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Bill Peckham
Seattle, Washington USA
Volunteer; Philanthropist; Dialyzor.
Recent Activity
By Bill Peckham I check in with Dr Peter Laird for Sharp End of the Needle Talk5: It is hard to discuss the hundreds of thousands dialyzing incenter who do not want a transplant, and who do not want to... Continue reading
Posted Apr 2, 2018 at Sharp End of the Needle
By Bill Peckham My last SEN Talk with Dr Hippen caused me to reflect on the big picture of kidney care. The problem goes beyond silos. If there were no silos dividing dialysis from transplant, early stage CKD from Stage5,... Continue reading
Posted Mar 29, 2018 at Sharp End of the Needle
By Bill Peckham Dr Hippen (writings, LinkedIn interview) talks with me about the need to integrate kidney transplant care into comprehensive care models, risk and what patient-centered means in the kidney transplant context. Hippen's AJT is article is here. One... Continue reading
Posted Mar 28, 2018 at Sharp End of the Needle
By Bill Peckham Henning Søndergaard in Copenhagen joins me for SEN Talk3. He describes a self-care dialysis unit that is patient-centered beyond what is usually proposed in the United States. I know of Hui Laulima o Hana Maui (here, here)... Continue reading
Posted Mar 26, 2018 at Sharp End of the Needle
By Bill Peckham I can make myself feel uremic by decreasing my dose of dialysis. I can make myself feel unwell, struggle to walk up a flight of stairs, lose my appetite and my energy in general ... and then,... Continue reading
Posted Mar 21, 2018 at Sharp End of the Needle
By Bill Peckham This is the first official Sharp End of the Needle Talk - SEN Talk - that I will also publish as a podcast (assuming I figure out how). As an active advocate, volunteer and donor for and... Continue reading
Posted Mar 20, 2018 at Sharp End of the Needle
Here is my second post on visualizing fluid removal: In my first post I offered this diagram to show a way to imagine what the solute transfer process would look like; I imagined each molecule of waste was a pixel... Continue reading
Posted Dec 24, 2017 at Sharp End of the Needle
These next two post are among the first I wrote, I think they deserve more attention. Here is part 1: Rich points to two articles (part 1; part 2) by Dr. Agar on Home Dialysis Central. I really enjoyed the... Continue reading
Posted Dec 24, 2017 at Sharp End of the Needle
I thought I would reup some of my favorite DSEN posts over the holiday. Here is the first DSEN post, it's about traveling while using dialysis, but really it is about thriving while dialyzing. I was reminded when I read... Continue reading
Posted Dec 23, 2017 at Sharp End of the Needle
By Bill Peckham I started this blog just about 10 years ago, my first of 21 posts went up on the 26th. Anna was there from the start watching the site stats with me, wondering about each visitor; it took... Continue reading
Posted Dec 17, 2017 at Sharp End of the Needle
By Bill Peckham The PATIENT Act necessarily divides the kidney stakeholder community. S. 2065/H.R. 4143 enthrones two members of the kidney community as the central command point for dialysis patients to access their Medicare reimbursed health care services. The PATIENT... Continue reading
Posted Dec 17, 2017 at Sharp End of the Needle
By Bill Peckham Home Dialyzors United has posted a video compilation of dialyzors reflecting on their personal experience with more frequent home hemodialysis, it should be compelling to anyone interested in the treatment of CKD5: And they have partnered with... Continue reading
Posted Dec 16, 2017 at Sharp End of the Needle
By Bill Peckham Existing Electronic Medical Record systems (EMRs) can be improved by changing the way staff access the screen they need. Currently EMRs speed users to a screen tailored to a procedure for a given patient with as few... Continue reading
Posted Dec 15, 2017 at Sharp End of the Needle
Bill Peckham I'm going to be in New York CIty on Wednesday to give half of a talk: Pay for performance in ESRD; defining CQI Metrics focused on disease center performance and metrics focused on the patient experience. What are... Continue reading
Posted Dec 11, 2017 at Sharp End of the Needle
By Bill Peckham Self-centered care is a good idea. I look forward to discussing the macro and the micro with doubters, fence sitters and the confused. I’ll put Gary in the skeptic camp You are obviously proposing a radical change.... Continue reading
Posted Dec 7, 2017 at Sharp End of the Needle
By Bill Peckham RenalWEB’s Gary Peterson asks: How is this Copernican system defined in terms of policies, metrics, and financial incentives? From earth whether we believe we are at the center of the universe with the Sun and all else... Continue reading
Posted Dec 6, 2017 at Sharp End of the Needle
By Bill Peckham I like the commentary Kevin Fowler shared on Twitter, Innovation in Chronic Kidney Disease: The Need for the Patient Voice, read the whole thing. Fowler is making a big picture case that including the patient voice in... Continue reading
Posted Dec 5, 2017 at Sharp End of the Needle
By Bill Peckham With The Modality Mayhem Of Modern Dialysis Dr Agar runs through the reasons why it is so hard for any of us to answer the question: What is the best dialysis option? On internet discussion forums it... Continue reading
Posted Dec 4, 2017 at Sharp End of the Needle
By Bill Peckham In January this year HDC published an article by Dr. Agar, Home Dialysis Central Beware What You Wish For, Or How Good Dialysis Got Gazumped. First I should confess my astonishment that Gazumped is a word. Second,... Continue reading
Posted Nov 17, 2017 at Sharp End of the Needle
By Bill Peckham Among my last posts before my blogging break was a series of post in support of incenter every other day dialysis schedules (Part One); (Part Two); (Part Three); (Part Four); (Part Five); (Part Six) EOD was a... Continue reading
Posted Nov 16, 2017 at Sharp End of the Needle
By Bill Peckham My asking the questions: could 3x3 dialysis ‘work’? is HD a shield?, is not a signal that I have changed my mind about any of my previous positions (though I might have since I don’t have a... Continue reading
Posted Nov 15, 2017 at Sharp End of the Needle
By Bill Peckham As Dori says I do know that the only way three hours of dialysis three days a week could work for me (not that I am considering it) is if I had working kidneys. It is true.... Continue reading
Posted Nov 14, 2017 at Sharp End of the Needle
By Bill Peckham I agree with Mark that more frequent hemodialysis should be reimbursed fairly and currently I don’t think it is. I’ve written that EOD schedules are implicitly supported by MAC/FI charter. However, I’ve often skirted around a fundamental... Continue reading
Posted Nov 13, 2017 at Sharp End of the Needle
By Bill Peckham I’ve been using dialysis for 27 years. I dialyze ~6.5 hours, overnight as often as I can stand. For years I have advocated to increase the number of people using home and more frequent hemodialysis as opposed... Continue reading
Posted Nov 13, 2017 at Sharp End of the Needle
By Bill Peckham The market wants people to get by with three hours of hemodialysis, three days a week. How that could work? What sort of additional tool would a person need to feel well with a low dose of... Continue reading
Posted Nov 12, 2017 at Sharp End of the Needle