Navy Vet Opts for a Flexible Dialysis Machine for Home
Summary
Along with a 240-pound weight loss, switching from NxStage to the Tablo dialysis machine for home last year has made a big impact on Neil’s quality of life.
Neil and his wife of 35 years live in a rural suburb of St. Louis, MO. He retired after a long career serving in the Navy and then as a federal police officer. Three years ago, just as the pandemic hit, Neil weighed 440 pounds, his kidneys failed and he was put on in-center dialysis. After discovering he had options with his chronic kidney disease (CKD) treatment, he switched to home hemodialysis.
Having lost 240 pounds since starting dialysis and eliminating the need for blood pressure and Type 2 diabetes medications, Neil has learned valuable lessons about his choice of home dialysis machine. After using NxStage at home for nearly two years, he switched to the Tablo® Hemodialysis System last year, and has seen a huge impact on his quality of life.
An In-Center Start
Neil’s kidney disease journey began in 2013, when a severe case of benign prostatic hyperplasia (also known as enlarged prostate) led to kidney damage, progressing to kidney failure six years later. In 2019, a year prior to the inevitable day when he would need to start dialysis, he had arteriovenous fistula (AVF) surgery in his left arm.
When seeing his nephrologist in June 2020, Neil found out that his lab numbers were off the charts, and he needed to start dialysis right away. His overall health wasn’t good, as he was carrying an enormous amount of water weight, coming in at about 440 pounds. He had to face the reality of lifelong dialysis, as he didn’t qualify for a kidney transplant due to his health issues.
“I came to the realization that I had a disease with no cure,” Neil says. “It really opened my eyes, and I started learning as much as I could about kidney disease and the different treatment options. I also asked a lot of questions, which is something I strongly recommend to other new patients. Join groups on Facebook, talk to other patients. I wish I would have done that sooner. I thought I was mentally ready for dialysis because I did the fistula surgery, but I definitely wasn’t. The first few times I went to the clinic I was scared to death.”
“I also asked a lot of questions, which is something I strongly recommend to other new patients.”
Neil went to a dialysis clinic for his treatments three days a week, that was about 10 miles from his home. He had considered peritoneal dialysis, but after talking to patients using it, he decided that it would be too much for him. He’d had both knees replaced, and is disabled with severe diabetic neuropathy from Type 2 diabetes. He uses a mobility scooter to get around outside of his home, and has handrails in his home and a stair lift to go into and out of the basement.
Being that he began dialysis at the start of the COVID-19 pandemic, he really didn’t want to be in a clinic environment with so many other patients. And, after a couple of months, he was unsatisfied with the quality of care he was getting. “It felt like an assembly line. Hurry up and get in here, so we can get you out and turn your chair over to the next patient,” he says.
He switched to another clinic that was closer to his home that he liked much better, including the staff and clinical director. He then heard that his previous clinic was establishing a home hemodialysis training program. Neil didn’t want to switch back to that clinic, but was intrigued with this concept that he hadn’t heard about before: potentially managing his own dialysis at home. It had only been six months since he started dialysis, but he told the clinic staff he wanted to learn more and begin training to go home.
In December 2020, after six weeks of training on NxStage, Neil was using the system at home. During his training he quickly learned how to cannulate himself using the buttonhole technique.
A New Dialysis Machine for Home
About a year later, in February 2022, his dialysis machine had mechanical issues and he went 12 days without dialysis. He was also having trouble lifting the heavy bags of dialysate required for his NxStage treatments because of his mobility issues. He ended up in the hospital, and while receiving dialysis there, a nurse commented that there was a new dialysis machine for home he should check out, that makes its own dialysate on demand: Tablo.
Neil started researching Outset Medical and Tablo, and began working with his nephrologist to convert over to the new system. Neil and his wife saw a Tablo console for the first time when they went to a dialysis clinic to learn about it, and a patient happened to be treating on a machine during their visit.
“While a gentleman was having his dialysis, I was able to see Tablo in action, and all the things it could do. I saw the touchscreen and the animations that show step-by-step how to set up the machine, place the cartridge and fix any alarms. Also, no more dialysate batching, and wireless connectivity to your care team. Seeing what it could do in person had a big impact on me,” Neil says. He and his wife as his care partner begin the brief training on Tablo soon after.
In August 2022, a Tablo console was delivered to Neil’s home. He treats four days a week, about 3.5 hours each time, usually in the evenings after dinner.
“I can do treatments any time and work it around my schedule. It saves me a lot of time because I’m not having to batch dialysate hours ahead of time. Whenever I’ve had an issue with my machine, the Outset Medical team gets on it right away.”
Neil says that in comparison to NxStage, the Tablo dialysis machine for home was above and beyond a better experience for him. For one, NxStage supply storage was a big issue in his home. “I was storing my hanging dialysate bags in our living room, as we didn’t have any other space. It was a challenge. With Tablo it’s so much better. My wife is happy as she has her living room back,” he says.
A Better Life at Home
Now, almost a year since he started on Tablo at home, he says he feels much better. His weight is down to about 200 pounds, he’s able to get around easier and no longer requires blood pressure or diabetes medication.
He also appreciates the convenience of being able to set up and start his treatments on Tablo quickly. “From the time I walk in the door from running errands until I’m doing treatment, set up is only about 20 minutes. It’s a piece of cake. Although my previous dialysis machine for home helped me live, my life on Tablo has been so much better than my first two years on home dialysis.”
“Although my previous dialysis machine for home helped me live, my life on Tablo has been so much better than my first two years on home dialysis.”
“It’s the little things that make Tablo such a better home system in my experience, and I want other patients to know the difference,” he continues. “It eases a lot of the pressure that’s on you. I don’t have to search for two clamps to undo, and thankfully there are no heavy bags to hang. If you need to do a manual blood return, it’s not a strain. You just use the hand crank, which makes it so much easier. Instructions on the touchscreen walk you through every step.”
Neil says that it’s so important for chronic kidney disease patients to learn as much as they can about their options so that they can make the choice that works best for them and their lifestyle. “You’re in total control, and in my opinion the more you know the better off you are.”
* Tablo Hemodialysis System Disclaimer:
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 if home dialysis is suitable for you, and if you are a suitable candidate for treatment with the Tablo Hemodialysis System.
