I thought I would reply to this because switching between short daily and daily nocturnal is possible anytime. It’s not a daily nocturnal hemo program, but a home hemo program. It’s pretty much left up to the patients as to whether they do short daily or daily nocturnal, and the number of days can vary too.
While I prefer daily nocturnal, I very much like the fact that I could switch anytime. Our Fresenius system is very capable of both without any modification or adaptation of any kind. We all train doing short daily first, we do short daily to start at home, and then those who want to go to daily nocturnal then go on to sleepover 3 nights at the hospital.
In practice, I would never do short daily unless I had to for some reason, but it’s nice to know I have that flexibility available.
I did short daily initially at home for about 3 months before switching to nocturnal. Since then, I’ve done short daily for a week or more at least a couple of times. Both times, it was necessary for a technical reason. For example, at one point, there was a batch of bloodlines which couldn’t be trusted overnight because there had been a few cases in-centre of a connector becoming detached. So, until that problem was resolved and they could replace our bloodlines with another batch, all nocturnal patients had to do short daily instead (which was MUCH better than going in-centre!). More recently was when I had to create a new buttonhole. Plus, there have been a few times when I chose to do a short daily instead, such as when I wanted to pick someone up at the airport late at night.
It hasn’t happened yet, but I might decide to do a short daily in the morning if I had a power failure or something at night. It would depend on the circumstances.
Like I said, it’s nice to have that flexibility.
Overall, I probably don’t feel that different during short daily stints, but my bloodworks isn’t as good. The big difference medically is that my blood pressure goes up on short daily. If I was on short for the long term, I’m pretty sure I would need a BP med as I did during my first 3 months at home on short daily.
Dietwise, it’s the same, but fluidwise is very different. I drink whenever I want on daily nocturnal, but I do watch it a bit on short daily. This is because there just isn’t as much treatment time to remove fluid, and I don’t like to have those higher UF rates when I’m too heavy.
I prefer daily nocturnal mainly for 3 reasons:
1- Medications: I don’t need any BP meds, and only minimal Eprex. No phosphate binder. Furthermore, I can eat ALL the phosphorus I want without exception.
2- I can drink anytime I want.
3- All my daytimes are free.
Pierre