Patient stories: Joyce Cagle
"I've tried every kind of dialysis there is—even a transplant," says Joyce Cagle, "and for me this (nocturnal home hemodialysis) works better than anything."
Voice of experience
Joyce has been doing some form of dialysis for 15 years; for the last 7, she has been doing nocturnal home hemodialysis. "I was one of the first to try it here in Lynchburg (Virginia)," she says, "and now they tell me I've been doing it longer than anybody else in the U.S."
Joyce started nocturnal home hemodialysis in October 1997. Dr. Robert Lockridge, her nephrologist at the Lynchburg Dialysis Facility, offered her a chance to try a "new" type of dialysis that was being tested in Canada, because she was not doing well with her in-center treatments. "I thought about it for several months," says Joyce. "It was very new, but the Canadian patients were reporting such good lab results, and I was having so many problems, that I decided to give it a try."
Do-it-yourself routine
Joyce learned how to do her nocturnal home hemodialysis during 5 weeks of intensive training. "In the last week, they put me in a room with a phone and I had to do the treatment by myself," she says. "If I needed help, I had to call."
Even with the training, Joyce admits she was nervous the first few days at home. "It's human nature to watch the machine," she says. "Now I know it's safe and the alarm will wake me up if there's a problem." She avoids daytime naps to make sure that she is tired and ready to sleep at bedtime.
After all these years, of course, Joyce has her dialysis routine down pat. Five nights a week, she sets up her machine and does about 7 and 1/2 hours of dialysis while she sleeps. "The machine set-up used to take me an hour," she says. "Now I can do it in 40 minutes." To make it more convenient, Joyce breaks her set-up into segments: 20 minutes at about 7 pm, and the final 20 minutes just before she goes to bed. "The morning clean-up doesn't take long at all," she says. "I just disconnect and turn my machine on heat disinfect." Because her Fresenius 2008H dialysis machine uses a resin bag water purification system, she doesn't need to disinfect any reverse osmosis (RO) water treatment equipment. "My husband helps with lifting supplies," she says. "Everything else I do by myself."
Better health
"With nocturnal home hemodialysis, I feel good," Joyce says. She no longer has the problems with nausea, cramping, or loss of appetite that she had on with other types of dialysis. She also enjoys the freedom to eat and drink fluids with very few restrictions. "Every aspect of my health has improved," she says. "Even my color is good. Most people don't even know I'm on dialysis."
Feeling good has made it easier for Joyce to stay on the job as a tax preparer and office manager at H&R Block. Although she never quit during her first 8 years on dialysis, she often had to take sick leave. Since she's been on nocturnal home hemodialysis, she's only taken a few days off.
"Every person is different when it comes to dialysis," says Joyce, "so it's hard to be an expert." And, she still has problems with allergies—mostly to the skin cleaners she uses on her catheter exit site. Still, Joyce feels so good with her home dialysis that she would tell any new patient who has the chance to "take advantage of it!"