KIDNEY NEWS MANITOBA BRINGS INNOVATIVE NEW HOME DIALYSIS MACHINES TO PATIENTS. We are getting them back home and out of the hospital.

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1 Manitoba Renal Program KIDNEY NEWS NEWS AND INFORMATION FOR MANITOBA RENAL PROGRAM PATIENTS FALL 2015 manitoba renal program MANITOBA BRINGS INNOVATIVE NEW HOME DIALYSIS MACHINES TO PATIENTS More Manitoba Renal Program dialysis patients will be able to have dialysis treatment at home thanks to an innovative home hemodialysis machine being introduced in the province. The new system is more user friendly, requires minimal home renovations and can be moved around a patient s home or moved to a different location. It also requires fewer supplies and consumes significantly less water than the only system previously used. In earlier summers, Mendel Schnitzer used to drive back to Winnipeg from his cottage near Kenora every second day to have dialysis treatment at home. This past summer Mendel was able to take the new system out to the cottage. It s a lot better for the patient, says Schnitzer. His set up time is less than half of what he previously took and he says cleaning and operating the machine are much easier. It s virtually impossible to make a mistake. Darren Turner has been on home hemodialysis for three years and also started trialling the new machine last year. It was very easy to learn. It s about one-tenth as complicated, he says, comparing the new machine to the one he previously used. In my opinion it opens up a whole new world for people who aren t technically capable of running [the previous machine] by themselves. Manitoba and British Columbia are the first provinces to complete trials and evaluations of the machine and Dr. Paul Komenda, Medical Director of We are getting them back home and out of the hospital. Seven Oaks General Hospital s Home Hemodialysis Program, says plans are underway for more patients to be trained on the machine. This gives us an opportunity to get patients on home therapies that maybe couldn t before, he says. We are getting them back home and out of the hospital. For those who had space restrictions, issues with water sources or inadequate septic systems, this new system might be a better fit. Training also takes about half the amount of time than training for the previously used system. While we are still using all of the systems we have always used, we are excited to add this new system and offer more options for patients so they can have what best suits their lifestyle and their health needs, explains Dr. Komenda. Increasing the use of home dialysis in the province also helps address Manitoba s growing need for dialysis services which require significant hospital

2 NEWS AND INFORMATION FOR MANITOBA RENAL PROGRAM PATIENTS INNOVATIVE MACHINES CONT D resources when done in-centre. Over the last two years the renal program patient population increased by over 700 people with 100 needing dialysis and 600 in earlier stages of kidney disease. For each patient who uses home dialysis instead of in-centre dialysis, the renal program may save between $20,000 to $90,000 per year. Home hemodialysis patients are also reimbursed for utility costs through a new Home Hemodialysis Utility Reimbursement Program funded by the Province. Apart from kidney health education and prevention initiatives, the renal program aims to increase home hemodialysis use by four per cent by PROVINCE ANNOUNCES HOME HEMODIALYSIS REIMBURSEMENT PROGRAM Manitoba has become the first province in Canada to offer a Home Hemodialysis Utility Reimbursement Program. Manitoba s Health Minister Sharon Blady made the announcement Thursday, August 20 alongside Manitoba Renal Program, who manages the province s kidney health care, and Kidney Foundation of Canada Manitoba Branch, who will be administering the reimbursement. Utility costs can add up for patients who undergo hemodialysis treatment at home, and we will be there to reimburse additional costs, said Minister Blady. We hope the new supports will enable more patients to undergo hemodialysis treatment in the comfort of their own home, and enjoy a better quality of life. The announcement took place at dialysis patient Mukhtiar Singh s home. Singh has been undergoing home hemodialysis since 2009 and has been on various types of dialysis since Singh is one of many patients who advocated for the creation of a reimbursement program. It s a historic kind of announcement - a pioneering step. I am sure others will follow and this will make the home hemo choice more popular, Singh said. It s a win-win situation. Patients feel better, they live longer, less medication, less hospital visits. The [home hemodialysis] program saves millions of dollars if we reach our potential. Home dialysis treatments are less expensive than hospital dialysis, reducing the need for hospital space and requiring the support of fewer healthcare workers. Home dialysis can also be beneficial to patients offering greater independence through managing and scheduling dialysis treatments, less travel to hospital, less exposure to infection, better blood pressure and phosphate level control and fewer dietary restrictions. There are numerous benefits to home dialysis and, with the support of this new program, we hope to see even more people able to utilize home dialysis moving forward, says Dr. Mauro Verrelli, Medical Director of Manitoba Renal Program. Details of the program are still being finalized with a goal launch date of October 1. Reimbursement rates will be based on home hemodialysis schedules and machines utilized. While various forms of home dialysis have been available in Manitoba since the early 1970s, it wasn t until the 2000s that the technology became more user-friendly and transportable. Manitoba Renal Program launched a redesigned home hemodialysis program about eight years ago and has seen a continuous increase in home hemodialysis use since that time. Types of home hemodialysis include conventional (three times a week), nocturnal (nightly) or short daily (two to three hours daily). 2

