In an alley east of the elementary school in Qutang Town, Hai'an County, Jiangsu Province, there lived a strange family. The family consisted of only a mother and son, the mother was in her eighties and the son was in his prime.
They seldom go out, but they often pull barrels of pure water to their doorstep. This aroused the curiosity of the locals. Some said the men had a strange disease and had to bathe in pure water.
But water delivery worker Qin Yifan thinks otherwise. She has been delivering water to the family every week since she started work at the water plant. She knows it's a poor family, and it's rare to see meat in their meals. The man was really sick, too; he had a dark face and walked with a limp. She couldn't believe this poor man would bathe in pure water at all.
The buckets of water needed to be carried to the second floor, and the man had no strength, so he had to rely on Qin Yifan to help him. She also had to help him put the bucket of water on a wooden rack. There were some pipes hanging from the wooden rack, a bunch of salt water bottles next to it, a blue machine, and three stainless steel pots. Across the front of the bed was a large wooden pole scale - such wooden pole scales are rare these days.
On one occasion, Qin Yifan finally couldn't help herself, "What's the point of using all this water?" She asked carefully.
"Dispensing medicine." The male sank his face and said only two words.
The man who uses pure water to "dispense medicine" is Hu Songwen, a patient with end-stage renal failure (commonly known as uremia, a disease that is recognized as incurable). He built a homemade hemodialysis machine and miraculously survived for 13 years, far longer than the average survival time for uremic patients on dialysis.
Expensive hemodialysis
A 2008 study reported that the total number of dialysis patients in China had exceeded 100,000, with nearly 100 percent spent on dialysis treatments each year, but most of the patients were kept out of hospital hemodialysis units for financial reasons.
To avoid getting himself into trouble, Hu carefully guarded the secret for 13 years. in July 2012, he changed his mind. With the help of that second-hand computer, he posted that blood dialysis secret online.
The 18-minute, 11-second video shows a miracle: a uremic patient, without the help of any medical personnel, doing hemodialysis - a high-end alternative medical technology - for himself in the most humble of environments, using the most primitive of materials and methods.
One of the great inventions in medical history, hemodialysis was born about 100 years ago. It came about as a result of a doctor's fond desire to create an artificial kidney that would operate outside the body, replacing a human kidney, in order to prolong the lives of those with uremia.
Today, the ideal has become a reality, and the artificial kidney has become one of the most sophisticated medical replacement technologies. It establishes a blood pathway outside the human body based on principles such as "diffusion" in physics, whereby the patient's pumped blood is exchanged with a dialysis solution formulated to simulate the human body's internal environment, and metabolic wastes and excess water can be discharged from the body through a special device.
But doing it can be a different story. It took 14 years for hemodialysis to go from animal testing to treating the first patient, and another 40 years for it to become commonplace as a routine and effective life-prolonging measure for patients with uremia.
While hemodialysis is medically sophisticated, it is extremely expensive. In China, a single dialysis session costs more than 400 yuan, and a patient needs dialysis three times a week.
However, they account for only 10 percent of the total number of patients needing dialysis, and most are kept out of hospital hemodialysis units for financial reasons.
In 2009, the banning of self-help dialysis units in Tongzhou, Beijing, became a national sensation. Unable to pay the high medical bills, 10 patients used three second-hand dialysis machines to help themselves, but they were banned by law enforcement officials for violating the Regulations on the Administration of Medical Institutions, pulling away the kidneys they relied on for their survival. The poor patients are not willing to wait for death, but there is no way to help themselves, which has become a cruel and difficult reality.
In 1993, Hu Songwen, a junior at the Nanjing Meteorological Institute, was diagnosed with uremia and underwent six years of hemodialysis treatment in the hospital. Despite help from the school, the community, family and friends, the family's savings were exhausted.
All uremic patients like Hu Songwen depend on dialysis (both hemodialysis and abdominal dialysis, with hemodialysis being the mainstay) to sustain their lives, except for a few lucky ones who can get a new kidney. Once off dialysis, they don't live more than a month at most.
