I hope that the photo I attached to this discussion goes at the end of the text. There might be some that would be freaked out over what happened to me at dialysis on Saturday.
They are using the dialysis access that is in my lower arm. Things have been going well for almost two weeks. Then…
They put the needles in the access and checked to make sure everything is okay. They draw some blood in an empty syringe and then push it back into the line to see if there is any swelling or pain. All felt great so connect the dialysis machine and away we go.
About 5 minutes into the treatment I feel something wrong in my arm. I get the nurse to come over and look at it and it appears that I have had an infiltration on the needle that returns the blood after it is treated. This means that the needle is not where it needs to be and my arm has started swelling some.
So we stop the treatment and the nurse puts one of those rubber band type tourniquets around my lower arm and right over top where the swelling was occurring. She wants to reposition the needle and try again but decides to run a “one-n-one” where the machine is connected to my are and to one of the catheter lines in my chest.
Normally this is connected so that they pull fro the catheter and return to my arm. Instead the nurse reverses that and tries to pull from the connection in my arm and return to the chest catheter.
Don’t work. Can’t get the flow from the arm connection so the nurse reverses the lines so that they are pulling from the catheter and returning to the arm.
We start the pump and my arm immediately starts swelling and hurting.
The picture shows the result. That is going to look really pretty for the next week. 2017-image.jpg (1.53 MB)
And the bruising that is going to keep coming up, is only going to get worse. Its going to take a month for all that blood in there to break down and dissolve. The fistula is still new, so people seem to have these infiltration problems at first for a while, what other dialysis patients have told me. I so feel bad for you baby.
Unfortunatly this will probably happen again. Getting the 2 big needles into the fistula, which is deep, is apparently not easy for many nurses. The vessel walls are not hardened and scarred yet, so they can infiltrate easily. Its easy to stick the needle in and go right through the other side. Sometimes, it will tear right where the needle is in under the pressure they are under. By the time the pain and swelling starts, quite a bit of fluid has infiltrated beyond the vessel, and the blood is being pumped back in by the machine. They have to use heparin to keep the needle from clotting, so its hard to stop the bleeding inside once they pull the needle out. We just hope the fistula isn't ruined by this happening. He still has the chest catheter they can use for access while its healing. He just wishes they could take it out so he can shower like normal people, but its going to be a few more months now, maybe longer
oh gosh Sparky,I'm so sorry you have to go through this. I mean, you have suffered enough, my friend. I know this has got to be painful. I am sending you baskets and bushels of hugs, love, and prayers for a speedy and complete healing.
Will they let you do your own needles? I was thinking of that about my ankle as I asked "can you shoot steroids into it or something like that?" and the doc said "eh, it's hard to get it into the right spot" but, since I am handy with needles, it occurred to me that I could put it into the right spot myself...
There is no way I am going to put those needles in myself. I don't like it when they do and I doubt that I would be much happier with myself. But you never say never right;)
Now that is doubtful Zoe. People that have ben doing this stuff still have the occassional problem. Usually it is from bleeding after they take the needles out because of the heprin. But I hear it does get easier the more they use the fistula. They do plan on trying to use it Thursday.
Well darlin', you have the one I had looking like a mosquito bite. So sorry, Sparky. Major suckage.
I know this would be tough, but would they consider doing a new fistula - maybe in the other arm? Perhaps it was the surgeon who screwed up. And, different techs have different skill levels.
My fistula was in the upper arm, right above the elbow crease.
Do you take blood thinners?
Dialysis is a big challenge in so many ways. It's tough for a regular person to comprehend all that must be endured.
Stay strong, my friend. We are family and here for you.
There was one guy on my run who did put the needles in himself, but he had been on dialysis for many years, and the fistula, I guess, forms some sort of scar tissue tunnel that the needle can slide through - like a pierced ear. But it takes a long long time for the tissue to toughen up. Those needles are like nails. No way would I ever have considered doing my own.
