Wednesday, January 14, 2009

Is home dialysis risky?

I have been trying to get my acid solution from other vendors because my regular vendor ran out of low Calcium solution and due to the truckers strike (called off now, thankfully) could not get additional supplies from elsewhere.

During these inquiries, one of the vendors got to know that I was on home hemo, a rarity in these parts of the world. He was genuinely worried about it and thought I was on it because of an 'overenthusiastic technician'. I assured him that it was my doctor who advised me to do this. He said it was risky and asked what I would do if there was an emergency.

I explained to him that the dialysis I was doing was less risky than that in hospitals because of the gentle nature of the treatment with slow pump speeds and low rates of fluid removal. I also told him that I had learnt how to start my session and was doing it myself these days. He was quite well-informed about the modality since he said that most people in the US on home dialysis also do it themselves.

On the face of it, home dialysis does sound risky. In the hospital setting, there is, theoritically, better preparedness for any emergency or complication that can result during dialysis. At home, in comparison, there is hardly any such infrastructure.

The primary difference is the nature of dialysis. Dialysis at home, especially at night for long hours is much more gentle and the chances of complications and emergencies are much lower.

Well, the risk is not zero. But its not high either. And I can vouch for that with the 30 months of experience that I now have.

Whatever the risk, I am willing to take it. I am confident I would not have been able to take the life that comes with regular in center dialysis. It would not have been worth it. I would not have been able to work, to do anything that I truly wanted to do. I probably would not even want to do anything. Its that bad. I know there are people who do live complete lives on regular dialysis. But I am not that strong.

Nocturnal home hemo has given me my life back.

If in the future, I do happen to die due to a complication during my home hemo session (very unlikely), I do not want anyone to say that this happened because of home hemo. There is a greater chance of dying in a road accident or by a meteor falling on your head. Whatever I have lived, I would have lived more fully, more enrichingly because of this modality. And that counts for more than anything else.

1 comment: said...

What I would say is that since you can only get a high dose of dialysis at home, home dialysis is safer. The greater risk is trying to live with too little dialysis. CKD is what is dangerous, you have to do what needs to be done to get enough dialysis.