Meet Melvin & Cleo – At Home and At Ease with Tablo
Summary
Melvin, a 23-year U.S. Air Force veteran and end-stage kidney disease patient, and his care partner and wife, Cleo, are experiencing a “night and day” difference in their lives since starting Tablo hemodialysis at home in April.
Melvin, who has been on home hemodialysis for his end-stage kidney disease since 2018, and his wife and care partner Cleo, live in San Antonio, TX. The couple, high school sweethearts who have been married for 46 years, switched Melvin’s home dialysis system from NxStage to Tablo this past April. They say that the difference between the two systems and the impact on their lives is “night and day,” and they have more time in their schedule for things that they enjoy, including their four children and nine grandchildren.
Melvin served for 23 years in the U.S. Air Force as an aircraft electrician, and production and maintenance supervisor. This includes spending six years on the team responsible for maintaining Air Force One, the iconic Boeing 747 aircraft that transports the U.S. President and staff. He retired from the military in 2016.
Melvin discovered that he had kidney disease in 2009, when he visited a nephrologist for the first time—Varshi Broumand, MD, MHA, FACP, FASN, at South Texas Renal Care Group. At that point, his condition was classified as stage 2. His medical history included heart bypass surgery, stent placement and type 2 diabetes. Also, several of his siblings were on dialysis. In 2015, as his kidney disease had progressed, he had an arteriovenous fistula placed in his arm in preparation for dialysis. In 2018, he started feeling sick, and his lab results showed that he needed to start treatment.
“I’ve seen dialysis before with my family on it, but to actually have to start it myself, at first it was depressing, I’ll be honest with you,” says Melvin. “I told myself, you have to deal with this. There are a lot of people worse off than I am. I’m still living and getting around, walking and talking. I can do most of the things I used to do.”
“We decided that we just have to keep going, we will deal with this, it’s going to be all right,” added Cleo. “Then I just jumped right in and learned everything I could about his treatment, because that’s the kind of person I am.”
From NxStage to Tablo
Melvin and Cleo met with Dr. Broumand to discuss treatment options, and decided without hesitation that home hemodialysis would be the best option for them. In-center dialysis was not a consideration. In June 2018, they started training on the only option available in the U.S. at the time, NxStage.
“Training on NxStage was a lot, there were binders of information to learn, and it was quite overwhelming. But, I would do anything I could to take care of Melvin, so we made it work,” says Cleo.
With her caring and positive spirit, Cleo was confident that she could perform Melvin’s cannulation at home. “It’s not difficult. You might think it’s a little scary to place the needles, but during the training they show you exactly what to do. You just pick out your areas on the fistula, sanitize very well, then just insert. I also rotate the access sites, which has helped his fistula stay healthy over the three and half years that he has been on dialysis. Then I do the blood draws for his monthly check-ups with Dr. Broumand,” says Cleo.
This past April, Dr. Broumand and his team introduced the couple to a new hemodialysis system, Tablo, recently FDA-cleared for patient use in the home. It had previously been cleared for treating patients in acute and chronic care settings. He described that it would be much easier for them to learn and use, it only needs tap water and an electrical outlet to operate, and treatment would take less time. Also, the supplies would be minimal in comparison to what was needed for their current machine, that had taken over their home and garage.
Melvin and Cleo told him that they would love to try the technology. Their first impressions were very positive. “When I first saw the machine, I said, I like this, it’s so sleek and different. Easy to move around. Then after we saw how it works, I told Melvin, ‘I don’t believe this. Where in the world has this been?’” says Cleo. They decided right then and there to start their two-week training on a Tablo console set up at Dr. Broumand’s office. They wanted to be able to continue treating at home, due to the COVID-19 pandemic.
“When our Tablo was delivered, we called NxStage and told them thank you, we appreciate what it did for us, but to please come pick up their machine as we found something so much better. We have been happy with Tablo ever since,” she continued.
Now that they have more than seven months of experience at home with Tablo, the couple offers their candid assessment. “I simply cannot believe how much better Tablo is. Not only is disinfection easy, but setting up for treatments is so quick and simple to do,” says Cleo. “Tablo walks you step by step through everything on the touchscreen, and you never feel like you are lost. We also love the animation and the music. If you have an alarm, it tells you exactly what it is and how to correct the issue, within seconds. Usually we just need to adjust Melvin’s blood pressure cuff. That is a wonderful thing. Priming and take down are all very quick too. At first, I felt like I was forgetting to do something, but I wasn’t!” (See the brief video here of Dr. Broumand talking with Melvin and Cleo about their experience on Tablo.)
“I simply cannot believe how much better Tablo is. Not only is disinfection easy, but setting up for treatments is so quick and simple to do.” – Cleo
She compared that to their experience on NxStage. “If there was an alarm or other issues, we had to call technical support, which sometimes was very difficult. It often interrupted treatment and made everything take much more time.”
Melvin treats on Tablo four days a week, three hours a day, at any time that works for their schedule, with weekends off. Previously, he was treating five days a week, three and a half hours a day, and additional time and effort were required to prepare and lift eight heavy bags of dialysate for each treatment. They have his dialysis chair and Tablo set up in a corner of their bedroom, with the minimal supplies stored in a small closet.
“After treatments are done, we can just move on with our day. You have more time to do what you want to do,” adds Melvin.
Since starting treatment on Tablo, Melvin has discontinued his blood pressure medication, and he hasn’t been feeling as drained and dehydrated following treatment. Eating a healthy diet including fish, chicken and fresh vegetables at home has helped him lose weight, lower his cholesterol, control his diabetes and achieve positive lab results for his kidney disease.
Cleo recently had back surgery, during which time Melvin treated on Tablo at Dr. Broumand’s transitional care unit at his office. “I have been feeling better and have more energy, so I was happy to help her after her surgery while she recuperated here at home, which is something I could not have done before,” Melvin says. “He took such good care of me, I felt like a queen!” added Cleo.
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Results may vary. Keep in mind that all treatment and outcome results are specific to the individual patient. Please consult your physician for a complete list of indications, warnings, precautions, adverse events, clinical results, and other important medical information. It is important that you discuss the potential risks, complications, and benefits of this product with your doctor prior to receiving treatment, and that you rely on your physician’s judgment. Only your doctor can determine whether you are a suitable candidate for this treatment.
