Advertisement His life centered around trips to Gundersen Lutheran’s dialysis centers.
But during the past four months, Szymkowiak has found freedom with a new type of do-it-yourself dialysis at home.
The 55-year-old Onalaska diabetic is the first in the La Crosse area to use a new system of home dialysis, which provides shorter, more frequent and possibly even more effective treatments.
The treatments — which last for two hours a day, six days a week — more closely mimic his kidneys’ natural functions and ease many of the side effects that come with traditional dialysis.
Szymkowiak said he now gets a chance to choose his time for dialysis, but more importantly, he feels like his life has been transformed.
“Now it feels like my kidneys are actually working,” Szymkowiak said. “I have more energy, and I feel so much better. I don’t think I could go back to regular dialysis.
“Everyone’s flabbergasted at how well I’m doing.”
Home dialysis has been around for many years, but the dialysis machines have been big and cumbersome and required special plumbing, said Dr. Wilfrido Yutuc, a kidney specialist at Gundersen Lutheran for more than 40 years.
Yutuc said home dialysis is starting to gain popularity as technology makes it easier for patients to treat themselves at home.
At the forefront of the movement are medical device-makers, such as NxStage of Massachusetts, that have developed equipment that’s simple enough for patients to operate and fits in their homes. The method is hemodialysis, which runs the blood from the patient’s body through a dialysis machine and back again to clean the blood.
NxStage broke ground last year with its introduction of a 75-pound machine for home dialysis. It looks like a 13-inch TV set, uses standard electrical outlets and doesn’t need special plumbing connections or permanent installation.
More than 100 dialysis centers in the U.S. now offer NxStage’s system. Szymkowiak is now one of three Gundersen Lutheran patients on the system.
“It’s portable dialysis,” Yutuc said. “You can take it with you for the weekend or vacation, and you set the time for dialysis. It fits easy into one’s lifestyle, and patients gain more independence.”
Patients also have better control of their blood pressure, often reduce the number of medications and may not be hospitalized as often because the home dialysis system may help prevent complications, Yutuc said.
Szymkowiak already has seen the health benefits. His blood pressure is lower, and he has reduced the number of medications he takes from more than 30 to nine. High blood pressure is Szymkowiak’s enemy because he has major heart problems.
Szymkowiak was diagnosed with type I diabetes in 1980 and took six to eight insulin shots a day until four years ago when he received an insulin pump, a small device programmed to automatically and
continuously deliver small amounts of insulin around the clock.
In December 1999, Szymkowiak was ill and ended up in a Texas hospital, where he was diagnosed with kidney failure. He later was treated for several heart attacks and a stroke. He moved to La Crosse in 2001 and continued dialysis at Gundersen Lutheran.
Szymkowiak said he is not eligible for a kidney transplant due to his heart problems. He will be on dialysis for the rest of his life.
“The saying goes that nobody dies from kidney failure,” Yutuc said. “I’ve had one patient who was on dialysis for 24 years. You die from other things such as stroke or heart attack.”
Szymkowiak plans his home dialysis treatments around his wife’s work schedule. In late afternoon, he takes about 40 minutes to prepare for his treatment. The dialysis machine sits in a basement room equipped with a stereo and video system.
He opens bags of dialysis solution and sets up the tubing and accessories he’ll need for that day’s treatment. When his wife, Shirley, comes home from work, he inserts needles into his arm, and he’s ready for dialysis.
Szymkowiak passes the time on a couch watching TV or movie, or listening to music. The dialysis machine has alarms to signal a malfunction or improper setup, and help is only a phone call away, he said.
He is preparing to take his dialysis machine on the road for a week — supplies will be sent to his destination.
Szymkowiak had about a month of training before he started his treatment at home. “Learning how to set up the machine is not that hard,” Szymkowiak said. “It becomes routine after a while.”
But Yutuc said, “Not everyone is a candidate for home dialysis. They have to have confidence in themselves and feel comfortable with the setup.”
Jane Brodrick, a Gundersen Lutheran registered nurse, said people who are successful at home dialysis often have a supporting partner. “They’re also not afraid to do the setup and feel they can handle it,” she said.
Jane Welch, another Gundersen Lutheran registered nurse, helped Szymkowiak with his home dialysis machine. “Keith is doing very well and is committed to make it work,” Welch said.
Szymkowiak said he’s always trying to buy more time with his life, and home dialysis makes his life easier.
“I’m on borrowed time already,” he said. “God had six chances to take me, and I’m still here. I’m going to enjoy it as along as I can.”
Terry Rindfleisch can be reached at trindfleisch@lacrossetribune.com or (608) 791-8227.
KIDNEY FAILURE TREATMENT OPTIONS
For patients with kidney failure, there are just three options to filter toxins from their bodies and replace some of the organs’ functions. Without those treatments, they would die.
Peritoneal dialysis, which uses the body’s own peritoneal membrane inside the abdomen to remove impurities. It can be performed at home but must be done every day and is feasible only for certain patients. About 8 percent of dialysis patients use this method, according to the most recent federal data available. Gundersen Lutheran has about 25 patients using this method of home dialysis.
Hemodialysis, which runs the blood from the patient’s body through a dialysis machine and back again. The treatment cleans the blood, but many patients feel wiped out. Typically, patients visit a clinic three times a week for four-hour sessions. Hemodialysis also can be done at home.
Kidney transplant can offer some patients greater freedom, with fewer diet restrictions than the other treatments. But organ recipients have to take medicine to prevent rejection of the kidney, and there’s a shortage of donor kidneys. About 130,000 patients had transplanted kidneys in 2003, according to federal data.
ABOUT DIALYSIS
Dialysis is a method of removing impurities and waste from the blood when the kidneys are unable to do so. About 325,000 people in the U.S. are on dialysis. Patients with severe kidney disease, which is most often caused by diabetes, would die without dialysis or an organ transplant.
What happens? Dialysis replaces some of the functions of the kidneys, which act as filters for the blood. Because dialysis isn’t an ongoing process, it can’t monitor the body constantly the way normal kidneys do. But the treatment can eliminate waste products and restore the body’s chemical balance.
What’s different about at-home dialysis? Patients typically perform shorter, more-frequent treatments at home than at dialysis centers. Advocates say daily dialysis helps patients feel better, because it comes closer to mimicking the kidneys’ natural functions.
Can anyone do it? It’s not an option for some patients, such as people with poor eyesight or numbness in their hands who
wouldn’t be able to perform the treatments. Patients generally must live with a spouse or partner who can help.
Sources: McClatchy Newspapers and Gundersen Lutheran Medical Center
