It’s been a few months now since we switched over from a 2 needle setup to a single. When I started on dialysis in the hospital and clinic, only the traditional 2 needle method was offered. One needle / line is an “out”, the other is an “in”. In the single needle method, only one needle, branching into 2 lines is used and the dialysis machine alternates using it to pump the blood out, then pump it in.
In B.C. where I first had home dialysis, the possibility of single needle was never discussed with us. I don’t know why, it has worked out just great so far. There is a slight reduction in the amount of blood processed each night with the single needle system compared to the double needle, but the total amount processed over the entire week of dialysis is so much larger than with conventional 12 hours per week dialysis that it really isn’t noticeable.
The biggest difference is in the number of alarms.
In the clinic, I would alarm almost every time I shifted in the seat. This would have been unworkable in a nocturnal setting when I am trying to sleep. During the first few days in training for the home dialysis program, Susan tried various methods of taping down the needles and lines to my right arm, eventually finding a system that worked for us and my fistula. I could lift my arm and move it a bit without problem.
Then the training nurse had us surround the site and lines with “burn netting”, a light-weight, flexible mesh that comes in rolls in a tubular form. This netting is used with burn patients since it is sterile and weighs almost nothing. The burn netting lightly holds everything in place an additional amount so that moving the arm flexes the needle’s position even less.
The last element was the addition of my neoprene sleeve. For those who have not read my archive posts, I took the last 12 inches from a scuba suit arm and slid it on over the burn netting / taped lines. That cut down the number of night time alarms to just a few over the course of a run.
However, even with all this, some nights the alarms just kept coming. The culprit seemed to be the upper needle. We use the ‘buttonhole” method on home dialysis, where you use the same holes every night, unlike in the clinic where you establish new ones each run. After a few sessions, the buttonhole process establishes a “track” much like the hole in a pierced ear and no longer hurts when the needle is inserted. Once I started getting alarms at night with the upper hole, they would not go away until we established a new hole and tract in a different spot.
I talked this over with Rose, one of the wonderful nurses who look after our program. She suggested going to single needle dialysis and using the bottom hole’s area for that needle. The dialysis machine needed to be changed as the single needle system requires 2 pumps (one for each blood flow direction), but that was arranged for without problem. Rose warned Susan that it would take a few weeks to get used to the differences in the systems and it did. The first few nights were very frustrating for her as she had to make adjustments to her thinking, often at 4 in the morning when Susan is not at her best.
Now however, everything has settled down. The one hole that we are using works perfectly and more nights than not, we have no alarms whatsoever. I toss and turn in bed, sit up, adjust the covers, reach for things in my night-stand, all without alarms. For the first time in years, Susan and I are getting uninterrupted sleeps. The payoff is less fatigue the next day and a happier wife!
If you haven't already read my experiences starting dialysis, check out these important archives: