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Nxstage Medical, Inc. Message Board

david_reaves 28 posts  |  Last Activity: Jan 24, 2013 6:32 PM Member since: Mar 24, 2002
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  • david_reaves by david_reaves Jan 24, 2013 6:32 PM Flag

    I posted this originally under a different message, but the way things thread it was lost in the clutter.

    I've been using the NxStage System 1 and Pureflow at home since December 2009. I first used it in the short daily modality and I am now using it for slow, extended, daily dialysis. I actually only treat 5 days a week. Previously I have done peritoneal dialysis, in-center hemodialysis, and had a kidney transplant.

    I'm very happy with the NxStage system. It is the only home hemodialysis system that provides the patient with the flexibility to travel with their system and continue the frequent modality. Other home users (with Fresineus, for example) still generally only dialyze three days a week. They also must find a clinic and get scheduled if planning to travel. Those systems also require separate power, a separate water filtration system, and are more complex to set up, maintain, use, and clean.

    The ONLY complaint I have about the NxStage system is that the dialysis machine, while portable, is too heavy for one person to carry. It is easy to set up, easy to use, and can be used anywhere there is normal electric power and a drain. For travel, the clinic prescribes and NxStage provides hanging bags of pre-mixed dialysis solution, so you don't even really have to have a source of water.

    I have felt substantially better since I started the extended treatments. My lab values have improved, and the measured clearances are good. I'm fairly certain that I should be able to continue dialysis with NxStage indefinitely.

    From my perspective as a patient, the product is a winner. As an investor, I would wonder why the company isn't doing more to get into every clinic and provide promotional material to encourage patients to consider the NxStage system.

  • Reply to

    I Repeat... Get This One While You Have Time

    by hoperalot Dec 4, 2007 3:16 PM
    david_reaves david_reaves Jan 24, 2013 6:22 PM Flag

    I've been using the NxStage System 1 and Pureflow at home since December 2009. I first used it in the short daily modality and I am now using it for slow, extended, daily dialysis. I actually only treat 5 days a week. Previously I have done peritoneal dialysis, in-center hemodialysis, and had a kidney transplant.

    I'm very happy with the NxStage system. It is the only home hemodialysis system that provides the patient with the flexibility to travel with their system and continue the frequent modality. Other home users (with Fresineus, for example) still generally only dialyze three days a week. They also must find a clinic and get scheduled if planning to travel. Those systems also require separate power, a separate water filtration system, and are more complex to set up, maintain, use, and clean.

    The ONLY complaint I have about the NxStage system is that the dialysis machine, while portable, is too heavy for one person to carry. It is easy to set up, easy to use, and can be used anywhere there is normal electric power and a drain. For travel, the clinic prescribes and NxStage provides hanging bags of pre-mixed dialysis solution, so you don't even really have to have a source of water.

    I have felt substantially better since I started the extended treatments. My lab values have improved, and the measured clearances are good. I'm fairly certain that I should be able to continue dialysis with NxStage indefinitely.

  • Reply to

    Frequent dialysis benefit

    by david_reaves Sep 22, 2011 11:38 AM
    david_reaves david_reaves Oct 14, 2011 11:21 AM Flag

    "It is the same, more or less..."

    You sound like a clinician with little regard for the patient's quality of life. Your off-hand comment disregards the benefits to the patient to be able to schedule one's own treatment, to travel freely, and to have a somewhat normal life. The fact that I can consume relatively normal amounts of fluid and that I never have to suffer through a weekend with two days between treatments are all more than enough for me to continue with NxStage.

    I will agree that once I can start doing daily slow/nocturnal treatments that I should have better labs and a better long-term outcome. For the home-hemo systems that I know about, though, the additional flexibility and ease-of-use makes NxStage well worth it.

  • david_reaves david_reaves Sep 23, 2011 11:19 PM Flag

    They've been playing a Fresenius dialysis commercial in Austin , TX. I've seen it on both morning and evening news.

  • david_reaves by david_reaves Sep 22, 2011 11:38 AM Flag

    The new retrospective study published in the NEJM should be beneficial to NxStage if the results hold up. The study found that the day after the 2-day weekend for thrice weekly treatment had more cardiac events and more deaths. With the NxStage frequent treatment modality, there's no 2-day weekend. Patients don't suffer the extreme swings in fluid or toxins.

