How smart an idea is it to do nocturnal when a blood leak could occur? Yes I know there are safety measures, but are they foolproof? What if other things go wrong and there is no one there to straighten them out? What if the patient was experiencing a heart attack or a stroke and he is alone? What if split second decisions have to be made and the patient is half asleep? What evidence is there of how the multiple needle sticks per week affect the life of the access? Do patients ever have a problem of feeling too tired right before they go to bed to set the tx up? Do patients feel left out when company is over and they have to leave the festivities to get on the machine for the night? Do the needles ever hurt in the arm being there for so many hrs and not having enough time to heal inbetween txs? Is it difficult to feel tied to the machine every evening unable to walk in the kitchen or living room etc? Is it difficult to have to pull the needles and hold the sites first thing in the morning when your half asleep?

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 You have to compare what could go wrong at home with what can go wrong incenter. Home patients are much less likely to get infections or suffer at the hands of ill-trained staff. Because home patients can give themselves adequate dialysis they do not have the complications incenter patients have who are forced into the 4 hour/three time a week cookie cutter.

Home dialysis is a very smart idea if you would like to have a full life. But in exchange for their life the home patient must give effort.

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 I have wondered some of the same things another poster expressed. In Center you do have quality issues but you are only there 3 times per week so you do have weekends free to do as you wish. Home hemo I have heard is 6 nights/days per week.

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 Regular dialysis is only 3x a week but for those who have dialysis fatigue and BP problems they are dealing with dialysis more than just the in-center time. In-center patients are also dealing with it watching fluid and diet. My father feels "much, much freerer on nocturnal and so does our family. For one thing we no longer think about the in-center schedule when we want to do something. We make our plans and adjust the dialysis time around those plans. Dad loves eating and drinking like he used to before becoming a dialysis patient. He loves the fact his energy level is good. On nocturnal there is the freedom of how many hrs. you want to run. There is the freedom of starting when you want to and quitting when you want to. Also there is no law that says nocturnal has to be 6 nights a week. Some times we run 5 if there is something special going on. We have even run 4 nights and a day to get a long weekend or we have a short run during the day to take a night off. I believe the Fresenius programs are all 4 nights a week. For us being at home just makes it so much more comfortable that the time to get ready for dialysis doesn't seem to be a big deal. Actually I set up the machine and I turn on the TV and listen to the news while I'm getting the machine ready. We, Mother, Father and myself don't have any trouble sleeping through dialysis and it feels good to wake up in the morning and know dialysis is taken care of and the day is ours. Living in the North with all the winter, it's comforting to know we can do the treatment at home and not have to go out in the cold and clean the car off and all that. I can understand someones concern about blood leaks but I have to assume it is rare. The program we are in has been going on 5 years and no problem yet. Also I think Lynchburg hasn't had any either. As the other poster mentioned it is peace of mind knowing we have some control over infection. We do our 3 minute washes, use gloves and don't take chances. Nor do we have to worry about patients coming in sick and spreading germs. Or for that matter staff coming in with colds etc. and spreading germs. We also have peace of mind knowing the machine is set right, the bicarb etc. isn't out dated. The dialyzer is new. And most important of all dad feels healthy and has for the 3 1/2 years we have been on it. Our family believes the benefits outway the risks. Trust me from some of the techs I have come across I'd rather be my dads tech any day. I think there is something patients should keep in mind. To fully understand what decision is right for you, you really need all the facts that fit your particular situation. The best way to get those facts is to do it. Rather it is home hemo, daily dialysis or nocturnal you can quit at anytime and go back in-center.