The "The Tools of the Trade", edition.

Good Saturday morning. Well, it's been about a week since we started the nocturnal home hemodialysis. The excellent news is, is that the process is similar to regular home hemodialysis. The differences are the cartridge and the blood leak sensor. These differences are minor. Really minor. The change is us. Lol. Our schedule used to be eat dinner around 5:00 PM, take a break, then start prepping around 6:30 and I'm on the machine by 7:30. Treatment lasted about 3.5 hours. Done around 11:00, finish up, clean up then be in bed by midnight.  We did this 5 days a week. Never, ever missing 2 consecutive days. Our schedules revolved around this. If there was an event in the evening we wanted to attend or travel, we'd adjust the schedule. Sometimes adjusting the days. Or adjusting the time of treatment. 

Now with nocturnal we make sure I'm on the machine by midnight. Why midnight?  My time on the machine is now 5 hours. Yes. I sleep 5 hours a night. Most nights. I know. You want to know why I'd even want to wake up so early. The quick answer is, is that we're early risers. And our water fitness class starts at 8:00...way in the other side of town. We leave at 7:00 to get there in time to change clothes and whatnot. Anyway. The alarm goes off 5 hours after we start..sometime between 5;00 and 5:30. Take the final numbers, clean the machine, drink some coffee, pack our bags and off we go. 

My dreams were pretty vivid the first couple of nights. They've calmed down. An alarm went off only once during the night and I don't recall what it was. Brian got up pushed a button and we went back to sleep.  We have run across an issue. I now do treatment every other night. MWFSunTTHSat.  ...  The issue is we have deep water fitness on MWF.  When I do treatment Sunday night, Tuesday night and Thursday night, I finish around 5:30. It also means I have bandages on my arms. The scabs on the accesses are not formed. I can't get into water for 6-8 hours. D'oh!! Theoretically that means that I can go to deep water fitness only every other week. But wait!  My treatment is still flexible. The only restriction I have is I cannot miss 2 consecutive days. If I do treatment MWFSat nights then I'm back to swimming! Yay!  And we can adjust as necessary. So then. So far so good. 

We're adjusting. Realizing our evenings are free. We can actually go out in the evenings to do stuff. 

So now. The tools of the trade. 

Some of my medical supplies. 

Boxes of needles and syringes (with and without needles) And needles are not syringes. Face masks, sterile gloves, and a sharps container in the corner..you know, a hazmat container for used needles and things that stick you. And needle-less syringes with blood in them. 

A needle and a syringe. 2 of these needles are inserted into me for treatment and stay there. One needle is blood out, the other needle brings the cleaned blood back into me. The syringe is used to extract medicines from a vial. The medicines are directly injected into me, but rather through the tubes. Brian takes off and discards the needle and screws the needle-less syringe into tubes and administers the medicines. 

Just to get an idea of the size of the needle. The syringe and the needle have protective covers so I don't accidentally puncture myself. The needle is blunt, so it won't hurt. The syringe is quite pointy.  And yes, I've accidentally punctured myself. If I do that I discard the needle because once I've punctured my self, the needle is no longer sterile. The more you know!  

The needle and syringe with the protective covers off. The needle with the blue "butterflies wings" is one of two needles I stick (cannulate) myself with for treatment. I have 2 buttonholes on my upper left arm which are called buttonholes...not unlike pierced ears. I stick myself with blunt needles in those buttonholes. If I didn't have buttonholes, I'd use sharp pointy needles to stick myself, but never in the same place. Story for another day. 

Just to get a perspective of the size of the needles. Yes the entire needle is inside my arm for the duration of treatment. So yeah. 5 hours. 

This little doohickey is called a picker. Because its used to pick the scabs from the buttonholes, scabs form on the buttonholes and yes that's a good thing. However when it's time to do treatment, I need to get the scabs off...cleanly..so I can insert the needles into the buttonholes. And before you freak out, I clean the buttonholes with antibacterial soap for  2 minutes, soak the scabs for 5 minutes with a sterile solution, then swab them with betadine before I "pick" the scab. By then I've really dissolved the scabs and am just removing stray residue. The last thing I want is stray scabness getting into my bloodstream. Blood infection.. (runs screaming in terror from the room).