dw
Joined: 02 Feb 2004
Posts: 2
Posted: Mon Feb 02, 2004 7:43 am Post subject: Nocturnal Dialysis
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I would like to know everything about nocturnal dialysis. How long does it take to set up the machine and tear it down? What if the machine
eaks down-when do you dialylze next? Is it that much more gentle then incenter dialysis?
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Arlene
Site Admin
Joined: 02 Feb 2003
Posts: 52
Posted: Mon Feb 02, 2004 9:17 am Post subject: Give me a call...will put you in touch with someone
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Call 360-604-4440.
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jfwag
Joined: 11 Jan 2003
Posts: 140
Posted: Tue Feb 03, 2004 3:26 am Post subject: You can...
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...also ask Marty on this board. She has plenty of experience. I can help in I can say that you can set up a machine, F2008 in about 1 hour after getting a routine down and practicing. In an emergency I have set it up in a half hour. Breaking down is about the same time but not as much work because the machine does alot of the heat cleaning etc... itself. The treatment time obviously depends on the length of time your neph. prescribes. I am giving you generalities her of course.
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Marty
Joined: 28 Oct 2002
Posts: 160
Posted: Fri Feb 06, 2004 5:12 am Post subject: Slow Nocturnal
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At first you will spend about an hour after about 6 months you can get a routine going and if you really want can cut the time down. Because we are home I am never in a "big" hurry. Takes me about 15 minutes to get dad off the machine. If you want me to get real specific let me know. It takes around 40 minutes to go through an acid clean and heat disinfect but you actually only do about 5 minutes of work. Push the button for acid clean connect the jug and walk away for 15 minutes. When it is finished push the button for heat disinfect and walk away about 40 minutes. The machine will shut down by itself when finished. If our machine
eaks down a repair person is there the next day usually.<
>If you have to miss a day of dialysis no big deal; you are so well dialyzed it won't make a difference. The biggest advantage is the patients health. To our family the second big advantage is being able to schedule dialysis according to whats going on in our life. We can take an extra night off if something comes up. Our center will even let us run during the day if we need too. My mom was in the hospital a while back and I wanted to spend a couple of nights with her. So I just ran dad's dialysis during the day when I wanted a night off. I didn't run the full 8 hrs. but he got better than he would in center because I ran every day at 4 hours and threw a couple of 8 hr. nights in. Not to mention in our area with all this crappy weather we don't have to think about getting to dialysis. If you have any specific questions you would like answered post again or if you contact Arlene and she doesn't have someone else for you to talk to you can call me. <
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>Arlene, our area code has changed from 716 to 585.
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Marty
Joined: 28 Oct 2002
Posts: 160
Posted: Fri Feb 06, 2004 5:17 am Post subject: Nocturnal
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It's a lot gentler. My dad used to cramp and crash all the time from fast fluid removal. Haven't had an episode since slow nocturnal. You are removing the fluid over a much longer period this is a lot gentler and you are also removing a much lower amount because you don't have the day for it to build up. You also are running the pump speed at a lower rate less stress on the heart. Inspite of them trying to blame the patient for the crashes I can tell you he never went in fluid high. And all the salt and drinks in the world wouldn't keep his BP up.
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dw
Joined: 02 Feb 2004
Posts: 2
Posted: Fri Feb 06, 2004 7:30 am Post subject: Nocturnal dialysis
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Thanks very much for information. Do I have this right? 1) It only takes about 5 min. to set up the machine other than waiting for it to go through it's cycles? 2) Do you do this as soon as the tx is finished or can you wait until the next night before the tx begins, or even sometime during the day inbetween? <
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>3) Do you usually start the tx the same time every nite or can you start anytime you want when the person is ready for bed? 4) If you are on a 6 nite program do you evr skip more than one nite if you need to?<
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>5) What is the total time spent getting patient on and off, mixing solutions (do you mix bicarb and acid or is it pre-mixed), wiping down the machine, anything else to do? Is time spent for anything else like keeping records, giving meds (are meds given IV by the caregiver in place of a RN in dialysis center?)? 6) When the patient goes to sleep how is he watched for blood leaks and the machine watched for problems? 7) Do alarms interupt sleep often? Can patient sleep on his stomach or his side? 9) Is the patient aware of jerking his lines in his sleep? 10) Does his arm hurt from the needles being in his arm all night? 11) What are the most common things that go wrong? 12) Where do the wastes go? 13) What if the patient feels like sleeping longer-does he have to get off the machine in exactly 8 hrs? 14) Is it difficult for the patient to pull out the needles and hold his sites when he first wakes up in the morning? 15) Is it difficult to avoid blood spurts getting on things? 16) Where do you dispose of the needles and lines? 17) How much can the patient comfortably drink per day if he has little or no output? 1 How does he weigh himself at home (what scale is accurate to the 10ths)? 19) Is it difficult to not be able to ever get up for 8 hrs at a time to get a snack or do something if the patient can't sleep or is sick etc.? 20) Any other tips or insights on how to make the process run smoothly?
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jfwag
Joined: 11 Jan 2003
Posts: 140
Posted: Fri Feb 06, 2004 8:19 am Post subject: Re: Nocturnal dialysis
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Let me give this a try: Both Marty and I (used) she still does I beleive, the same machine. Not sure what you are using, however 1. There are water tests, mixing of bicarbb, saline solutions, heparin syringe drawing and over all testing of the machine to set everything up. Usually about an hour when you are good at it. There are other minor things too. Like Marty, I did it at home and generally took my time. 2 hours if I felt like it. 2. Cleaning up is right after the patient comes off the machine but the machine does most of this. You just basically push some buttons, and clean bicarb tanks. 3.In my case Lois was not on nocturnal and we did standard 3X's/week generally the same time of day (morning) but at home we always had the OPTION of changing our shedules, unlike in center.5. All this is done, records, wiping machine etc...mixing all falls into the general time of setting up or
eaking down. Records are kept throughoput the whole TX. 6? Lois did sleep most of the time and the caregiver, obviously cannot sleep. Must watch out for everything, record 1/2 hour BP's and everything else that goes on. Just like in center but there is only one machine to look after. 7. Lois always slept on her side. No problem except--and I can say this jokingly only now--she died while laying on her right side. NOT the cause however. 9. Must beware of jerking lines if sleeping. Caregivers job. (wow you have alot of questions, but that is good and you will learn alot here) Sleeping longer is no problem. Lois used to sleep all the time as I took her off the machine. No big deal. (She yused a Tesio catheter however, which was easier to disconect that needles.) Needles go into a ssharps container provided for you and tubing can just go into the garbage. (Alot of this will probably be checked by your provider. Ours happened to be Fresenius with a Fresenius machine) I weighed Lois on a regular dial scale (sitting) she had an amputation, and then converted the weight to Kilos. Easy. Scale was not accurate but this
is why at home is better. It is more personilized and you can adjust machine as you go if needed. (Can explain this later in more detail.) 20. Let me get back on this question but practice basically makes perfect. It all in all is not that difficult and beleive me if your training nurse and Neph. don't think you know what you are doing, well "You ain't goin' home"
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