BENNINGTON — First diagnosed with polycystic kidney disease at the age of 14, William Celley of Bennington always knew that dialysis was in his future.
For the past eight years, he faithfully made his way to the Renal Dialysis Unit at Southwestern Vermont Medical Center (SVMC) three times a week to receive lifesaving 3- to 3-1/2-hour dialysis treatments. That calculates to over 4,000 hours spent away from the comfort of his home and the company of his family, including three children ages 17, 15, and 5.
Very much a realist, Celley had learned to accept his absences from home as the cost of keeping his kidneys functioning and, quite literally, staying alive.
But, thanks to new at-home dialysis technology provided by SVMC, Celley is now enjoying more time at home and better health.
Acquired by SVMC just prior to the pandemic in 2019, the Tablo Hemodialysis System is an all-in-one system that reduces the complexity of dialysis, making it possible for patients to treat themselves at home.
Roughly the size of a college-dorm refrigerator, Tablo consolidates the essentials of dialysis — water purification, blood collection and cleaning, injections of blood thinner and dialysate solution, etc. — into a compact and mobile unit.
According to Ruth Rudnick, director of SVMC’s Renal Dialysis Unit, “The Tablo is a huge game-changer for patients. Not only can they dialyze at home, but they can set their own schedule, giving them more control over their lives. Plus, most at-home patients tend to dialyze more often for shorter stretches of time, which puts less strain on the heart and kidneys which leads to them feeling better overall and can contribute to a longer life expectancy.”
While Celley was immediately interested in the home-unit, there were a few hurdles to be cleared before he could get started. First, says Rudnick, was a home inspection. “The quality of the water and the water pressure available are key to being able to deploy the machine successfully,” she says. “In addition, you need sufficient space for the unit as well as the related supplies.”
Next, Celley had to participate in several weeks of training on how to operate and maintain the machine, how to insert and remove needles from his arm, and how to handle waste disposal.
“I thought inserting the needle would be more challenging,” says Celley. “But Ruth and the team did a great job of educating me and talking me through the process over the course of a week or so. Then one day, Ruth said, ‘Today you’re doing it by yourself.’ And I did. Now I don’t even think about it.”
Celley notes that the machine is incredibly user-friendly. “There’s a touchscreen mounted on top that walks you through every step of the process. You have to check a box after you complete each step and if you skip something, it basically says ‘Uh-oh. You forgot something.’ It’s impossible to do it wrong. The machine won’t let you.”
Linked to Celley’s home Wi-Fi, the Tablo uploads all activity from his machine to a portal which is accessible to the staff back at SVMC’s Renal Dialysis Unit. Donna Gunther, RN, lead for the home dialysis program, says, “We can see when William has done treatments and for how long, and we can see if he’s had any issues with setup or anything else. We have access to the exact same information related to his treatment that we would if he was still coming in for sessions. It’s really remarkable.”
As the lead on the Tablo effort, Gunther was present with Celley for his first at-home treatment just to make sure things went smoothly.
“Even with the training, there’s a bit of a learning curve,” says Gunther. “But once it was clear he had the routine down, I left him to it, and he’s done great.”
Gunther adds that Celley still meets with his dialysis team, including a doctor, nurse and nutritionist, once a month for an evaluation. “But now,” she says, “William draws his own blood at home and brings it in. This approach gives him more control and involvement in every aspect of his care.”
Currently SVMC has five Tablos, including the one at Celley’s home. The other four are being used in the dialysis unit. Rudnick says, “The repeated exposure to the units increases patients’ comfort with them and, eventually, we hope to send more patients home with them.”
As for Celley, he’s grateful for the normalcy Tablo has brought to his life and his improved health.
“I definitely feel like I have more energy,” he says. “Plus, because the machine is in my house, I can do treatments on my own schedule. If I want to go away for a weekend or one of my kids has a game I want to get to, I can adjust the schedule … I used to have to run out after dinner for treatments, but not anymore. Now, I’m home helping with homework or just watching a movie with my family. That’s truly the biggest gain.”
For more information regarding home dialysis, please feel free to reach to SVMC Renal Dialysis Unit at 802-440-6020.
