Stayin’ alive

A kidney dialysis/transplant diary

And so it begins

I wish someone would have warned me: “Fasten your seatbelt. It’s going to be a bumpy night” before I went into dialysis.

I knew kidney failure was serious. I knew the choices were dialysis or die. I knew I’d been sick for many months. I knew as lousy as I felt I still didn’t want to die and I knew I was in desperate need of help.

What I didn’t know was how severely my body would react to the initial dialysis treatments.  My kidneys had been poisoning me slowly for months and my body had become accustomed to its failing state.  Saying dialysis shook me to the core would be putting it mildly.

My initial diagnosis of kidney failure early in the year progressed quickly to End Stage Renal Disease and by March 16 I was under a surgeon’s knife having a perma-cath placed in my right jugular to allow hookup to the dialysis machine.

I didn’t feel at all well before or during the procedure and had asked for someone to wheel me from the entrance to the outpatient surgical unit at St. Luke’s in Cedar Rapids.

 I waited, groggy from the toxins in my blood, and was then taken into a private cubicle for questions and prep.

I was then rolled onto a gurney and wheeled into the operating area where a masked surgeon I’d never met bantered with the nurses and then asked me to turn my head to the left. “Ah,” he said in a cheery voice, “Look at that big beautiful jugular just smiling up at me.” An oddly funny but intimidating comment, frankly, because I’d somehow managed to ignore the fact a surgeon was going to take a scalpel to my jugular. That seemed less than …  um … desirable in many ways.  I was awake, though I felt no pain during the procedure.

What he did, in layman’s terms, was slip a length of plastic tubing into the jugular. The tubing splits where it dangles outside my body, each end capped — one in red and one in blue — color coded for venous and arterial flow. The resulting “pigtail,” which I tuck into my bra when not on treatment, is the access point for my dialysis. I now refer to it as my keg tapper and think Dracula would believe it a marvelous medical advancement.

I was feeling so rocky after the procedure that I asked the nurse to accompany me to where a taxi would pick me up.  She wheeled me down and out to the cab itself and gave me a hug and wished me luck as she helped me into the cab.  Nurses are generally compassionate, but I probably should have read the hug as recognition that I was having a more difficult time than most patients.

My first dialysis treatment was scheduled for the next day, St. Patrick’s Day, but the luck of the Irish didn’t seem to be with me.
The nurse, the machine and me

I’d had a tour of the Mercy North Outpatient Dialysis unit several weeks earlier. It’s a pretty efficient operation. About 160 patients receive treatment through the center, the vast majority hooked up to the machines for 4 hours three days a week. The unit can process up to 99 patients a day in three shifts in its four 10-chair bays and one isolation room.

It’s very sterile, very cold – literally, very clean, very mechanical and smacks just a bit of a factory assembly-line atmosphere. But it has to in order to process the number of patients necessary.

Luckily the staff is warm, friendly and often funny which softens the sharp mechanical corners of the physical environment.

Dialysis Day 1:

I call a cab to take me to the center because I already feel weak and sick and have no idea what to expect from dialysis. I have trouble because I’m weak and feel off kilter but finally manage to get into the cab and back out once I arrive at the unit.

I feel unsure that I can walk any distance at all without some kind of assistance. I wait in the waiting room for a few minutes before my name is called and teeter to the scale to weigh in – I hate that even now. I was an 8-year-old the first time I was ordered to diet and I’ve hated scales and weigh-ins ever since.

I am led to a big green recliner chair and asked to stand while my blood pressure is taken. I manage to remain standing.

Once seated, my blood pressure is taken again by a nurse is a disposable lab coat and a protective apparatus that looks like a cross between a sun visor and a clear welding shield. She’s got a yellow mask on under the shield.

The nurse unwraps my pigtail and connects the two split ends to two tubes connected to a tallish machine at my left that’s hung with an IV bag of saline and a tiny red version of a K-mart bluelight special alarm. She tells me appropriate tops for dialysis patients are button-up. She punches buttons on the machine, sets programs, and suddenly the clear tubes turn dark red and — surprising to me– warm as my blood is pumping outside my body, through a series of Rube Goldberg twists and turns, clamps and toggles and a big plastic cylinder call the dialyser.

I’m on my plastic umbilical cord. It works kind of the same as Mom’s did, too. It cleans the wastes and excess fluid from my blood — it’s my artificial kidney — and returns the scrubbed blood to my body. It keeps at it for 4 hours before I’m detached.

Before she leaves my side, the nurse hands me a mask and proceeds to change the dressing on the jugular access, spilling betadine across a pristine white shield on my chest, the rusty red liquid spilling into a most bloody looking blot. Once the dressing is changed, I’m allowed to unmask.

She pulls a long robotish arm in front of my face and hands me a pair of earphones. At the end of the metal arm is a small TV. More robot than the metal arm, I watch TV hoping “Jeremiah Johnson” will somehow let me forget for awhile how bad I feel and how slowly the time is passing.

It does pass and though I felt drained and light-headed. I was able to make it into the cab and get home without further incident.

But that was just the beginning.


October 23, 2007 - Posted by | dialysis, health, kidney | , , , ,

1 Comment »

  1. Your story is very well written and interested me. I was on hemo dialysis for 7 years before the kidney transplant that I just got on Sept 30th 2007. I want to wish you all the best and I am going to tell other people on my site to come by your page. Thanks for sharing your story!

    Comment by Angie | March 13, 2008 | Reply

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