It was early in 2020 when Joy Ward found out she had kidney failure.
“It was a total shock,” says Joy. “I hadn’t been paying a lot of attention to my health—my mother had been ill and then passed so I’d been focused on that.”
Joy and her husband Walt were living in St. Louis at the time of her diagnosis, and she was first introduced to treatment options there. When COVID hit, they made plans to move to the Pacific Northwest—feeling it’d be better suited for them during the pandemic—and got connected with the home dialysis team at Northwest Kidney Centers’ Port Angeles.
“I knew I really wanted to do PD,” says Joy. “I was ready—the folks down there had been really helpful.”
PD—short for peritoneal dialysis—does the work the kidneys can no longer do, removing fluid and toxins to create a more balanced state in the body. Before starting PD, patients undergo surgery to get a PD access—a catheter placed near the belly button that brings dialysis fluid in and out of the abdomen.
Lara Severn, Northwest Kidney Centers’ PD nurse in Port Angeles, manages Northwest Kidney Centers’ PD program for the region.
“About 7 to 10 days after a patient has their PD catheter placed, they begin home dialysis training—about two to four hours at a time, weekly or biweekly,” says Lara. “We really work with the patient and their caregiver to create a schedule that works for them.”
“They got me set up with the machine, came out to the house and trained my husband on everything,” says Joy. “He’s really my biggest help.”
Although not essential, many people who choose PD benefit from having a partner at home to help with setting up the machine, monitoring supplies and troubleshooting any issues that arise. With Walt’s support, Joy dialyzes “pretty much every night, for about eight or 10 hours.”
When ready for bed, patients undergoing PD connect their access to an automated cycler, a machine that transfers fluid into the abdomen. After it’s filled, the fluid then drains back out, bringing waste and water from the blood vessels of the peritoneum with it. This process repeats about three to five times throughout the night.
There are some challenges with dialyzing overnight—sleep being the primary one, in Joy’s eyes.
“Trouble sleeping is a side effect,” says Joy. “I sometimes wake up to the machine beeping. But I still believe, of all the choices you have, PD is probably the best. I can still work and travel—if I’m doing overnight travel for work, I may not dialyze that night but I discuss that with my doctor first. You just have to be prepared.”
After the initial PD training, patients are monitored closely by staff at Northwest Kidney Centers. They meet with staff in the clinic once or twice a month to get labs and shots done, there’s a 24-hour nurse on call to offer support, and PD nurses do home visits on an annual basis. They’re also able to track data remotely.
“Advancements in technology mean that for almost all our patients, we are able to look at stats from each of their dialysis treatments,” says Lara. “I can be in my office and call to troubleshoot anything with them over the phone.”
While moving to Port Angeles and starting dialysis was an adjustment, especially given the pandemic, Joy enjoys her new home in the Pacific Northwest.
“Living near the Olympic forest is beautiful and the people at the kidney center are just fabulous—they’re one of the highlights of this whole experience.”
“You need to be prepared,” Joy says, about dialysis. “It will change your life. You could die or you could live your life and work around it. That’s what I do.”