Pampa resident chooses home hemodialysis as he waits for a new kidney
James Workman is a family man with a lot to live for. He and his wife, Vanessa, raise their twin children in a lovely home in Pampa and have an incredible support system within Vanessa’s family here locally. In addition to that, the pair and their children visit Workman’s own family in the wooded, river-carved hills of Missouri as often as possible, which typically doubles as a vacation.
On paper, Workman has an ideal life. But, not unlike most of us, he faces his own struggles- one of those struggles being that he is one of 93,000 Americans living his life on a waiting list for a kidney.
“My kidneys failed about two years ago. I had diabetes and high blood pressure in my 20s and 30s, and I just didn’t take care of it. I was like, I feel good, I’ll deal with that in my 60s, and it’ll never catch up to me. And then it did,” Workman said.
Despite this, he remains in positive spirits and has even joined the 11 percent of Americans choosing to do home hemodialysis in order to manage his condition. In an effort to educate others about the process, Workman invited The Pampa News to his home to observe and share with our readers who may be curious or considering doing home hemodialysis themselves instead of going to a clinic multiple times a week. (*Consult your physician about before coming up with a treatment plan that is right for you.)
Hemodialysis is a blood-filtering process that keeps a person with kidney failure healthy until a donated kidney becomes available.
“Your kidneys filter impurities and toxins out of your blood and excess fluid out of your body. My kidneys can’t do that. They aren’t totally dead, they function a little; but I’ve still got to do this (hemodialysis) four times a week to filter out the blood,” Workman said.
“It’s not for everyone. You have to be able to put a big 14-gauge needle in your arm, you have to understand how the machine works. You have to monitor your own blood pressure and vitals every 30 minutes.”
He says that many people choose not to do home hemodialysis because the process can seem overwhelming, or because blood and needles are something they are not comfortable dealing with on their own. There are also several pros and cons to weigh, and how a person chooses to do their hemodialysis will often depend on what is convenient for their own lives.
“Alot of older people that are on dialysis, their skin is fragile and can’t handle it (the needle every time). So a lot of them have like a port in their neck or their arm to hook up to (the machine with). If you have one of those though, you can’t swim or do a lot of other things due to risk of infection. My kids are young, they are six. I like to run around and play with them, so that wasn’t something that was going to work for me.” Workman said.
“Another thing is that the machines in the clinics are bigger, so obviously they can filter the blood faster. It takes a little longer at home with this smaller machine, but for me it’s more comfortable because I can watch my own tv and I’m able to take my kids to school in the mornings and do what I need to do.”
“Some people who do it at home have a pair partner that helps them set the machine up and all that, but it’s good to be private. I was taught to do this solo.”
Because he chose to take this path with his own hemodialysis, Workman spent several weeks being trained by nurses on how to read the numbers on the machine, how to work it, and how to properly monitor his own vitals. After a few weeks of in-clinic training, he was provided with a machine for his home. He was given another two weeks of in-home training by traveling nurses, and is now independently doing his own hemodialysis without having to leave the comfort of his home.
“The machine has an air filter kind of like the one in your car. (The resevoir) on the bottom (of the machine) is full of dialysate fluid. (The fluid) pumps through the machine on one side of the filter. There’s dialysate on one side (of the filter) and blood on the other side, they never touch. But, the dialysate draws the toxins out through the filter,” he said.
The machine itself was provided by Medicare and had to be connected to the plumbing in Workman’s home. The dialysate fluid is shipped to him in concentrated bags once a month, which he stores in his barn until he needs to use it. The night before a treatment, a concentrated bag is put into the machine. When the machine is turned on, it pumps water and mixes it into the fluid, a process that takes around six hours according to Workman.
“Then you prime the filter with saline, and that takes about 30 minutes to get all of the air worked out if it,” he said.
Once he hooks himself to the machine via 14-gauge needle, the process begins. He monitors his vitals through an iPad that was provided with the machine. Every 30 minutes, he is prompted to take his blood pressure until the process is complete, which in itself typically takes around four hours. The process has to be repeated three more times throughout the course of each week. Workman says that he usually watches tv, naps or plays on Facebook to help pass the time.
A router was also provided with the machine in addition to the iPad, so all of his treatment information is able to be sent directly to his doctor’s office. His doctors are able to keeps tabs on his treatments and vitals through this system.
“When I first started doing it myself, I wanted somebody with me to help me disconnect from the machine when I was done. If you don’t do it right, you could have blood squirting everywhere and make this room look like a scene from a horror show. Now I’m more comfortable doing that myself,” Workman said.
To avoid messes, he has a vinyl recliner that won’t soak up fluids and a plastic mat underneath it to protect the carpet.
The machine is semi-portable, but not exactly travel-friendly.
“This thing weighs like 80 pounds. And with travel, you can’t use the dialysate part. They have to ship you pre-made bags to wherever you’re going. So, you can’t just pull up to a motel and hook this thing up. I guess if you had a motorhome, you could set it up in a motorhome. But, keep in mind you need something you can recline in. You’ve got to kind of keep your feet up and keep your pressures right,” he said.
While the treatment process is a pain and restricts Workman’s life in certain aspects, he looks forward to the day he can be done with all of it.
“The national list (of people needing a kidney) is about a five-year wait. I’ve been on the list since March or May. I’m on the list with Baylor and they have two campuses, one in Fort Worth and one in Dallas. Those are actually two separate zones, so I’m on two different lists,” Workman said.
“(Getting a kidney from this waiting list) would from be a deceased donor, someone who’s passed away who’s an organ donor. They harvest it (the kidney), and when they get one that matches your blood type they call you and you have about six hours to make it to Dallas or they go to the next person on the list.”
“So that’s why I’m not going to California or one of the 100 other places to get a kidney transplant, because I can’t get there in time.”
“A live donor is a possibility. My brother, actually, went and tested his blood type to see if we are compatible. He was B-positive and I’m A-positive, so he’s not compatible at all. If there were a live donor that was compatible, then we could kind of plan it and schedule it. But, they would need to take off work for about six weeks. It’s hard. Most people can’t take six weeks off work and they have kids, and their own stuff. Every time you turn around, it’s COVID or something. There’s something going on in everybody’s lives. So I get it, and I’m not sweating it,” he said.
In addition to hemodialysis, Workman has also changed his diet and quit smoking in an effort to get healthy.
“You’ve really got to watch your diet. There’s potassium and phosphorus that the machine doesn’t do a very good job of taking it out. That can damage your heart that can make your veins turn into stone basically, they will calcify. Dark sodas are full of phosphate, any leavened bread is full of phosphate. So basically, I eat a lot of meat.”
“There are some medicines I can take when I do want to eat something different. But you have to be careful with that and you can’t just do it all the time,” he said.
The Pampa News would like to thank Workman for sharing his experience and are rooting for him to get his call for a new kidney soon.