While doing hemodialysis at the hospital, Hu Songwen had witnessed the tragedy of several uremic patients. One of them, Wang Jianhua, was originally from a good family, but after three years of dialysis, he was still broke.
Wang Jianhua's family spent money that could have built a building in the countryside. Because there was no money for blood dialysis, his health was getting worse and worse. At the end of that year, his family scraped together the last of the money to carry him into the hospital, where he died after barely surviving the New Year.
Without the self-help that followed, Hu Songwen's fate would have been the same as that of Wang's fellow survivors. "I never expected to live this long." Hu told a Southern Weekend reporter.
Building a kidney
Hu Songwen planned to build his own hemodialysis machine and move it to his home -- to his less-than-five-square-meter toilet, to be exact. Almost everyone thought the young man was crazy.
The idea of doing dialysis at home first came about in 1996. At that time, Hu Songwen carefully read the "blood purification chemistry" written by Wang Qigang, a famous nephrologist, and realized that blood dialysis is actually not mysterious at all, but only some scientific principles he learned in high school were used on people. And there have long been home hemodialysis abroad.
"What really works in hemodialysis is the dialyzer, not the machine. The hemodialysis machine is just assisting the dialyzer to work." Hu Songwen said, "But this basic truth is not understood by most patients."
An imported dialyzer costs about a hundred dollars. But an imported hemodialysis machine costs hundreds of thousands of dollars -- it is a major factor in supporting the high price of hemodialysis. In addition, disposable supplies are one of the reasons for the high price of hemodialysis.
Hu Songwen's approach is to buy his own dialyzers and reuse them as many times as possible (usually eight times), reducing the cost per session to about 10 yuan; to buy his own powder and purified water to prepare his dialysis solution; to buy his own saline for flushing the lines, and to buy his own heparin. Those three items add up to about fifty dollars.
In addition to the dramatically reduced cost of blood transfusers and skin tubing, the total **** works out to be less than $60 for a self-help dialysis session, just one-eighth of the cost of a hemodialysis session in a hospital. The total **** works out to less than a thousand dollars for the 13 dialysis sessions required in a month.
The 5,000 yuan blood pump is one of Hu's most expensive pieces of equipment. To save money, Hu even tried to build one himself, but ultimately found it beyond his means.
He also tried to spend more than 1,000 yuan to install a water treatment system, which would have eliminated the need to buy pure water. But the attempt was unsuccessful because of water quality issues.
When Hu first told doctors about his idea, almost everyone thought the young man was crazy. Wasn't he?
Blood dialysis has long represented a high-tech medical treatment. Hospitals need strict approval to set up hemodialysis laboratories. In addition to expensive equipment, hemodialysis laboratories must be operated by strictly trained health care workers to achieve therapeutic results.
Because blood circulates outside the body, hemodialysis laboratories are also often the most highly sterilized areas of hospitals, with the exception of operating rooms. Even so, hemodialysis accidents cannot be completely avoided.
Hepatitis C infections in hemodialysis patients have been reported repeatedly. The Ministry of Health issued a document on hemodialysis in 2010 to ensure its quality and safety.
Hu Songwen is planning to move all this to his home -- to a toilet of less than five square meters, to be exact (in the winter, to save on heating costs, Hu will move the dialysis site from the second floor to the toilet on the first floor). Is there anything crazier in the world?
In fact, there's a deep-rooted belief in China's dialysis community that the treatment is so unpredictable and risky that it can only be done in hospitals, mainly large ones.
Hu wanted to live, but he didn't have the money. All he had to work with was a blood pump, a hollow fiber dialyzer, two puncture needles, several lines, buckets of purified water, pasteurized disinfectant, formalin disinfectant, and his 81-year-old mother.
On the afternoon of March 31, 1999, Hu Songwen, who had been brewing for a long time, began his first hemodialysis trial. He took out all those materials he had prepared 96 years before, dispensing, inserting and flushing. In his eyes, everything was no different than when he was in the hospital doing blood dialysis, and he had it all figured out.
