For the Manganaan's, taking care of Bessie's chronic kidney disease is a team effort.
Every few days, Willie runs a hose to the bathroom sink in order to make the dialysate his wife needs for her treatments. Just like conventional dialysis, the home machine will do the work her kidneys can't -- cleansing her blood and keeping her healthy.
Initially, her husband was worried about doing it all at home.
"We need to hook up this one, we need to prime this, you have to assist me, and like I'm scared sometimes with those things," says Willie Manganaan, Bessie's husband.
But he learned. And the improvement in his wife's condition convinced him it was worth the effort. Going to the center for dialysis left her drained and depressed.
"By the time you got your energy back, it's time for you to go to the center again. It's like a roller coaster," says Bessie Manganaan.
"I think the more people we can get home the better. I really think it's the best place for the patient to be treated," says Dr. John Moran, the medical director of Wellbound, a dialysis company focused on training patients and empowering them and their loved ones to do it at home.
"The cost to the taxpayer is less for the home patients because there's less drug usage required, they're getting better treatment, there's less hospitalization required because in general they remain healthier," says Dr. Moran.
Recent clinical research found home dialysis with the NxStage System was comparable to in-center treatment -- both safe and effective.
As for cost, per treatment it's less expensive than in-center dialysis. But home hemodialysis typically means more frequent treatments, often six days a week, and currently, Medicare only pays for three. Patients ABC7 spoke with say that consistent cleansing is key to making them feel better.
"It's been great. I have the energy that I need in order to work and to do everything else that I want to do," says Lesia Walker, a dialysis patient since 1988.
Patients first train at one of 10 Wellbound centers in Northern California, and then check back once a month.
"If you get better dialysis, you're on less medications, you know, you have the energy, you have more control of your schedule and your life," says Walker.
"I was taking just a ton of blood pressure pills, I mean, I don't take any now, none whatsoever," says Arnold Pouncy, a dialysis patient.
"I don't want to feel like a cow, just going there, milking me and go, that's not for me," says Eleazar Reyes of San Pablo, also a dialysis patient.
And the timing is up to them.
"The patient at home can do it in the morning if it suits them, they can do it in the evening if it suits them, they can mix and match. It's very much more flexible," says Dr. Moran.
"The amount of food, the amount of liquid you eat and drink every day is very limited when you go to the clinic. But with this one, since you're cleaning yourself everyday, I have not been limited to anything," Says Bessie Manganaan.
And with the improvement in her health, Bessie's been able to return to work. That's something she says she couldn't' have done without home hemodialysis and the help of her husband.
"The best part is she's getting strong. She can do what she wants to do," says Willie Manganaan.
Home hemodialysis is not for everyone. Patients must have someone who lives with them who is willing to take part in the treatments. Right now, less than once percent of dialysis patients get treatments at home.