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Hello everyone and thank you for the returns on “A question”.
I have several more questions that I would like input on from “this side of the fence”.
First, the Nxstage system looks interesting, small, lightweight, simple.
a F 2008K machine.
We need to travel 60 plus miles to and from treatment.
150 miles away, so what do you do when you provider does not offer the system?
Second, how long does training take? I know we’ll need to know about putting the needles in, but what about the EPO, Calject, Heprin, etc?
Then what about the monthly “lab draws”.
etc, etc…how much simular would we need to be than a regular dialysis unit?
would all this be needed?
out there in “kidneyland”, have done or what they do.
hospital know nothing about dialysis. One dialysis patient started to bleed at home following a treatment, and the local hospita had not a clue what to do!!
to a larger hospital for help.
Our provider does not offer Nxstage in this area, and the company that does is a good 150 miles away, so what do you do when you provider does not offer the system?
The options are to use the machine the dialysis clinic uses, to advocate for that clinic to provide the NxStage machine, or to change clinics (and usually doctors) to one that offers the NxStage. You could look on the NxStage website (www.nxstage.com) to see what clinics use their machines to be sure that the closest is as far away as you think.
Training time depends on the complexity of the equipment and how fast the patient and/or care partner learn. Training takes 3-8 weeks up to 5 days a week.
Some dialysis clinics want patients to have labs drawn at the clinic while others have patients get their labs drawn locally and get copies from that lab.
Then, what about the actual dialysis procedure? will we need to chart, listen to the lungs, etc, etc, etc, contact the Dr. when there is a problem, get orders etc, etc…how much simular would we need to be than a regular dialysis unit?
In the home setting, the patent or caregiver learns as much as a dialysis technician.
They learn not only what to do and how to do it but why they’re supposed to do it that way. They learn about kidney disease from the nurse, diet from a registered dietitian, and financing and coping with treatment/rehabilitation from the masters prepared social worker. For the treatment, the patient or care partner learns how to set up the machine, check the settings, check vital signs, insert needles, give medications, complete dialysis records, report symptoms, how to order and store supplies and medications, do water testing, and much more.
and water making system.
In addition to the machine and water treatment system (or bags for the NxStage if not using PureFlow, its water treatment system). Patients may need a basic recliner that can be disinfected, a BP monitor, a scale, and various disposable supplies. Dialysis clinics are supposed to provide equipment for the patient to do home dialysis.
What about an AED or other such equipment, and what about lab equipment, There are simple units available for hemocrit and also INR, would all this be needed?
Patients don’t typically do any labs at home. I’ve never heard of anyone who had an AED in their home. Patients are taught what to do in an emergency (health, disaster, equipment failure, etc.). They would be advised to call the dialysis clinic for health problems, to call emergency medical staff for urgent emergencies and to call the supply company (Fresenius or NxStage) if the home dialysis training nurse can’t help troubleshoot a machine problem. NxStage trades out machines that aren’t working correctly. Typically a biomedical technician is sent to the home to repair the Fresenius machine and the dialysis clinic is responsible for that cost.
hospital know nothing about dialysis.
The dialysis clinic will provide information on who to call when and phone numbers to use. If a patient needs inpatient dialysis or more than something that the hospital can’t treat, he/she would be advised to go to the hospital that the dialysis clinic refers patients to. If the need is urgent, the patient could be transferred from one hospital to another by ambulance (or air ambulance).
Another home dialysis option for your father would be peritoneal dialysis. You can read about that from the entry page for Home Dialysis Central. Just because he’s doing hemodialysis now doesn’t mean that he can’t change treatments as long as there isn’t a medical reason why he would not be a candidate for another treatment. He may also be a transplant candidate. The transplant hospital can talk with you and him and do an evaluation to make sure that getting a transplant wouldn’t create more problems than it helps.
If you’d like to get feedback from patients who are doing dialysis and may have a similar situation to your father’s, you might want to post your questions on the patient message board for HD or PD.MOTION FOR A RESOLUTION on the cases of Crimean Tatar leaders Akhtem Chiygoz and Ilmi Umerov and journalist Mykola Semena
3.10.2017 - (2017/2869(RSP))
pursuant to Rule 135 of the Rules of Procedure
Elena Valenciano, Victor Boştinaru, Soraya Post, Tibor Szanyi on behalf of the S&D Group
See also joint motion for a resolution RC-B8-0545/2017
B8‑0552/2017
European Parliament resolution on the cases of Crimean Tatar leaders Akhtem Chiygoz and Ilmi Umerov and journalist Mykola Semena
The European Parliament,
- having regard to its previous resolutions on Ukraine and Russia, and especially those of 4 February 2016 on the human rights situation in Crimea, in particular of the Crimean Tatars, of 12 May 2016 on the Crimean Tatars, as well as of 16 March 2017 on the Ukrainian prisoners in Russia and the situation in Crimea,
- having regard to the United Nations General Assembly resolution 68/262 on the territorial integrity of Ukraine of 27 March 2014, affirming the commitment of the International community to the sovereignty, political independence, unity and territorial integrity of Ukraine within its internationally recognized borders, and to the United Nations General Assembly resolution 71/205 on the “Situation of human rights in the Autonomous Republic of Crimea and the city of Sevastopol (Ukraine)” of 19 December 2016, recognising the Crimean peninsula as Ukrainian territory temporarily occupied by the Russian Federation,
- having regard to the Universal Declaration of Human Rights, to the European Convention of Human Rights, to the International Covenant on Economic, Social and Cultural Rights, to the International Covenant on Civil and Political rights, and to the UN Declaration on Rights of Indigenous Peoples (UNDRIP);
-having regard to the international humanitarian law and, in particular, to its provisions on occupied territories and the treatment and protection of civilians,
- having regard to the Statement by the Spokesperson on recent developments in Crimea of 11 September 2017, regarding the so called “Supreme Court” of Simferopol sentence against the Deputy Chair of the Mejlis, Akhtem Chyigoz,
- having regard to the Statement by the Spokesperson on the sentencing of journalist Mykola Semena of 22 September 2017,
- having regard to the High Commissioner for Human Rights report on Situation of human rights in the temporarily occupied Autonomous Republic of Crimea and the city of Sevastopol (Ukraine) of 25 September 2017,
- having regard to the Statement by the Spokesperson on the sentencing of Crimean Tatar leader and Deputy Chair of the Mejlis, Ilmi Umerov, of 27 September 2017,
- having regard to Rules 123 and 135 of its Rules of Procedure,
A.whereas between February and March 2014 the Russian Federation has illegally annexed the Crimean peninsula and, since then, has exercised effective control over this Ukrainian territory;
B.whereas numerous credible reports, including the most recent by the United Nations High Commissioner for Human Rights, offer witness of the increased abuses of human rights in Crimea, affecting representatives of the Crimean Tatars, journalists, media workers, bloggers and simple people who speak up against the Russian occupation or just try to document the atrocities of the de facto authorities;
C.whereas abductions, enforced disappearances, as well as the use of torture and cruel and degrading treatment in detention facilities have been reported in various cases; whereas torture has been used to obtain false evidence of guilt; whereas