    As a patient I've felt much better with NxStage than I did on conventional dialysis. The frequency of treatment is the key benefit. Of course, the flexibility to manage my own dialysis schedule and the ability to travel with the system are strong positives, too.

  • david_reaves by david_reaves Mar 4, 2011 12:07 AM Flag

    I'm not sure how much is negotiated away by the insurance company, nor how much goes through to NxStage, but there is amazing money in dialysis! Due to a computer error, my insurance status changed for January--showing me as uninsured. As a result, I received the bill for the monthly treatment myself. I was astounded to see that the combined billing for the month for my treatment was about $100,000!

    I have a general idea about how much the machine costs, and I could guess how much the cartridges and dialysate solution cost. The next most expensive thing on the list are the weekly EPO shots (18000 units). Based on the bill I received, it would be possible to buy a new machine every month, with supplies for the month, and still probably have 80K left over...

    Why isn't every center in the world rushing to push patients into home dialysis? Very little staff overhead--I talk the a nurse once or twice a month, and see the doctor briefly once a month. The nurse does have to do some administrative overhead related to my treatment, but not that much.

    What I don't understand is how I could possibly be billed for almost $100K, when I know that Medicare only pays about $3K a month. Even at 3K, the machine is fully paid in less than a year, ongoing support and maintenance along with supplies are bound to be substantially less than the Medicare payment, so there is extra benefit to having a patient on NxStage once the cost of the machine is amortized.

    How could my provider possibly justify the bill I received?

  • Reply to

    New dialyzer

    by Haf48 Feb 20, 2011 9:26 PM
    david_reaves david_reaves Mar 3, 2011 2:30 PM Flag

    I have been a FMS patient for 3 years, and have been using NxStage at home for the past 15 months. If FMS stops using NxStage I will be changing providers.

    Key disadvantages to the Baby-K: requires separate water treatment/plumbing; requires separate/dedicated power; more complex setup; more difficult maintenance.

  • Reply to

    racharsh a follow up question

    by dontdropyourlunch Apr 11, 2010 12:30 AM
    david_reaves david_reaves Apr 12, 2010 5:53 PM Flag

    The training time is variable, and depends on the patient, the helper, and the policies of the dialysis clinic. There is a minimum amount of time (3-4 weeks) necessary to be sure that the process is managed safely (aseptically) and that possible medical contingencies and procedures are understood.

    My wife and I were trained at a Fresineus Dialysis clinic in just under 4 weeks. I had already learned to stick myself using buttonholes at the traditional clinic. The training was done five days a week, with a dialysis session on the System One every day as part of the training.

    I've been dialyzing at home, 6 days a week, since the first of the year. Labs have improved, energy has improved, and my quality of life has improved. The most significant benefit is the gain in control--I can adjust the time of day that I dialyze or the day of the week that I skip treatment as my personal schedule requires. It's no longer necessary to make my life conform to the dialysis clinic schedule.

  • Reply to

    Fresenius picks Nextstage

    by racharsh Nov 20, 2009 11:25 AM
    david_reaves david_reaves Dec 8, 2009 10:23 AM Flag

    I can verify that NxStage is being used by Fresenius. I am a Fresenius dialysis patient and I will be starting NxStage training on Dec 10th. I'm told that I am the pilot patient (at least for Texas). I'm expecting the training and treatment to go well.

  • Reply to

    Baxter: the writing is on the wall.

    by sneff14 Apr 2, 2002 8:41 PM
    david_reaves david_reaves Apr 4, 2002 2:01 PM Flag

    Excellent points...PD and Hemodialysis should be complementary, but too many people aren't fully informed of the availability and viability of PD.

    As an ESRD patient that has transitioned from PD to HEMO, I wish an AKSYS like solution were available to me today. The "clinic-dialysis-at-home" currently available is not as attractive to me. So in the short term I'm in the clinic 3 times a week. In the long run, I'm a transplant candidate. If my transplant fails, then I hope to have something like AKSYS available to maintain my life and lifestyle.

  • Reply to

    Distribution/Marketing

    by WTudor Apr 3, 2002 1:39 PM
    david_reaves david_reaves Apr 3, 2002 2:12 PM Flag

    CAPD is administered by a doctor, with the same level of supervision as hemodialysis. Many centers run in-center hemo, peritoneal (CAPD), and may have home hemo programs. The AKSYS advantage is that home hemo becomes less complex and requires fewer consumables that traditional systems, while allowing more frequent dialysis.

