Tuesday, October 27, 2009

"Do you have to be a doctor to do Home Dialysis?"

People have asked me if you have to be a doctor or nurse to do Home Dialysis. The answer? A resounding "NO!"

Now, I'd be lying if I said that it didn't help to be fluent in the language of medicine,or familiar with basic concepts such as sterile technique or drawing up medications: things I do on a day-to-day basis in my medical practice.

But most people who are trained in Home Dialysis are not health professionals at all, and they do just fine. The training for Home Hemodialysis takes about four to six weeks, and only about a week for Home Peritoneal Dialysis. The Home Training Nurses are extraordinary: exceptionally clear and patient.

But there are some basic requirements:
  • A team (i.e. patient and helper) that works well together - at least most of the time!
  • An ability to read and follow directions
  • Manual dexterity - or at least enough manual dexterity to allow you to connect tubing, and draw saline irrigation fluid and medications up into syringes
  • Enough physical strength to manage large IV bags (In our case, we must lift five ten-pound bags of IV fluid onto an IV pole for each treatment.)
  • The ability to do simple math
  • The ability to troubleshoot by using a manual (There are 1-800 hotline numbers associated with your dialysis center and the company that manufactures the machines, and the guidance is excellent.)
  • The ability to keep a cool head under pressure when dialysis machine alarms go off.
I have assited my husband, Steve, with Home Hemodialysis for two years. We have used both central lines (large IV portals surgically implanted in the neck or upper chest) and fistulas (surgically enlarged veins, usually in the forearm). We've run into a few snags along the way - but most of these have been related to fistula problems.

The process is time consuming, and it is labor intensive. But comparing Home Dialysis to In-Center treatment? The opportunity to do dialysis "on your own time and on your own terms?" The comfort of dialyzing in your pajamas? Home Dialysis is a no-brainer!

You may be interested in reading "Arranging Your Life When Dialysis Comes Home: 'The Underwear Factor;'" written by Interior Designer Jane McClure and me. We have a whole chapter entitled "Are You Cut Out to do Home Dialysis." (Order through http://www.lindagromkomd.com/ or http://www.arrange2live.org/.)

You might also find some entertainment value in reading about Steve's maiden voyage on Home Dialysis. It wasn't funny at the time, but we did get through it--and stayed together! (Order "Complications: A Doctor's Love Story" through http://www.lindagromkomd.com/.)

If you are considering Home Dialysis or have questions you'd like discussed, please write to me. While I cannot provide you direct medical advice, I'll happily give you the perspective of another traveler along this road. Take care. Linda Gromko, MD

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