no problem having pets around. You also need to be sure that you don’t do PD connections in a draft (window or heater/air conditioner). Obviously, you’ll also need to wash your hands thoroughly and follow instructions on caring for your PD catheter or vascular access.
So far as exercise and dialysis, I’ve known lots of patients that exercised regularly on dialysis. They often commented that because they sweated when they exercised, they could drink more fluid (within reason). You might want to read the booklet on exercise that is at www.lifeoptions.org/pdfs/exer_pat.pdf and Staying Active with Kidney Disease, module 12 on Kidney School at www.kidneyschool.org. The booklet on exercise advises patients not to exercise in “very hot” or “very cold” conditions. Like with anything else, it’s important to know and accept your limits which means you need to listen to and follow what your body tells you.
It’s good to ask questions and nothing is too trivial to ask. Hopefully other patients, Dori, or I will have answers.