Question. Those on home haemo, haha obviously this is the right place:).
Do you give yourself IV iron, via the machine during treatment? This is, when needed of course, when ferritin levels are low.
My hospital has so far refused to let me do this. Some people have bad reactions with IV iron, but as I’ve had it many times in the unit, it is only red tape that prevents them giving me an ampule or 2 to be used as prescribed. Therefore if I need iron I have to go into the unit.
Anyone else come across this, whats the situation across the pond?
Yep, I’ve run into the same wall here on the right side of the pond. It seems pretty silly since when I used to go into the clinic for my iron bolus that my RN would let me self-administer while sho would go out of the room and do other things. It seems if we can self-care regarding dialysis that we should also be able to give ourselves the IV iron.
As Richard B knows, all of us here in Australia allow and encourage (and always have) self-administration of Fe at home - it simply isnt an issue. Why this seems to be a problem in the Us escapes me.
Thanks for your replies folks! Seems it varies from location to location, even worldwide:)
A fellow home heamo friend of mine in the UK does do her own iron, but it’s a sort of ‘agreement’ between her and her home haemo nurse, if you get the gist She’s probably not supposed to be doing it herself on paper:)
One benefit (maybe the only one) of expanding CMS’s payment bundle is that it removes the reimbursement barrier to administering iron at home. Starting in 2011 I think it will be come common in the US.
[QUOTE=nocturnaldialysis;17193]As Richard B knows, all of us here in Australia allow and encourage (and always have) self-administration of Fe at home - it simply isnt an issue. Why this seems to be a problem in the Us escapes me.
John Agar[/QUOTE]
Hi Prof. Agar!
Thanks for joining in here. The reason I was given as to why I could not self-administer iron at home is that no matter how many times a patient successfully gets IV iron, a reaction is always possible. Fact or myth?
Years ago people had reactions and it was necessary to have a trained medical person nearby to handle any reaction that might occur. I don’t know how often reactions occur now with newer products, but I bet that the issue with self-administration of iron (which some CKD patients do) relates more to a fear by the some facilities and/or physicians that they could be sued if they do not require administration by a healthcare professional since the iron products carry a warning that they could cause anaphylactic reactions in people who are sensitive to those products. If that warning was not on the product (which I assume is there because the FDA requires it), I don’t think anyone would have a problem with patients self-administering IV iron. Some home dialysis patients take oral iron which is cheaper. It’s effective in some and not as effective in others. Might be worth trying oral iron to see how it works for you.
She’s probably not supposed to be doing it herself on paper:)