The "A Little Terminology and Explanation, Part 3", edition.

The end of this little series details the end of the run. I know it's not exciting, but I hope you learned a little about what happens during dialysis. Specifically home hemodialysis. The treatment lasts just under 3 hours. There is a 2 step removal process. We're notified when the toxins are removed and then notified when the fluid removal target is reached. When the fluid removal target is reached, the treatment is over. The time between the end of toxin removal and the end of fluid removal seems to be between 15 - 30 minutes. I think if I need more fluid removal, the time between the two is less. For instance. If I need to remove 1.5 kilograms of fluid, once the toxin removal is complete, it takes an additional 15 minutes to remove the rest of the fluid. If I need to remove .7 kilograms of fluid, it takes an additional 30 minutes to remove the rest of the fluid once the toxins are removed. 

So we're at the alarms. I like hearing the first alarm, toxin removal complete. This means the end of the treatment is near. When the final alarm goes off its time to go into action. The first thing I do is track my final blood pressure. Brian gets a saline filled syringe and attaches it to my artieral (blood out) access. He then attaches the venous tubing to a saline bag. Then he starts the "rinseback" process. What is that?  It's the process of returning my blood back to my body. Though the venous access...blood in. The blood remaining in the dialysis machine is returned to me flowed by the saline. When the venous access line runs clear, the rinseback process is complete. Brian then disconnects me from the machine and attaches a saline filled syringe to the venous access tubing. 

So now I have the the needles with the tubing still in me and the end of the venous and arterial tubing have syringes attached. Brian now checks the tubing for air bubbles, and then injects the remaining saline into my venous line. After that he removes the spiderweb of tape.  He gives me some gauze. As he removes the needle, I apply the gauze, with pressure, to the needle hole. After a few minutes we repeat with the arterial line. During the break between the two needle removals, he breaks down the dialysis machine. 

I apply pressure to the needle holes for about 5-7 minutes. Brian then applies an antibacterial ointment to gauze and tapes the gauze over each button hole, and then tapes the whole shebang. It takes about 5-6 pieces of tape. Heh. Sometimes when I'm out people ask about my uber bandage. I just say. I came from the doctors office. :). I leave the bandage on for no less than four hours. Just a precaution if the buttonholes decide to bleed and it allows scabs to form, leaving me less suseptible to infection. We don't want an infection in the bloodstream now do we?  

The final steps are taking standing and sitting blood pressure, a final thermometer reading and finally my weight after treatment. Oh yeah. The nurse wants me to take my weight au naturel. :-)   Anyway.  Sometimes during treatment my blood pressure drops. Well...always during treatment. It's averaging 90/70 with a 82 heart rate. I'm feeling fine with the low pressure, but to be on the safe side, Brian plies me with pickles. Clausen pickles. Yumm!  Oh yeah. The pickles for the salt content to help raise the pressure some. It works about 99% of the time. If I'm feeling like all hell is going break lose, I ask him to return some saline to me. And that works everytime. So, so far so good. 

Now you know the process and you learned a few dialysis terms. Flashback, rinseback, arterial, venous. 

Today we're finishing up getting what we need for dinner Sunday. We picked up the Honeybaked ham. And I got a praline cake from Nothing Bundt Cakes. Today I'll pick up some flowers and the remaining groceries. And we're dying eggs on Saturday. Have a wonderful Easter. :-)