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Kidney treatment offers patients mobility

July 19, 2012

Morning News — Leslie Mielke Brooks Barthlome from Grace uses Peritoneal Dialysis (PD) at home for his kidney disease. PD gives him mobility. Standing with him are his wife, Andrea, and their 2-year old son, Cole. They also have a 4-year-old daughter, Paisley.

 POCATELLO — Peritoneal Dialysis (PD), also called home dialysis, gives mobility to patients with End-Stage Renal Disease. The patients are taught how to treat themselves at home, at work and even while traveling.
As Brooks Barthlome explained, “I am hooked up to the home dialysis machine nine to 12 hours each night.”
“It’s a little inconvenient since the machine and all the supplies takes up about half the trunk space when we are traveling,” said his wife, Andrea, “but we are able to travel.”  
Brooks Barthlome, from Grace, has suffered from kidney disease since he was an infant.
"I've had two previous kidney transplants, one from my grandfather in 1988 and one from my father in 1994," Barthlome said.
"In October 2010, Dr. Rahim [of the Idaho Kidney Institute LLP] saved my life," he said.
"He was down to 120 pounds," Andrea said. “He was doctoring at the University of Utah but when he became so sick, I took to the local hospital. He was then transferred to the hospital in Pocatello.”
Lab work revealed Barthlome’s kidneys were not functioning.
Contacting the Idaho Kidney Institute, the doctors suggested Barthlome was a good candidate for home dialysis.
In home dialysis, a catheter is put into the patient’s belly. When hooked up to the dialysis machine, a water solution is pumped into the belly.
"The belly fills and drains every two and one-half hours, cleaning his blood," Andrea said. "PD is easier on the body."
“The first month after the catheter was put in, I was on traditional hemodialysis so the hole around the catheter had time to heal," Barthlome said.
Traditional dialysis, called hemodialysis, typically takes place in a hospital or clinic under the supervision of nephrology nurses or technicians. (Nephrology is the branch of medicine that deals with the diseases of the kidneys.)
"Now I come into the clinic two times each month," Brooks said. "The first visit is for blood work; two weeks later I visit with the doctor."
"We love this place," said Andrea. "We would recommend it to anyone who needs it."
Home dialysis has allowed Brooks to lead a normal life.
"I eat a fairly normal diet because I get plenty of exercise in my job," he said. He works for a farmer.
"I enjoy doing horse stuff," he said. "I team rope and enjoy playing cowboy.
"I'm able to do things with my family," Brooks said, "except I can't go swimming with them."
Bacteria in a lake or swimming pool could get into the catheter. Home dialysis patients can swim in the ocean because salt water protects against bacteria.
Dr. Naeem Rahim is the medical director for home dialysis with the Idaho Kidney Institute. Rahim and his brother, Dr. Fahim Rahim, and Dr. Michael Haderlie are the nephrology doctors at clinics in Idaho Falls and Pocatello. They also have an office in Blackfoot.
“You need to understand that dialysis is a life-saving procedure for those patients who need it,” said Dr. Naeem Rahim. “If the patient doesn’t do dialysis, he or she will die.
“A few years ago, a survey was conducted among nephrology doctors and nurses,” the doctor explained. “They were asked, if they needed kidney dialysis, what method of dialysis would they prefer? 
“Ninety percent responded they would prefer home dialysis,” Dr. Rahim said. “At the time, about 7 percent of our patients were doing home dialysis.
“We decided to become more aggressive in our presentation of the home dialysis method,” he said. “Now, about 40 percent of our patients do home dialysis.”
In fact, the Idaho Kidney Institute is one of the leaders in the nation for use of this home dialysis method.
"Home dialysis is not for everyone," said Nurse Manager Jan Leonard.
"Most home dialysis patients do better," said Leonard. "They feel better and take less medication.
"Patients are happier because they are involved in their own care," she said. "It gives them a sense of empowerment.
"We rely on our patients to tell us how they are doing," she said. "Many patients have support from family members who help them with the dialysis. We work as a team."

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