DECATUR - Lee Joy, 48, has been living with kidney disease since he was diagnosed in 1996.

Joy had torn an abdominal muscle at work, which caused a hiatal hernia. He went to the hospital because of the horrible pain he originally attributed to the injury.

"Well, I've been shot, stabbed, cut and burned, and none of it hurt this bad," he recalled thinking when he was admitted to the hospital. "It felt like an alien inside of me trying to get out with big claws."

Instead, his doctor told him his kidneys were deteriorating because of polycystic kidney disease, an inherited condition.

"The first thing I said when he told me what I had was, 'How do we get it fixed?' " Joy said.

His doctor said there was no way to restore his lost kidney function, and his condition could only be monitored and possibly slowed.

When healthy, the kidneys filter excess fluids and waste products from the body. Until recently, Joy was able to control the disease and prevent his function from deteriorating to the point where he would need dialysis, a process that does the work of the kidneys by filtering the blood through a machine and back into the body.

He has been undergoing treatments at DaVita Dialysis for a little more than a month but recently gained the opportunity to treat himself at home with a portable home hemodialysis machine.

"I work," Joy said, adding that he gets done with work just before the dialysis center normally closes. "And it's a four-hour deal when I come here, and they have to have people stay over."

He said he is looking forward to being able to do the treatments on his own time.

"When I get done with this," Joy said pointing to the portable machine, "I can just walk into the next room, take a shower and go to bed."

Home hemodialysis technology has changed over the years, said Ellie Suhl, DaVita regional operations director. Prior to the availability of the portable NxStage Medical dialysis unit, which Joy will use, patients converted areas in their homes to accommodate the same kind of large, complicated dialysis machines used at the clinic. Joy will be the first DaVita patient in Decatur to use the small NxStage unit.

"They say doing it shorter and more often, I'll have more beneficial results from it," Joy said.

And he won't have as high fluid gains between dialysis sessions, said Tina Stewart, the DaVita home hemodialysis nurse who is training Joy on the machine.

"They said this here is mobile and the others aren't," Joy said, gesturing to the machine humming beside him. "So, like, if I want to go home and visit my family back in Kansas, I can load this up and take some supplies with me and go back and visit for a week."

After three or four weeks of training, during which he is learning to become self-sufficient with the machine's operation, Joy will begin to perform his own dialysis treatments. He will have monthly visits in the clinic to follow up on his progress.

Stewart will be at Joy's home the first night he uses the machine on his own to monitor for any problems and answer questions.

"I'm a phone call away," Stewart said.

"I'm in good hands," Joy added with a laugh. "They've been really great here, you know, being helpful, telling me what to watch for and things like that."

One out of every nine Americans has some form of kidney disease, Suhl wrote in an e-mail, adding that diabetes and poorly controlled hypertension are among the leading causes of kidney disease. With the aging of the baby boomer population and the obesity epidemic, Suhl said, the number of those with kidney failure in the United States is only expected to rise.

Some patients opt to leave their dialysis to the professionals instead of doing it themselves. John Lair, 78, has been on dialysis for five years. Several years before starting, after tests and visits with his regular physician, Lair was diagnosed with kidney failure. He said he knew he would eventually need the treatments.

"I was pretty well informed before I started," Lair said, adding that a relative of his wife's had been on dialysis. Lair, a retired engineer, said he was not worried about starting the treatments.

For his dialysis appointments, Lair gets up at 5:30 in the morning three days a week, "which is the most difficult part as far as I'm concerned," he joked. By 6:45 a.m., the staff at DaVita begin the treatment, which requires needles into an artery and a vein. The arterial needle takes Lair's blood into the machine, and the venous needle returns the cleansed blood to his body.

Most of the time, Lair watches television, listens to music or reads while the machine filters his blood for the three-hour sessions.

All in all, life hasn't changed much for the Lairs since John's diagnosis. The most drastic difference probably is the change in dietary restrictions that limit liquids and foods containing high amounts of the substances the kidneys can't filter, such as salt and phosphates.

"Everything you eat is salted," Lair said of meals at a restaurant, which makes it difficult to go out for meals.

"I use a lot of lemon juice," his wife said. "And you'd be surprised. It tastes like salt."

Another thing the Lairs miss is being able to travel to visit their children, who are scattered around the country.

Asked his advice to someone who has been diagnosed with renal failure, Lair said: "The first thing I'd say is get yourself on a list for a transplant,"

For now, Lair keeps busy waiting for his kidney transplant by being active, playing golf and doing work around the house.

Most dialysis center staff members and patients agreed that it differs from other areas of healthcare because of the frequency with which the patients are seen.

"It's a very different kind of healthcare," Suhl said, adding that the staffs at the dialysis centers get to know things about patients' lives and families, their hobbies, joys and sadness. They see some patients for many years - sometimes until a transplant and sometimes until the end of their lives, she said. And patients agreed that they feel close to the people taking care of them.

"I mean, you can't have people poke needles in your arms three times a week and not feel close to them," Lair said with a chuckle.

Annie Getsinger can be reached at agetsinger@herald-review.com or 421-6968.