“How do I stay in charge?”

Anvil Nelson Jnr is a man in perpetual motion. The entrepreneur runs his own chemical manufacturing company in the city of Chattanooga, a two-and-a-half-hour commute from his hometown of Nashville, Tennessee. He is a member of the board of the local Nashville rescue mission, which provides food, lodging and training for people in need. He also sits on the board of the Tennessee Kidney Foundation, which offers screenings, education and help with transportation for patients with renal disease.

What is more, Nelson has held a leadership role at his local church for more than two decades. He also officiates at track and field competitions for state tournaments and at college meets. Last but not least, Nelson wants to spend quality time with his wife and two grown children who live nearby. After ticking off that comprehensive list, he concludes with a chuckle: “I have a pretty busy life. My family actually thinks I’m too busy.”

This can-do attitude has been a hallmark of Nelson’s journey as a dialysis patient for the last two decades. Back in 2003, he was diagnosed with a non-malignant tumour on his right kidney and had it removed. During his regular follow-up visits with his nephrologist, it became apparent that the function of his remaining left kidney was gradually decreasing. It reached a critical point in the summer of 2017, prompting Nelson to put his name on the national kidney transplant waiting list to find a donor organ.

During a check-up in the summer of 2017, his physician discovered two malignant tumours on his left kidney. “Over the past 14 years, I had kept my appointments with the doctor four times a year, but I hadn’t faced any major changes to my lifestyle. Even when I got the news that the cancer had got hold of my other kidney, it just made me want to get proactive,” Nelson recalls. “I told the doctor right there and then, ‘Let’s rip the cancer out as quickly as possible.’ Dialysis would change my life, but beating cancer was the bigger challenge.”

While he was still recovering from surgery, Nelson was already devising a plan to get his life back on track. Initially, he had to travel to a dialysis centre three times a week for his treatment. “It was very rigorous, because you had to schedule it and stay there for a few hours. I booked my treatments for 5 am on Mondays, Wednesdays and Fridays, so I could use the rest of the day, but that meant getting up around 4 o’clock in the morning to drive there.” In spite of his original expectations, Nelson found that the treatment schedule interfered too much with his many other obligations. “After getting treatment, you need time to recover. Often, I couldn’t even manage to drive to work in Chattanooga on Mondays after dialysis because I had to rest.”

So, Nelson told his doctor he needed to explore his options. “I wanted to keep on living my life and not be tied to a centre. That’s why I initially considered peritoneal dialysis as it was the only way I could continue working as usual. But then,” he adds, “I heard about home haemodialysis!”

Nelson found the System One home dialysis machine made by NxStage from Fresenius Medical Care and watched tutorials showing how it worked. “It was an amazing discovery, and I wanted to find out even more.” Shortly afterwards, he was sitting in his treatment chair at the local centre when his phone rang. It was an expert from the NxStage team, and Nelson ended up talking to her for an hour and peppering her with detailed questions. “I decided to go for it and asked my doctor to sign me up for the required training sessions right away.”

Within a week and because his wife provided him with ongoing and passionate support, Nelson was able to start his training on how to use the System One. This involved instruction by experts at a dialysis centre, followed by supervised use. Very quickly, he felt comfortable enough to prepare and connect the machine by himself.

Nelson’s wife Deneice or one of his children always try to make time to be available as his care partner – a routine the family has maintained, even as Nelson has continued tending to affairs at his company in Chattanooga. On Mondays, he drives to Chattanooga to be on-site at his company and is joined by his wife the next day at the apartment he rents there. “She is always there for me, gets the machine ready and makes us something to eat while I finish up work.”

As a result of the home dialysis training, his wife has also adjusted her schedule to make time as his care partner. That means preparing the machine on Thursdays and Fridays when he is back at home in Nashville. “I don’t want to make it sound too rosy,“ Nelson says, “but home dialysis is a great opportunity. I can really get on with my life, run my business, and even travel.”