by Peter Laird, MD
On February 1, 2007, I entered into a new life that was difficult and wonderful all at the same time. I developed IgA nephropathy diagnosed by one of my colleagues in 1998 when I failed an insurance physical exam. They found protein in my urine. I found protein and blood. After consultation with my nephrology colleague, the diagnosis of IgA nephropathy became the prime suspect which was confirmed later by renal biopsy.
My first experience with dialysis was rather benign with a shortened session at low blood flow rates. My dialysis tech happened to be my own patient who I had know for several years. Krystal knew her trade well and I am grateful for her compassionate care in my early months on dialysis. I learned many aspects of dialysis from her that I still use in my own self care practice. Recently, a friend forwarded the story of man in Sweden who insisted on learning self care to help avoid many of the symptoms of dialysis because he wanted to have control of his life. Interestingly, his example proved the inspiration for 60% of the current patients in his unit who likewise do their own self care HD and PD:
A Patient Directs His Own Care
Farman received a kidney transplant, but in 2005 he was back on dialysis. On the first day of treatment, he spoke with Britt-Mari Banck, a nurse in the Ryhov County Hospital hemodialysis clinic in Jönköping, Sweden. Farman said to her, “You have to help me treat myself. I need to have control in my life.” He had researched self dialysis and became convinced that if he could manage his own treatment, the side effects would disappear.
In many dialysis centers, the story would have ended there. But Farman’s unusual request was met with an unusual response. “I said, ‘Yes, how shall we start?’” recalls Banck, now acting head nurse for the hospital’s self-care dialysis unit.
Banck showed Farman how to use the dialysis machine, read and interpret lab results, and document his care in his chart. Within five weeks, Farman was managing his dialysis independently. He discovered that self-dialysis resulted in fewer side effects.
Christian Farman's hospital based unit now plans to push their goal of self care patients to 75%. American has paid even les attention to self care dialysis practices than even home dialysis options. For patients who do not have the option to do self care at home, self care in-center is a viable option. I did self care in my dialysis unit for nearly two years before going to the NxStage System One and the Laird hemodialysis unit came into existence.
I am thankful to Dr. Belding Scribner for his vision of hope and life from a machine. I am grateful to NxStage for opening up the home hemodialysis market where several others had toiled and failed. My five years of borrowed life have been some of the most production, perhaps not by shear volume, but in quality. The clear facts are that without dialysis, I would never have met my youngest granddaughter or the many friends and colleagues I have come to know in these last five years. I could not imagine the journey I started on that day in 2007, but I would not trade these last five years for anything. Having control of your life through self care, home hemodialysis fulfills the vision that Dr. Scribner brought to life all those years ago. There are many people to thank for my added five years of borrowed time, but of them all, the vision and perseverance of Dr. Scribner is the one that I continually am most grateful
I would hope all those that "hate dialysis" could one day have the opportunity that Christian Farman and I have had to regain control of our lives. Dialysis need not be a procedure filled with discomfort and dread, but instead in celebration of life. To all those that have labored to keep people like me and Christian alive, my heart felt gratitude is beyond words.
I, too, hope that all dialysis patients would have the opportunity to hate dialysis not quite so much. It is sad that your own home is the only place you can get optimal dialysis, and until patients who receive dialysis in clinic have access to the same optimal treatment, there will still be a majority who will "hate dialysis", and with good reason.
Posted by: MooseMom | Wednesday, February 01, 2012 at 12:13 AM
Peter,
Congrats on the optimal outlook on long term dialysis, this type of thinking inspires and gives hope to all of us... the longer you accomplish makes one think that it wasn't that bad after all.
Myself already at 34yrs with kidney failure and what not, AMEN!
Gus Castaneda
Posted by: DailyHemo | Wednesday, February 01, 2012 at 10:18 PM