As my broken dialysis arm is making long sessions on nocturnal impossible for a good while I am considering doing short daily as the longer I am on dialysis each session the more painful it is. Just wondering how long you short daily folk stay on for each time and how much you remove?
I realise you use different machines than the Freni and it is going to be a real pain for my hubby to have to do EVERYTHING each day as at present I am USELESS except I can still stick the needles in.
Cheers
Hi beachy!
Using NxStage, runs average 2 hrs for a person of my size, and UF removal is about .9- 1.5 and as much as 2.0 after the day off.
Hope you are feeling better soon!
Beachy;
Sorry to hear about your bike accident… Get better soon… and take care of that arm.
When we were using the Freni and on Nocturnal and had to go in center for treatments when we were on vacation… Think My partner’s treatment was usually about 3.5 hrs…
She had a difficult time, Machine alarms… Blood pump maxed out at 300 and was constantly alarming… Then you can expect that for using a catheter. also when going to in center for treatments we are only doing it 3X a week…About the 6th day on vacation she started to get tired and knew it was time to get home and start Nocturnal. But if you are doing it daily for a while, you should not have any problems…
Take care again
HemoHelper
HiFolks
Hello Beachy
I hope you Get Well Soon.
As to time on short Tx. for me at 105K I ran 3.5hr and would take off .7 to 2.3
Best To You
bob obrien
That was some nasty accident to have, Beachy. I hope you recover quickly. Its pretty easy to take a nasty spill on a bike when the road surface is wet, especially at first when the water just sits on top of a thin layer of greasy road film (you can’t see it, but it’s there). You can also quickly go down if you hit a painted road marking.
It’s been a while, but I can tell you that all of us here who are or were on Freni’s for nocturnal can do a short daily just about any time we want. There’s nothing to it, and the Freni is no more inconvenient for it than for nocturnal. The only difference is that setup effort is still the same for every treatment, so it is proportionately longer per treatment. I had to train for short daily and stay on it for a number of weeks before moving on the nocturnal, and so I had the opportunity to really see what the differences are.
Most people of average size need only 2 hours. The concept of “short daily” hemo is that your weekly hours of treatment should add up to what you would do over a week at the dialysis centre when doing it 3 times per week (although I guess a person could do more - I certainly never had to when doing short daily for more extended periods of time). For most people, that would be 3 treatments of 4 hours, on average. That’s 12 hours of dialysis a week. So if you are doing short daily 6 days per week, it would take 2 hour treatments to add up to 12 hours.
The treatment parameters for short daily are different than for daily nocturnal. They are more in line with what is done at the dialysis centre. But this is easily adjustable on the machine. To get adequate treatment in 2 hours, you need a dialysis pump speed of 800 (the same, no change), and a blood pump speed of 400 (versus 300 for daily nocturnal).
Because you only have a couple of hours, you of course end up removing more fluid per hour. Unlike nocturnal, since you are usually removing more per hour, you have to check your blood pressure during the treatment. When doing short daily, I set the BP to be taken automatically every 30 minutes. Should it drop too low, you just have to infuse some saline as per the standard procedure. While there is almost no risk of a BP crash during nocturnal, for short daily, it’s the same as it would be at the dialysis centre. We also had a rule that we were not allowed to remove more than 1100 mL per hour under any circumstances (for our own safety at home). If we had to remove more, we could add some treatment time, or simply remove the rest the next day if appropriate. It’s not that critical since we are doing it daily.
If you add phosphorus to your dialysate for nocturnal, you don’t for short daily (since short daily is not long enough to remove it aggressively like nocturnal does). You probably don’t need to add any calcium either. By the same token, while I didn’t need to take a phosphate binder on nocturnal, I had to take a couple of TUMS with meals when doing short daily.
You will also need to change what you do for heparin. If it’s only going to be 2 hours or so, you need your bolus, and just a bit more (whatever you need for the duration, taking into account that you need to stop heparin a certain amount of time before the end of treatment, same as you do for nocturnal). I always stopped my hep an hour before the end, and so I only needed enough for the bolus and the first hour on short daily. Some people might only need the initial bolus, but I know my venous chamber would start to clog with no additional heparin for 2 hours.
Doing short daily here and there doesn’t make any difference, but if you are switching to it for a more extended period, then it might make some difference, like for potassium, and so it might be wise to do some bloodwork after a while. It might also affect your blood pressure (higher), but not if only doing short daily for a couple of weeks.
You also have to keep in mind that you can’t drink with abandon when there’s an off-dialysis day, otherwise you might not be able to remove it all the next treatment. Same thing with regard to potassium. You never know. I never had to worry about it on daily nocturnal, but on short daily, there is more chance of eating too much potassium.
Some people might do longer daily treatments if they want to, but as I used to explain on here, we use the term “short daily” to mean what I described. It’s supposed to be daily (that is, 5 or 6 days per week), but at the same time, it’s supposed to be short if only for the convenience of the patient (keeping in mind that to those 2 hours, you also have to add prep and cleanup time). No matter how you slice it, you pretty much end up slicing out a whole morning, afternoon or evening out of your day. But if someone wants to spend more of each day on dialysis, that’s up to them. Also, since you aren’t changing your dialyzer, it might be different than for those who are doing short daily on a NxStage system. Those Fresenius machines are every bit as efficient as the ones in any dialysis centre.
Now, I’m just saying what the differences were for me and others on the program where I live. As I said, we could choose to do a short daily just about anytime. But for more extended periods, we did have to talk to our dialysis nurse. Also, some of this might not apply in your case, since as I recall, you aren’t doing your nocturnal daily.
How does someone follow the post Pierre wrote? Anyways I’ll be alot shorter and to the point. First, Beachy, what the heck were you thinking? Cycling in the rain? What kind of crazy Aussie are you? Probably like me, the crazy Yank who went tubing and threw his back out for over two months and had two staph infections and one viral. We do have to keep active after all. We are dialyzing to live and not living to dialyze. So once your elbow heals just jump on the bike again – and live.
Regarding SDD, I was in the hospital for a couple of days earlier this week. It was a case of being “safe rather than sorry” and it probably was nothing. But it’s a lesson I learned awhile ago. I had one tx in the hospital on a Freni and we set it for 2 3/4 hours at a BFR of 400 and I took off 2 kg.
Normally, my NxStage tx is from 2:15 to 2 30 but because my BP is low and I’m experiencing orthostatic hypotension I’m probably going to play around with different variables, including lengthening my tx. However, if I don’t need to take off much fluid I can run pretty quickly without any apparent effect. But I am getting convinced that longer probably is better. That’s too bad because I’d rather not have to spend much time dialyzing.
thanx everyone typing getting worse with pain
rich your post cheered me up thankyou
from crazy but STUPID aussie
[quote=beachy;15125]As my broken dialysis arm is making long sessions on nocturnal impossible for a good while I am considering doing short daily as the longer I am on dialysis each session the more painful it is. Just wondering how long you short daily folk stay on for each time and how much you remove?
I realise you use different machines than the Freni and it is going to be a real pain for my hubby to have to do EVERYTHING each day as at present I am USELESS except I can still stick the needles in.
Cheers[/quote]
[B]Lately, been removing nothing…no UFR…running at 2.5 hours and feeling great!! I also think every individual varies. For example, you may weigh more than me so perhaps you need much longer time.
Get well soon!
Merry Christmas…
[/B]