The only thing he was worried about was the vascular puncture. When he was on dialysis in the hospital, he did most of the work himself, except for the puncture, which required the help of a nurse.
Unexpectedly, the first puncture was successful. As he watched his blood instantly pass through the tubing and into the dialyzer, Hu knew he could live.
But, after all, it was the first time. Hu was a bit frazzled during several parts of the process, including weighing water, dispensing fluids, and administering needles, but nothing went terribly wrong. His first blood transfusion took more than an hour longer than normal and lasted well into the night.
As was the case for the next 13 years, Hu did not have any medical professionals around to guide him every time he gave himself a hemodialysis, and was accompanied only by his mother. "I was scared, afraid that he would die in front of me." The old man told a Southern Weekend reporter.
Dancing on the tip of the knife
Han Lianggen and Hu Songwen had just learned to do their own blood dialysis, and drove their motorcycles to the hospital to "show off their skills," which made the doctors lose face. The result of the home to do not long after the blood filtering rumors of his death. The company's main goal is to provide the best possible service to its customers.
In addition to the blood pump and cylindrical dialyzer used to provide power, the other components of Hu's hemodialysis machine are used in the earth's way: Hu Songwen purchased his own dialysis powder, and used three stainless steel pots to prepare dialysis solution; he used an induction cooker to heat it up, and weighed it on a large scale; he punctured himself, inserted the tubing himself, prepared his own A and B dialysis solution, injected his own heparin, rinsed himself and sterilized himself, and controlled the amount of dewatering himself. .
It's this last point that makes dialysis patients so curious, because the amount of water removed from each patient's dialysis is tightly controlled by the hemodialysis machine. Too much or too little can make patients feel uncomfortable. Hu, however, manually regulates the amount of water he dehydrates - usually when he feels dizzy and tinnitus, and realizes he's dehydrated enough.
Another surprising fact is that in 13 years of dialysis, Hu has never used erythropoietin, a drug used to boost the production of red blood cells in the blood. The drug is often considered essential for dialysis patients.
Zhou Guangda, a former deputy chief physician of the urology department at the Second Hospital of Tianjin Medical University, analyzed the reason for this as the development of cysts (acquired renal cysts) on Hu's diseased kidneys. In his experience, these cysts can produce erythropoietin.
Because they are prone to complications, hemodialysis patients need to take a variety of other medications, which are also expensive and some are not reimbursed by health insurance. Hu Songwen uses the cheapest drugs instead, such as two or three dollars a box of aspirin, cardioplegia, etc. He also takes industrial drugs sold by the pound. He also takes industrial calcium carbonate, which is sold by the pound, to replenish the calcium (elements) lost from his body.
Hu Songwen's method of hemodialysis reminds Zhou Guangda of the situation 30 years ago. At that time, blood dialysis machines were not as advanced as they are now. Some dialysis units in small hospitals were similar to Hu's approach. Today, most of the operations of hemodialysis are automatically controlled by instruments, and a variety of advanced and expensive drugs have been introduced.
In the eyes of Sun Hua (a pseudonym), chief physician of the nephrology department at a tertiary hospital in Shanghai, Hu is "dancing on the tip of a knife". In her opinion, the dialysis process is full of risks and accidents can happen if there is a slight mistake, because it is necessary to establish a vascular channel outside the body and the dialysis solution has to be precisely formulated to simulate the environment inside the human body.
Sun Hua said the risks that need to be avoided when doing dialysis at home include infection, air embolism, abnormal dialysate concentration, and inaccurate heparin dosage, not to mention the limitations of the equipment. "It's just unimaginable that all of this can be done for one patient."
Sun Hua wondered how Hu could have danced for 13 years if he was really "dancing on the knife's edge". "It's too good!" That's the only way she can explain it.
