The 'Interruptions, or Life on Dialysis is never Predictable", edition.

Good Thursday morning!  I had a carefully scheduled week. Things I planned to do. But sometimes things go awry. First of all let's start with early last week. I had to miss a treatment and that screwed with the treatment schedule. We just got back to the regular schedule. And getting off schedule meant that some days I had to do treatment during the day instead of at night. Ugh. Being in the bed attached to dialysis machine for 5+ hours during the day. Bleah. Had to a few sessions like that. In addition the monthly blood labs were off schedule..yes..we (Brian) takes the blood samples and then they're shipped via FedEx at the expense of the clinic. Four vial of blood taken before treatment and one after treatment. Brian has to run the samples through a centrifuge, and then store them in the refrigerator overnight. In the morning he packs the blood in the special packaging and then drops the package at FedEx for same day delivery to the lab.  

Well. We took the labs Sunday, because we can't send it over the weekend. And the lab results are reported pretty quickly and will be reviewed with me by my neohrologist and dietician. Except my monthly appointment was on Monday. And we didn't take the labs until. Monday night. D'oh. Anyway. It was time for my yearly TB test so that happened on Monday. My nurse wants me to return today to see how these turned out. Short of a momentary itch and the little dot where the needle was inserted, it looks ok. 

But wait!  There's more!  Last week I started having trouble during the stick. Specifically my venous needle...blood in needle. When Brian tried to inject the med (heparin-blood thinner) through the tube, it wouldn't  go. The syringe plunder wouldn't plunge. That meant there was clot somewhere in the line or in the fistula. *sigh*. No blood moved through the line. But then!!  When Brian slowly moved the needle out, the blood started to flow. What this meant though was that my fistula needed maintenance. Yes. It was time. What is a fistula you ask?

"A fistula used for hemodialysis is a direct connection of an artery to a vein. Once the fistula is created it’s a natural part of the body. Once the fistula properly matures, it provides an access with good blood flow that can last for decades. It can take weeks to months before the fistula  is ready to be used for hemodialysis." 

Well since fistula is created, it's something that is not natural to the body. It allows the blood to flow and this is where the needles are inserted. But every now and then the fistula closes in on itself. And that's what happens to me. Usually every 6 months. This time was 9 months, but I was in the lookout!  I called my nurse and she made the appointment. Because the fistula is my lifeline, I needed to get it taken care of immediately. 

So yesterday I had the procedure to fix my fistula. It was my fifth time. Once in Detroit and number four here on Vegas. The procedure takes place at a vascular access center. So.  A nurse gets me. We review my previous record. I am allergic to the dye...that is used for the fistulagram.  We review the procedure and meds. I get conscious sedation.  Whoo hoo!!  I get sent to the dressing room, disrobe just my top. Get escorted to the holding area. Placed in a chair with heated blankets, vitals are taken, and finally I talk with the vascular surgeon. Same one as before. A few moments later I walk to the procedure room...very much a surgical environment. The nurse is there, 2 other people to prep me and the finally the doctor comes in. 

Prep involved putting the ekg nodes on me, getting oxygen, scrubbing the hell out of my left arm and they create a sterile area. Oh yeah. I have permanent little hole on my left arm for insertion of stuff related to the fistula. Doc injects me with megadose of benedryl.  That's the conscious sedation and it hits me immediately. Look out. Here comes high Pat. Lol. I'm on my back. Doc is on my left, with some kind of plastic bubble tent. I'm facing to the  right and there are 2 monitors, so I can see what is happening as the doc is doing what he does. I see the fistula and I see 2 areas where the fistula is closing in. I ask and point it out and the doc says yes. He has to insert a balloon into the fistula to expand it, the angioplasty procedure.  It doesn't hurt, but I feel the pressure. Procedure may take 15 minutes at best. After procedure I'm rolled back to the staging area, given apple juice and crackers. Doc comes to talk to me, but we had talked about it during the procedure. Lol. I'm in and out in less than an hour. However, the sedation drug is still at work. For most of the rest of the day. 

Oh. And we're in the process of purchasing a new condo. I needed to go to the credit union to do stuff. Ah well. We went after I napped, but I was still wiped out. But it got done. I still have the bandage. And I have an additional bandage on my arm from doing treatment last night. I'm gonna get a shit load of questions about it today. And today, I still have to speak with the real estate agent and the title company. Yay?  And I have to go back to the dialysis center for the nurse to check the TB test. Alrighty. Oh yeah. We go to the trainer today. Long day. 

That's it for today. Lengthy entry. But you can see being dialysis is not routine.  Ah well this is my life. Have a good day. My adventures in dialysis!  

This is what I see during the procedure. The closed spaces are what needs to be expanded, hence the angioplasty...inserting a ballon into the  fistula and expanding the ball onto force open the fistula.