Stayin’ alive

A kidney dialysis/transplant diary

Closer to a new access

Getting this fistula of mine ready to use for dialysis has been a longer process than I believed it would be.  The outpatient surgery was done September 5 which means it would probably have been ready to use the first week in November, but that’s when my round of assessment appointments at Mayo’s began so beginning access through the fistula was postponed.

When Sue, the nurse who does initial needle placement for the fistulas, looked at the site, her eyes brightened with anticipation at the strong thrill she felt, but she had some questions about whether the vessel narrowed and how deep the vessel was so a fistulogram was scheduled in early December. 

 Results of that came out fine but when Sue checked again, she wanted further assurances and guidance on the depth of the vessels so an ultrasound and “tracing” were completed Monday.

The ultrasound tech traced the path of the vessel — and it’s depth at several intervals — on my left bicep in permanent marker. At dialysis Tuesday, Sue traced the path and “landmarks” from my arm to a clear plastic sheet.  She’ll use that sheet to create a template for the needle sticks. We’re hoping buttonholes can be established so blunt needles can eventually be used during dialysis. 

The other hope, those of you who are regular readers here know, is that I will be able to knit during dialysis when the fistula is being used.  There’s a pretty good chance that will happen. I’m hoping so because knitting makes the sit-and-wait part of dialysis less frustrating.

Sue’s schedule is chock-a-block full of meetings next week, so the initial flight of the fistula with be the week after next.  Keep your fingers crossed, por favor.

I really do appreciate Sue’s efforts to help me continue knitting during treatments.  She really is trying to make dialysis less intrusive in my life and I truly appreciate that commitment to patient care and the extra time it means she’s taking with this.

Another of the nurses at the center, who shall remain nameless here, when consulted by Sue, snapped something to the effect, “well, you may just have to give up knitting or find a new hobby.”

I bit my tongue on that one. What I wanted to say is, “OK, let’s just trade places here for a week or two and see how well you like the prospect of 12-13 hours a week chained to a chair and a machine watching old reruns or stupid ‘reality’ shows and feeling unproductive as hell.”

But I didn’t. And she probably didn’t deserve that kind of answer either, the operative word being probably. She’s generally a good nurse and seems to care about the patients and our comfort although her extra administrative duties sometimes make that less than apparent.

It’s kind of like when I mention the fact I think the unit needs a blanket warmer. Actually not so much for my own comfort, though there are evenings that that would certainly be nice, but for other patients who sit and shiver and complain about the cold. 

Is there anything more miserable than sitting and shiverring and feeling you can never get warm? If you’re tied to a chair, unable to move around and not at home where you can grab an extra blanket or sweater, it’s miserable and you just keep getting colder and colder ’til you’re cold to the bone. Try that for four hours.

When I mention the blanket warmer to the staff, there’s a kind of universal horror that comes across their faces: “Do you have any idea how many blankets we’d have to pass out every day? We’d need to hire an extra person just to do that and laundry would kill us.”

OK. So talk to the auxiliary. Maybe they’d not only fund a blanket warmer but pay someone to just hand out blankets. They could make things a lot more comfortable for about 100 patients a day with just that one addition.

Ask any baby, a warm blanket can go a long way in making bad things feel better.

And while we’re at it, isn’t there a better way to handle “hot packs” for cramping?

Years and years ago when I was an aide in a physical therapy department, we had special sand- and jelly-filled hot packs that would swell in warm water and retain heat for at least 20 minutes. They were wrapped in pouches of multiple thicknesses of terrycloth equipped with snaps so the packs could be wrapped to offset the initial onslaught of heat that can burn patients.

Today’s modern dialysis unit – at least the one where I receive treatment – has someone run the tap water until it’s hot then fill a plastic bag, tie it and wrap it in a towel. The only assurance they have that it’s not too hot is asking the patient.  That can be a little tricky when you’re dealing with diabetic patients who often suffer from neuropathy in legs and feet that leaves the patient unable to register things like pain or heat or cold. A large proportion of dialyis patients are diabetic. 

Back to my original point, isn’t this supposed to be about paitent comfort rather than convenience for the staff?

It’s difficult to run as many patients through treatment as the center does and they do a pretty remarkable job keeping patients at the top of priorities in a situation that can get a lot like herding cattle for branding, but from the patient’s view, things could be improved.

Just sayin’.

Another voice

I stumbled on another kidney dialysis journal/blog I think dialysis patients, staff, family and friends might enjoy.  Check out Jack’s Kidney Adventure.


January 17, 2008 - Posted by | diabetes, dialysis, fistula, health, kidney, renal diet, renal recipes, transplant, weight loss

1 Comment »

  1. Kathy,

    Thanks for the Blog. I am about a year behind you down the kidney failure road and it helps that someone is shining a light on what is ahead for me. It makes it less scary.


    Comment by SteveA | January 17, 2008 | Reply

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