3 FALL 2015 EXPERIENCING THE FUTURE OF HOME HEMODIALYSIS For Darren Turner, everything seemed to happen at once. After experiencing some heartburn and visiting his family doctor, he ended up in hospital having arteries stented. The next day the doctor told him an ultrasound showed a mass on one of Turner s kidneys and it was likely cancer. After a year of monitoring, the mass along with his kidney were removed and Turner was left with one kidney to rely on. Less than a year later that kidney was no longer performing and he needed to start dialysis. I just decided that if I could get into the home program from day one, I d be better off, Turner says. He started training on home hemodialysis in April of 2012 and has been dialyzing at home ever since. Turner, now 48, credits his wife and kids with supporting him through the transition. Devyn [his son] was helping me like a dirty Turner says the benefits are numerous from shirt. His daughter, only nine at the time, took a bit the machine s ease of use and limited need for water more time to get used to the new machine in the to a shorter set-up and tear-down time. It also requires home. It was a little more difficult for her to watch. less supplies which means less space needed in the In 2014, Turner was one of a handful of home. Manitoba Renal Program (MRP) patients who started I would tell anyone considering home trialling a new home hemodialysis machine. dialysis that it s one billion times better than the Being the geek hospital because it s on your own I would tell anyone considering home dialysis that it s one billion times better... and nerd that I am, I of course constantly research what s going on. He had heard of the NxStage machine and one day heard home hemodialysis nurses talking about it and was approached to try the machine at home. It was very easy to learn. It s about one tenth as complicated as the Bellco, he says, comparing the new machine to the one he previously used. With the NxStage, my mother could run it and she has no technical abilities whatsoever. She doesn t even know how to program her PVR yet. schedule. Turner still hopes for a transplant down the road and is approaching his fifth year of being cancer-free which he says is required to be a transplant candidate. Transplant is the ultimate. He feels strongly about organ donation and wishes the province and Canada would implement stronger policies to improve organ donation rates. People don t understand the importance of organ donation. The transplant aspect of it changes people s lives. There s no doubt about it. My life would be ten times better in the sense of how I d be feeling most of the time. Check out a video on Darren on kidneyhealth.ca! 3

4 NEWS AND INFORMATION FOR MANITOBA RENAL PROGRAM PATIENTS KILOMETRE CRUNCH! KEEPING UP WITH DALE CALIBABA MRP & Friends Exercise Challenge Results: Dale 6,599 km (approx) MRP Team 11,285 km 135,004 minutes Thanks to everyone who participated in our summer exercise challenge and attended our Welcome Celebration. B.C. peritoneal dialysis patient Dale Calibaba stopped in Winnipeg during his cross- Canada bike ride to raise awareness about kidney health and organ donation. Dale posted about his stop on his website believeinthepossibility.org: Visiting the renal clinic in Winnipeg was a blessing. My coach Shad and his brother drove up from Minnesota to join, as we got the chance to meet many patients, doctors, and healthcare workers. If was amazing to witness hemodialysis patients cycling, using stationary attachments to their chairs as they were being dialyzed! Something I have always looked forward to seeing because it brought so much life to the entire dialysis unit. Thousands of kilometres into his ride and only days from home, Dale has had to postpone finishing the trip due to an infection. He plans on finished the last portion once he is feeling better. 4

