D & d #2

Diabetes and Dialysis #2

Just got back from the first surgical consult to setup getting the "plumbing" installed so that I can start dialysis. The surgeon was one of those doctors that I generally really like talking to. He was very outgoing and loved to talk and crack jokes. That is usually right up my alley.

Now please don't get me wrong. I like this surgeon. At least it first impressions are any indication. But today I just wasn't into that. I have come to terms with the fact that I am going to have to have dialysis. I guess that I am still feeling the fear of the unknown.

There are three types/ways they can setup the access that will be needed to hooked up the dialyzer, the machine that will act as my kidneys for the rest of my life.

First is a good old fashion central line. This is an access that is exterior to the body and is put in the upper chest. I had to have a central line done once when I was in the hospital. It is no big deal really but the problem with that type of access is that with it being exterior to the body there is a much greater chance of infection. You have to keep a dressing over it and it must be kept dry (aka no showers). This type of access can be used immediately and is generally only used as a temporary measure while one of the other methods is done or if they cannot do the other types of access for some reason.

Second is a graft. Incisions are made in the lower part of the non-dominant arm and a graft is placed that connects the artery in the lower arm to the vein. This type of access is below the skin so there is a lower chance of infection. It can be used in about two weeks. The down side here is that it only lasts a couple of years and then has to be redone. There is also a much greater risk of developing clots.

Lastly is the fistula. In this type of access an incision is made similar to the one made for the graft only in this case the artery and vein are actually stitched together. This type of access is also beneath the skin and is the type of access that is preferred. Less chance of clotting and the fistula access lasts for many years. The problem here is that is takes about twelve weeks for the fistula to "mature" and strengthen to the point that it can be used.

I have decided to get the fistula done and if I must get dialysis treatments before the access is ready then I will have to get the exterior access installed temporarily.

The next step is an ultrasound on the veins and arteries in my right arm to see if I have enough flow for the fistula to work. That procedure is scheduled for next Monday.

I have still had no one tell me that I need to change my diet or fluid intake. I have read some on it and it does concern me some. One of the big things is that orange juice is not allowed and I love me some oj. That is my treatment of choice for a low BG. Guess now I either use another juice (if allowed) or I used the tablets.

So the dialysis car is in gear and the trip has started. If I said I wasn't scared and worried I would be lying to you and to myself. I am a bundle of nerves at the moment.

Thank you for sharing your journey with us. My thoughts and prayers are with you and I'm sending you as many feel good vibes and as much strength as I can muster. I think many of us worry about our kidneys and will be right here with you through this ride. Take care.

I am sorry to hear that. We all would like to grab you and run away as fast as we can. You are in my thoughts.

A new trip; a new life for sure. I hope that we here at TuD can help to make it all a little easier for you. As I wish for a lot of advancements in treatment in diabetes (or a cure!), so do I hope and wish for advancements in your situation. My best to you and your family.

You will have many new decisions to make regarding the dialysis. My thoughts are with you and hope you take a deep breath and take it one step at a time. Remember we are always here to listen to your rant whenever you have one. Cat

Thanks for keeping me informed Sparky, This is going to be most challening but as we know in our private messages I am there for you each and every day. That is what we do for friends. It was interesting to read your summation as I did not know all of that. Take good care my friend,Reed

Sparkey - you have an excellent grasp on this. Knowledge is power.
Since my kidney failure was acute, I had an immediate insertion of the external catheter. It wasn't too bad, but the docs were always on the lookout for infection because it leads directly to your heart. I was told to report even the slightest fever. And yes, the sponge baths got tiresome.
A couple of months later I had the ultrasounds for them to look for good vessels to hook up for the fistula. The surgery was day surgery and I sailed through it. For some reason, however, it took 7 months for the fistula to mature.
I'm assuming that when the time comes for you to make dietary modifications, someone will tell you. Everyone is different, but yes, potassium is generally restricted. Usually orange and bananas. But you can have lot of other fruit like berries, apples, pears, grapes, etc. And apple or grape juice can be used for hypo. Once you start dialysis, they will do labs every month and the dietician will then go over the results and talk about dietary modifications. The dietician at my unit was extremely understanding and non judgmental. I just loved her.
Sparky, I clearly remember how frightened and confused I was when I started dialyis, and I could see those feelings on new patients who came to the unit.
But I sense you are strong at heart and have a good attitude.
We are here for you. TD is an amazingly supportive community and I'm glad you found us. Message me at any time you need to unload.

OMG Sparky I didn't know that u were going to get dyaisls. (Here I was gone for about 2 weeks with my poor self) I hope everything works out for u and if u need to talk I'm always here.

Thanks for sharing your story. Usually they have you restrict citrus (oranges, OJ, grapefruit, etc) with kidney failure because of the potassium. Potassium usually is excreted through the urine by the kidneys and is at risk of building up in your system when that isn't working the way it should. When your potassium is too high, it can affect the way your heart beats, which can be dangerous.

You do seem to have a really good level of knowledge about dialysis, which will definitely be invaluable to you as you start your journey. Best of luck to you and please keep sharing your story. Thanks!