  • Reply to

    Still no reply where the link? eom

    by xerxes2345 Apr 3, 2002 10:17 AM
    david_reaves david_reaves Apr 3, 2002 10:44 AM Flag

    http://www.aksys.com/ninepatientscomp.htm

    Aksys also has received FDA approval for patients� continued use of the PHD System, once patients have completed the study, while Aksys pursues market clearance. Bill Dow commented, "Most of the patients that have completed the study have requested that they be allowed to continue dialyzing on the PHD System. The FDA�s post-trial approval allows them to continue to do so. The positive reaction of these patients to the PHD System to date has been very encouraging. This provides a great deal of satisfaction to our hard working employees, particularly those in the field interacting with the patients on a regular basis. The exciting aspects of this story continue to build."

  • Reply to

    Insidetruth

    by z3eyzonme Apr 2, 2002 10:40 AM
    david_reaves david_reaves Apr 2, 2002 12:00 PM Flag

    Hawk,

    A well summarized post of the potential problems with AKSYS. With all your points, I'd still say the PHD concept is worth money. The recent prices were due to the market's concern that FDA approval might not be forthcoming after all. Prices last year, after the 510(K) submission, increased to nearly $12. That was a reflection of the technology's potential. The subsequent drops were due to delays in approval and additional submissions required by the FDA.

    Of course, there has been a huge increase in volitility resulting from the increased attention of the short-term traders.

    >3. Why should the stock double in price
    >because of FDA approval of the machine? Was
    >the approval really in doubt in the first
    >place? The approval only means that this
    >machine looks OK-- it isn't an endorsement of
    >this unit compared to other units that are
    >available.

  • Reply to

    The real story

    by value_oriented2001 Apr 1, 2002 12:24 PM
    david_reaves david_reaves Apr 1, 2002 12:28 PM Flag

    The real story is that there is a large group of investors, both short and "pump-and-dump" longs that have no interest in the company or the product. Their only intent is to manipulate the market for a short-term gain. Unfortunately, that's one of the results of capital markets.

  • Reply to

    David Reeves no reply?

    by xerxes2345 Mar 28, 2002 7:03 PM
    david_reaves david_reaves Mar 28, 2002 8:49 PM Flag

    I did reply, but unlike others, apparently, I have a life beyond Yahoo message boards.

  • Reply to

    Daily dialysis is not so great eom

    by xerxes2345 Mar 28, 2002 6:04 PM
    david_reaves david_reaves Mar 28, 2002 8:48 PM Flag

    Yes, I do know what it's like to be stuck with two 15-guage needles...they are like water pipes! If the therapy makes me feel better, then I will do what it takes.

  • Reply to

    Daily dialysis is not so great eom

    by xerxes2345 Mar 28, 2002 6:04 PM
    david_reaves david_reaves Mar 28, 2002 6:45 PM Flag

    >Do you know what happens when you dialyze every day?

    Yes, you have fewer fluid restrictions, fewer dietary restrictions on high-potassium and high-phosphorus foods, less strain on your heart (since you aren't building up as much of a fluid load), more balanced blood chemistries, etc.

    WHY ARE YOU TRYING TO MINIMIZE THE BENEFITS OF DAILY HOME HEMO AS DEVELOPED BY AKSYS?

  • Reply to

    Daily dialysis is not so great eom

    by xerxes2345 Mar 28, 2002 6:04 PM
    david_reaves david_reaves Mar 28, 2002 6:40 PM Flag

    Where are the facts to support your opinon? AKSYS has facts that show that daily dialysis is better then thrice weekly.

  • Reply to

    Are you people that stupid. Baxter and

    by xerxes2345 Mar 28, 2002 5:30 PM
    david_reaves david_reaves Mar 28, 2002 5:50 PM Flag

    You may certainly be on home hemo now. I know several people who are. The point, again, is that the AKSYS system improves treatment when compared with the current 'center' systems.

  • Reply to

    Are you people that stupid. Baxter and

    by xerxes2345 Mar 28, 2002 5:30 PM
    david_reaves david_reaves Mar 28, 2002 5:45 PM Flag

    Xerxes,

    The point isn't that other home hemo doesn't exist...the point is that AKSYS' current solution is better than the existing solutions.

    The key points:
    -Better patient health with more frequent treatment
    -Fewer Consumables
    -Reduced operating cost
    -Smaller size, less storage
    -Ease of use; setup, operation, and cleaning

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