In 13 years of dialysis, Hu had only one accident. Once, after dialysis began, he suddenly felt a stabbing pain in the eye of the needle, and when he looked again, the blood in the tubing changed to a wine-like color. Hu realized that he had encountered the most dangerous complication of dialysis: hemolysis caused by abnormal concentration of dialysis solution. He immediately stopped the dialysis and changed the dialysis solution.
Hu later recalled that he must have confused the concentration of dialysis solutions A and B. The dialysis solution was not the same as the dialysis solution, but was more concentrated than the dialysis solution.
A similar accident happened to Zhou Guangda once in the hospital. At that time, the patients who were on dialysis suddenly shrieked and went into spasms. It was later found out that the original blood dialysis machine used to automatically configure the dialysate concentration of the proportional pump is out of adjustment due to.
Not everyone is as lucky as Hu, but at the end of 2005, a uremic patient named Guo Henggen followed Hu's example and got a set of equipment to do his own dialysis at home. But he lived only three months longer.
Another named Han Lianggen suffered the same fate. He initially wanted to learn from Guo Henggen, but he died before he could learn from Guo, so he found his way back to Hu Songwen.
After that, no one dared to learn from Hu Songwen.
Nevertheless, in Hu's view, the risks of dialysis are exaggerated. "As long as one has a high school education, understands the basics of dialysis, follows the code of practice and pays attention while doing it, nothing will happen." Hu Songwen said, "Those two people had accidents mainly because they were uneducated and not humble."
There are also patients with uremia who want to use Hu Songwen's equipment to help them do hemodialysis and give him appropriate compensation. Hu Songwen refused all of them. "It's OK for me to do it for myself, and it's OK for me to teach others, but it's not OK for me to do it for others," Hu said, adding, "If something goes wrong, it's a problem."
These patients invariably died in despair. Hu Songwen is puzzled that one of them, there is a certain culture, sister is a nurse, father is a teacher, according to be completely cultured to do it themselves. But rather than wait for death, did not try it himself.
In a sense, Hu Songwen will be blood dialysis secret public from its reverence for fate. According to him, every year with a "2" in it, he would always face a disaster: in 1982, he got acute nephritis; in 1992, his untreated nephritis deteriorated into uremia; in July 2002, he fell and became a disabled person; and four months later, his father died of a cerebral hemorrhage.
2012, another year with a "2" is coming, and he has a feeling that it will be another threshold in his life. He doesn't believe in the "end of the world," but he is worried about another year of bad luck.
Hu Songwen desperately needs help from the outside world. His mother, who has always taken care of him, is beginning to lose her strength. She is 81 years old and is her son's only support.
Like his decision 13 years ago to stay home and do blood work, Hu decided to "go out on a limb" again.
Shortly after Hu uploaded the video to the Internet, a news story broke in Beijing about blood transfusion: Previously, Liao Dan, a motorcycle driver who had exhausted his family's wealth, took advantage of a financial loophole in the hospital to save his uremic wife's life by using a fake stamp to do blood transfusions for four years for free at the hospital. However, things finally fell apart and Liao Dan was arrested on suspicion of fraud.
The incident caused an uproar. Liao Dan was hailed as the "greatest liar" in history. The community has been helping out. Liao Dan was eventually sentenced to probation, and his wife received a large amount of relief funds.
When he saw the news, Hu Songwen was delighted, expecting to be as lucky as the Liao's after his story went online.
The result was disappointing. He has only 50 followers on his microblog, and less than a double-digit number of people have retweeted the video. The dialysis specialists he had "tweeted" to had not responded. One professional forum even deleted the video he posted.
In fact, only those in the dialysis community can understand his miracle. But their unusual silence gradually made Hu realize that the dialysis community probably doesn't want outsiders to know too much.
The bad luck of the "2" came again, when on Nov. 17, 2012, Hu's mother was hospitalized with sepsis. This was the first time in 13 years that she left Hu Songwen. Hu Songwen was even more helpless. He said he had planned to make a news story if there was no movement again - to report himself to the Health Bureau and have his hemodialysis unit "banned". The first time I've seen this, I've seen it in the past.