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6A Daily News – Tuesday, October 30, 2012 Vitalityfitness health By Gracie Bonds Staples The Atlanta Journal-Con- stitution (MCT) ATLANTA — For Chuck Letner, there really is no place like home. Letner, who has under- gone three failed trans- plants, has no kidneys and has lived nearly half of his life on dialysis. But instead of having to go into a clinic three times a week for three to four hours each session, Letner, 49, cleans his blood while sitting in his easy chair at home in Alpharetta, Ga. "The level of indepen- dence it provides is very empowering," Letner said recently. "It changed my life." Although home dial- ysis has been available at least since the 1970s, its use has yet to become widespread, said Charlotte Frasier, a registered nurse and home therapy manag- er for Fresenius Dialysis Center in Marietta, Ga. In fact, according to Home Dialysis Central, an online resource developed by the Medical Education Institute to raise awareness about in-home dialysis, more than 400,000 Ameri- cans need dialysis, but just more than 1 percent of them use home hemodial- ysis. In Georgia, there were 16,646 dialysis patients last year, and of those, 1.6 percent were using home hemodialysis. Dialysis can be physi- cally draining and requires a significant time commit- ment, so many patients are unable to work and find taking extended overnight trips can be difficult because dialysis requires scheduling. With in-home dialysis, though, patients can do dialysis whenever it is convenient to them. It's important, Frasier said, that patients talk to their physician to determine whether they are mentally and physically able before they proceed. "Home is fantastic," said Dr. Stephen Pastan, a nephrologist and medical director of Emory's kidney transplant program. "Patients love it." Frasier said the option, which is covered by most health & Home dialysis giving patients' lives back On Nutrition: Feedback MCT photo Chuck Letner, 49, who suffers from renal dysplasia, looks at the display screen as he undergoes treatment at his home in Alpharetta, Ga., on Oct. 10. Letner has received treatments at home for the past 17 years after having received the first of three kidney transplants at 13. care insurance and Medicare, has been slow to catch on because of "a lack of knowledge." Plus, Pastan said, a lot of people find sticking themselves with needles frightening and are reluctant to do the self-care even though home dialysis is easy to do. "A lot of people get renal disease, start doing in-center dialysis, and no one ever tells them they can do it in the comfort of their own homes," she said. any concerns," Frasier said. According to Frasier, your entire blood supply flows through your kid- neys every two minutes. In addition to removing waste and fluids from the bloodstream, the organs also produce hormones that help make red blood cells that carry oxygen to other organs, control blood pressure and build strong bones. Unlike dialysis care, where patients must go to a outpatient clinic, those who elect to be treated at home must be able to stick themselves with the nee- dles and have a spouse or other helper in case of problems. Letner, a retired com- putational biochemist, is one of nearly 100 patients Frasier has trained to per- form in-home hemodialy- sis. Patients, she said, are required to come into the clinic at least once a month to check blood levels and manage medications and dialysis prescriptions. "In between visits, we have a nurse on call 24 hours a day to help with most likely due to hyper- tension, diabetes or both, dialysis performs that work, she said. When kidneys fail, Fresenius, which has about 1,800 clinics in the U.S., recently launched what it calls the "TOPS" program to help raise awareness about the differ- ent dialysis options avail- able to patients and the advantages to doing the procedure at home. at age 6, first went on dial- ysis in 1979 soon after he rejected the second of two donor kidneys, including one given him by his father. By Barbara Quinn The Monterey County Herald (MCT) even though my computer suggests I replace this term with "comments" or "opinions," I prefer "feedback." This is, after all, a nutrition column. Sometimes the feedback is an advertisement for a This column generates interesting feedback. And new book or food item. (Stay tuned for a review of some of these products in the near future.) My favorite feedback is from readers, however. So I He was 16 and in high school then, trying desper- ately to maintain his quali- ty of life. Even though he would undergo more than 50 surgeries, including one more transplant, he said he managed to live a normal life. "Fresenius' mission statement is 'Improving the quality of life of every patient, every treatment,'" Frasier said. "I went to football games and parties with friends, and I even learned to scuba dive and ski," he said. "I had friends who'd come with me to dialysis from time to time." He dreamed of graduating from high school and col- lege, and he did. Letner was in graduate school studying to become a computational bio- chemist when, he said, he decided the dialysis clinic was too confining. "By almost all mea- sures, patients who do home hemodialysis do bet- ter than those who don't," said Pastan, the medical director of Emory's kidney transplant program. "They feel better, their appetites are better, their energy level is better and they live longer," he said. Letner, who was diag- nosed with renal dysplasia was the scheduling," he said. "I had to be there at 5 p.m. even though I wasn't getting in until around 6:15. It made no sense to go there and wait. "I walked into the "The biggest obstacle was delighted to hear back from a young man I men- tioned in a recent column. I met with him and his moth- er several years ago when she was concerned about his extremely limited food choices — mostly peanut butter sandwiches and spinach. I analyzed his diet at the time and found (to some surprise) that his basic nutritional needs were met … at least for the short term. Not to worry about temporary food jags, I advised. Kids usually outgrow them as their tastes mature. And then I received this letter last week: "Hello, Barbara! My mother sent me a copy of your article from August 29th after she recognized that you were probably talking about me! I'm the one who only eats peanut butter, bread, spinach and apple sauce. According to my mom, I saw you something like 20 years ago. I'll be 30 years old in December and I still eat pretty much the same way I did when we first met. "I still eat a peanut butter sandwich every day for lunch and dinner and I still eat spinach and apple sauce every night. Apparently the long term effects of eating this way aren't so bad either. I'm currently 6'1" and weigh 203 pounds according to my bathroom scale and I have no major health problems. I certainly could lose weight, but I'm working on it and making progress. "My wonderful fiancee figured out how to get the charge nurse's office and said I have to go home now. I can't do the units anymore." That was in 1995, the year Letner began home dialysis. "It was hands down the best decision of my life," he said. peanut butter I eat in bulk and in order to figure out how much we needed, she figured out how much I actually eat. We kept track of my consumption over a few months and it turns out I eat a 26-ounce jar of Laura Scudder's All Natural Smooth Peanut Butter every 5 days on average. I've been eating this way for about 25 years, so if you use that average I've eaten around 3,000 pounds of peanut butter over my lifetime. "It was fun to read your column, I'm amused you still remember me. I'm glad I saw it so I could write in and say hi. It is almost dinner time, so I had better go make myself a sandwich." — F.Z. And I'd better go check my email… Barbara Quinn is a registered dietitian and certified diabetes educator at the Community Hospital of the Monterey Peninsula. She is the author of "Diabetes DTOUR Diet," Rodale, 2009. 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