5 FALL 2015 RECIPE: PUMPKIN CHEESECAKE BARS Although pumpkin is a higher potassium food, because there is only a small amount of pumpkin in each portion, one bar can fit into a kidney meal plan. Ingredients: 5 tablespoons butter 8 ounces cream cheese 1 cup all-purpose white flour 1/3 cup packed brown sugar ¾ cup granulated while sugar (or Splenda ) ½ cup pureed pumpkin 2 large eggs 1-1/2 teaspoon ground cinnamon 1 teaspoon ground allspice 1 teaspoon vanilla extract Preparation: 1. Preheat oven to 350 F 2. Set out butter and cream cheese to soften. 3. In a medium bowl combine flour and brown sugar. Cut in butter to make a crumb mixture. 4. Set aside ¾ cup mixture for topping. Press remaining mixture into bottom of a 8 x 8 x 1-1/2 baking pan. 5. Bake in oven for 15 minutes. Remove and allow it to cool slightly. 6. Lightly beat eggs. Combine cream cheese, sugar (or Splenda ), pumpkin, eggs, cinnamon, allspice and vanilla in a large mixing bowl. Blend until smooth. 7. Pour mixture over baked crust. Sprinkle with reserved topping. 8. Bake an additional minutes. 9. Cool before cutting into bars. Portions: 16 Serving Size: 1 bar- or 2 square Nutrients per serving: Calories: 184 Protein: 2g Carbohydrates: 22g (14g if Splenda ) Potassium: 62g Phosphorus: 40mg Adapted from DaVita.com/recipes 5

6 NEWS AND INFORMATION FOR MANITOBA RENAL PROGRAM PATIENTS PERITONEAL DIALYSIS COMMUNITY CARE PROGRAM IN FULL SWING The Manitoba Renal Program is now providing assistance for some peritoneal dialysis (PD) patients within Winnipeg. Peritoneal Dialysis Community Care (PDCC) sends licensed practical nurses into the homes of patients who are unable to safely perform the tasks involved with PD on their own. PDCC is closely linked with the PD programs at St. Boniface Hospital and Seven Oaks General Hospital. This option is great for individuals who can t manage some aspects of this type of dialysis but otherwise qualify and want to utilize peritoneal dialysis, explains Dr. Mauro Verrelli, Medical Director with the Manitoba Renal Program. Nurses help with setting up and taking down the night cycler machine, choosing the solution to use each night, exit site care, and medication administration. The program has been used by patients going home after a hospitalization, by families that require a respite break for a caregiver in the home and by patients Photo courtesty of Baxter new to PD who just want some support at home for the first while as they become familiar with the treatment. Some patients use the service for a few weeks only while others have remained on PDCC permanently. The WRHA Home Care Program is also available to these patients for non-nursing tasks in the home (i.e. bathing, toileting, meal prep, etc.). Patients wishing to learn more about the PDCC program can talk to their clinic or dialysis nurse Across 4. Transfer of organ or tissue 6. Contains nitrogen and is cleaned from blood 8. A disease of insulin deficiency 10. The joining of an artery and a vein 11. Important for bone growth 13. Solution of water and chemicals 15. Placement of material between artery and vein 17. To do with heart Down 1. Swelling due to excess fluid 2. Free from any living organisms 3. Element that helps regulate body s fluids 5. Element used by body for muscle, nerve and cells Used to kill bacteria and fight infection 9. What is cleaned during dialysis treatment 12. The belly 14. Condition of low red blood cell production 16. Term relating to kidneys 6

