I know... I know... its been a while since you've heard from me, right? Well its not like I've been too lazy to write or anything. Its been more or less by design that we haven't had an entry into my little wimpy kidney blog. You see over the last two months there's really been nothing to report... I wake up every day and go about my business like anyone else except that on Mondays, Wednesdays and Fridays I spend four hours in a dialysis chair with a couple of needles in my arm. Oh there's an occasional issue like a needle that hits a nerve on the way in or an infiltrate (that's when they miss the target and my arm swells up and bruises) but you guys don't really want to hear about all that do you?
I suppose I could tell you about how anything that gets me excited or passionate like a conversation at work or even typing a blog entry seems to kick my uremia into effect and turns me into a Michael J. Fox. More than one person at works has worried that something was wrong with me during a heated conversation. This used to get me a little sympathy as it must be unsettling to watch someone vibrate as they're standing their ground on an issue, but now that everyone has caught on that its just a symptom of the uremia its business as usual.
But the real reason I'm writing an entry today is that I'm on the recovering end of a procedure that I had earlier this morning on my fistula arm. For those just catching up here.. a fistula was added to my arm in June of this year to create a sort of super vein in my arm that is used by my dialysis center for access to my blood which literally gets removed and replaced after passing through a filter. I suppose its a little more complicated than that but that will do for now, right?
So this morning's procedure is the result of some recent issues at dialysis. When I first started dialysis I was using a catheter in my chest while the fistula was maturing (turning my normal vein into that super vein I had mentioned). Then they started using the fistula with size 17 needles eventually increasing the size to 16 and with the intention of of increasing them to size 15. This takes time but by now they should have been able to get me on 15s, which would increase the flow at which they could run the machine that pulls my blood.
As mentioned in an earlier post I'm allergic to heparin, which is a product they use to help prevent the blood from clotting while its out of the body. Since they can't use heparin with me they need that blood flow to be as fast as possible.
More recently they felt the super vein just wasn't doing as good a job as they were expecting, especially considering that its so straight and pulses quite nicely (enter dirty joke here). So they asked me to have it looked at. Last week I saw my fistula-ologist... (there is no such thing.. I just made that word up) and he noticed two things. One was a pinch point near the fistula which reduced my generally 8 mm vein to 3 mm. The other was a tangential vein that was riding the coat tails of my super vein... this tends to happen with veins in the area of the fistula... they all take advantage of the increased flow of blood and start growing to support that flow.
Between the pinch point and the secondary super vein being formed the flow was being prevented and stolen from the access vein and this was preventing them from increasing those needles and getting more flow. So this morning my doctor cut open my arm and removed the section of vein that wasn't necessary and while he had my arm open he discovered a third and removed it as well. Then he opened up my arm above the fistula and sliced it open, then sliced a piece of my own vein that had been removed and stitched it onto the super vein. This will allow the pinch point to open up and provide better flow and will prevent the two coat tail riding veins from stealing flow from the access vein.
The whole process took about 2-3 hours and another hour or so of recovery and we were out the door and on our way home. I may have lied a little when I told the nurse that I was feeling fine... I was feeling hungry and wanted to leave so we could go eat. I was craving oatmeal but it was approaching noon and no one was going to have oatmeal so we decided to go with Meg's craving for a french dip sandwich and we ended up at Joe's American Bar & Grill.
Meg ordered the French dip style prime rib sandwich and I ordered the overpriced meatloaf and we ordered a couple of Arnold Palmers. The drinks came and I had a few sips.. it wasn't particularly great... but it was at least something in my stomach, having not been able to eat since dinner last night. Alas.. a strange sensation followed those few sips. I stepped outside for a breath of fresh air. I came back in a few minutes later and could tell I wasn't going to last much longer. It probably didn't help that I had taken a pain killer just before leaving the hospital. I was going down and there was nothing that I could do about it. I tried to play it off as if it would be okay but Meg saw right through my thin veil.
My phone rang. It was a work colleague calling with an issue. I stepped out again to talk to him and by the time I came back in Meg was walking out... she had cancelled our order and decided to get me home. Thank goodness the nurse had set us up with a special bag... just in case... because two minutes later "in case" happened right there in the car.
At home I was making my way to bed and the phone rang again. I was talking to my colleague again as round two hit... "sorry Steve I'll have to call you BAAAAAAAAAAAAAAAAAAAA." Thank goodness I had that bucket handy.
My name is Bil... and I have kidney disease
