The new process is called Nocturnal hemodialysis, meaning the machine runs while we sleep at night. It uses the same machine and method with slightly different settings and equipment. Before it would take about 3 1/2 hours of time on the machine, plus about an hour for set up and take down. Now we change the settings for the machine to run much slower, which provides better cleaning (hypothetically) and reduces the potential of low blood pressure problems since the fluid is being removed at a rate much closer to what your functioning kidney would. Hopefully this will also improve his blood work numbers and we will be able to eliminate a prescription he has been taking three times a day.
Because the machine runs while we are asleep, it means we aren't constantly monitoring his vitals like we used to before. So we have more monitors and alarms in case a problem should arise and we don't wake up for it on our own. This in addition to Bryce sleeping with a CPAP makes for a pretty crazy sleeping arrangement- lots tubes and wires and plugs and cords all over the place. But we are grateful for the blessings of modern medicine and technology that make all of this possible from our bedroom! Pretty amazing.
The nurses came last night to help us get started and get comfortable with the new parts and settings. One of the changes that comes with this new machine is a heparin pump. Heparin is a medicine we use every treatment, it's a blood thinner that keeps Bryce's blood from clotting while its outside his body and running thru the machine. His treatment used to be short enough that one dose at the beginning would last til the end. But since the machine is running so much longer now, just a starting dose wouldn't last the whole time. So we have a pump, similar to an IV pump at the hospital, that slowly releases doses of Helprin throughout treatment. It's a little finicky, and not at ALL user friendly.
We spent a while figuring it out and the appropriate dosage of heparin for the length of our treatment before we got settled in last night. The machine was set to finish at 4:15 AM and would alarm when it was done. It went really well, no extra alarms or problems during treatment (at least not that we heard!) so we woke to the finishing beep and got him unhooked and went back to sleep. I'm sure it won't always go this smoothly, but it gave us a little confidence since we were kind of unsure. Bryce is the first patient at this center to do nocturnal dialysis; He's also Dr. Senekjians first nocturnal patient and he has been practicing nephrology for 30 years. We will be the guinea pigs and figure things out as we go, but we are so glad to be in such capable hands. We're hopeful this will be a good, effective change and that it will improve the quality of treatment and also our quality of life for the duration of this dialysis part of our lives, however long it takes.
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