Monday, July 30, 2012

30 July 2012

Alright...

A few details are in order, so here you are...

-After nine dialysis treatments I am still not at my dry weight. My legs continue to cramp if too much water is removed at any one time. My last weigh-out on Saturday was 104.3kg's (229.5 lbs) after having had 1.2 kg's water weight removed.

-The after effects of dialysis are still hitting me pretty hard. Typically, my day goes like this:
   545a--Dialysis
   1015a--Leave Davita dialysis center, get some early lunch.
   1200p--Sleep
   400p--Awaken very groggy. Stay that way until about 930p, then begin to feel somewhat "normal." Remain sleepy until I go to bed around midnight.

Sounds like fun, doesn't it?

The next day--my "off" day--is usually a mix of feeling better, then slowly (or quickly) crashing sometime during the day. If I have things that I would like to do, I get to them earlier so that I actually get stuff accomplished.
By the evening my strength and energy are gone, and I spend the rest of the day feeling lousy.  Even more fun!

-As I stated in my last entry, my appetite is indeed up. However, that thought is tempered with a couple of things. First, I am snacking very little during the day. Second, I usually either eat two very small meals, or just one larger meal during the day. Though I do have hunger pangs, the total; food intake for a day is about three cups.
Additionally, my liquid intake has dropped significantly. Where before I was taking in between 40-60 oz of fluids per day, I am now ingesting about 25-35 oz's per day. I am almost never thirsty now, and find myself sipping more than actually drinking.  Like I've already stated, this is not unexpected. As my kidney function drops, so too will my total fluid intake and subsequent urine flow.

-I stopped taking the med my neurologist prescribed because I was continuously dizzy on it...and I hadn't yet even reached the therapeutic dosage! No way I am going to voluntarily put myself through 24 hour a day dizziness.

-I've had a total of two shots thus far at the dialysis center: Pneumonia and Hepatitis B. Plus, I've had a redundant TB (Tuberculosis) test, as well. I still have a number of inoculations to receive in order to get on the transplant list.

-I already told you that the dialysis center is trying to establish button holes in my fistula. Well, on Saturday, there was a problem. The distal site (nearest the hand) was canulated just fine. However, the proximal site (nearest the trunk) was not so luck. The tech administering the stick--the canulation--infiltrated the wall of the fistula into the surrounding tissue. An unknown amount of blood and heparin--used to flush the line--escaped into my arm. A nice hematoma developed where the infiltration occurred.
I immediately knew something was wrong when the tech began flushing the line. I had a painful pressure develop in my lower arm that was increased as fluid was moved in or out.
The tech got the supervisor.
The canulation site was sealed with direct pressure, and a second site distal to that one was canulated. This one had zero problems.
Lucky for me I knew something was wrong. I only had relatively minor compartmental intrusion. I will only have a nasty bruise around the site. Had I not discovered the infiltration, I could have had a really bad compartmental bleed; which would have been really, REALLY not good.
So, for anyone out there who feels as if something isn't right, speak up immediately! You might just be saving yourself from some very unpleasant things.

I think I wrote everything I was thinking of.

I will continue to try to be better about writing on my off days so this information is fresher on my mind.

Good Health to All!

ScottW


...and now...Pictures!

(Receiving a Lidocain injection at the distal canulation site. 28 July 2012
Notice the numerous canulation sites along the fistula.)



(Canulation of the fistula at the distal site using a 15 Gauge needle. 28 July 2012)



(Canulation of the proximal site. This is the one that missed! 28 July 2012) 

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