7 FALL TH BIKE RIDES ON HEMODIALYSIS Congratulations to all participants in the MRP Biking on Dialysis program reaching the century mark of 100 bikes rides! Eutiquio Catacutan is very proud to reach his 100th cycling ride because he was not very active before he started the cycling program. Therefore, he challenged himself to cycle every dialysis treatment and it is his motivation to keep biking. His favorite part about cycling during hemodialysis is that it is fun and a good change of pace in his everyday routine. In addition, he feels more energetic since he started the biking program. On a personal note, Eutiquio would love to travel back to the Philippines, where he has not been for over 30 years and meet his favorite actress, Jennifer Lopez. Brian Rowe feels great attaining the goal of his 100th cycling ride. He likes to cycle during hemodialysis because it helps pass the time. In addition, he loves the feeling of exercising because it helps promotes good mental, physical, and emotional health. On a personal note, Brian s favorite car is a 1967 Corvette 427 and he would love to travel to Berlin and Paris because of the overpowering history and energy within these cities. Scott Monaghan is motivated to cycle during hemodialysis because it helps keep his weight down and builds muscle in his legs. His favorite part about cycling during hemodialysis is that it helps pass the time. In addition, he feels stronger mentally the longer he cycles. On a personal note, Scott would love to travel to Niagara Falls to visit friends and meet the great Mario Lemieux. Ralph Ferland has noticed that his legs are stronger and that he has lost weight since he started the cycling program. He is motivated to cycle during hemodialysis because he hopes to get a transplant and it helps pass time. Furthermore, Ralph bikes for two and a half hours every hemodialysis treatment, which is the longest cycling time at SCDU. On a personal note, Ralph would love to travel to Montreal to watch the Montreal Canadians play a hockey game and meet his idol Patrick Roy, the former goalie for the Montreal Canadians. Patricia Stapon feels like she has gone up a step to achieving better health with her 100th cycling ride. The cycling program is the main exercise she does weekly. She enjoys the fact that it helps pass the time. Moreover, she has noticed that she gets less leg cramping during her hemodialysis treatment. On a personal note, Patricia would love to travel everywhere because she wants to see everything. Herbert Carvery feels it was a great accomplishment to reach the Century mark because he was not very active before he started the cycling program. Now, he has a lot more energy on a daily basis. His favorite part about the program is the exercise helps strengthen his legs and make the time pass quickly. On a personal note, Herbert would love to travel to the East Coast to see his family. 7

8 ON THE WEB! Like MRP on Facebook Like our Manitoba Renal Program - Kidney Health page for news and updates. Get Kidney News by If you haven t yet, kidneyhealth@wrha.mb.ca to be added to our list. NEWS & UPDATES KFOC Manitoba Drop the Pop Know a school that might want to participate in Kidney Foundation of Canada Manitoba Branch s Drop the Pop challenge? KFOC MB invites elementary schools from across Manitoba to apply for a one-time $250 grant that will help them carry out a Drop the Pop Challenge for children in kindergarten to grade six. This is an opportunity for school and community staff to help educate young students about the dangers of sugary drinks. The $250 grant is available to elementary schools that have a significant Aboriginal student body (50% or more of the school population). There are eight grants available, for a total of $2000 being made available to schools across the province. The deadline to apply for a grant is October 31. Interested parties can find an information sheet and application form at: We know this fun challenge has a positive impact on children by getting them to think about nutrition and the connection between diabetes and kidney health, says KFOC Manitoba Branch executive director Val Dunphy. This grant is made possible with generous funding from CN Rail. Patient Representative Committee Meetings happen the second Tuesday every month and meeting dates are advertised on posters displayed at your unit. For more information contact our MRP patient liaison at Patient Opinion Boxes Look for patient opinion boxes at each unit. Feel free to write down thoughts on services provided and how you feel there could be improvements. Visit Us Online Make sure to check out kidneyhealth.ca for helpful information and patient stories. Watch Darren Turner s video: youtube.com/ kidneyhealthmb Read about Joseph Kollar s 100 mile bike rides and kidney failure diagnosis Like our Facebook page: Manitoba Renal Program - Kidney Health Read about all our Active Living Champions featured on our home page