11 July 2012--First Dialysis

Well, my first day of dialysis is done. I cannot say that I was not apprehensive--because I most certainly was--but it went fairly well. Let's get started talking about it...

My dialyzing time is 545a (I know...eeewwww!).

The first thing I had to do was paperwork. LOTS of paperwork. You just have to sign your name to various agreements, understandings, etc in addition to normal things like insurance, medical Hx, etc.

After that, I am required to weigh myself upon entering the dialysis center. In this case, the center uses Kg's rather than pounds. My "Wet Weight" as they call it is 108.8kg's (239.36 lbs).

I print out my weight from the in-floor scale, then hand it to a nurse, and then go to my assigned chair/recliner--very comfy, by the way.

At the chairs my pulse and BP are taken both standing, then sitting.

The nurse then lays out supplies for a blood draw and cannulation of the fistula.

(My arm and supplies 6/10/12)

The nurse went on to educate me in great depth about everything that would be happening. The more you know the more relaxed you will be in the middle of all of this. Remember, if you don't understand something, ask the nurse! It is within your rights as a patient to have all the info you want about what you are going through!

My dialyzing time for the first treatment will be three hours. Subsequent treatment durations will increase until I reach my optimal dialyzing time period.

First thing...Cannulation of the fistula. I was poked with a 16 gauge needle on this day, but that will increase to a 15 or even a 14 gauge for the remainder of my treatments. Following cannulation of both needles (one for outtake, one for input), the sites are secured, and labs are drawn. (I'll have the results on Thursday).

(My arm post-cannulation 6/10/12)

(My arm post-cannulation ready for labs to be drawn 6/10/12)

Next, tubing is hooked into the dialyzing machine.

(My arm and blood going to and coming from the dialysis machine 6/10/12)

(Dialysis Machine  with my blood. The dialyzer--filter membrane--is the vertical tube to the R)

After I am on the machine, a nurse checks on me regularly. My BP is taken automatically every 30 minutes. Additionally, the nurse asks me several questions which you must answer honestly.

No being brave or stoic here!

These questions are along the line of 'How are you feeling? Do you have any questions or concerns? Are you having any leg cramps? Do you need anything?'

After all of this, you just sit/lay there.

(Me in my first dialysis treatment 6/10/12)

Remember what I was telling you about the pillow, blanket and slippers? Well, the room is so cool that you need to cover up and get comfy! (Yes, the lime green pillow was my idea...I knew it would clash loudly with my purple blanket!)

While dialyzing you must keep the cannulation sites visible to the nursing staff. That way they can easily see if there is an issue with the needles or tubing.

By the way, in dialysis, the cannulation needles stay in your arm, so it is vital that you avoid any unnecessary arm movements because one poke through the fistula wall will result in a nasty compartmental bleed...You don't want that to happen!

About an hour and a half into my treatment I began to have muscle cramps in both calves. The nurse happened by right then and I told her about the cramps. She stretched and compressed the calves on both legs trying to get them to relax. That didn't work, and the R calf became really painful. The nurse infused 400cc's of saline into the return tube, and put my feet down so I could press my feet into the floor. Between both, the calves settled down. They remained sore, but the cramping stopped.

I also noted a discoloration of the arm veins proximal to the cannulation sites and asked the nurse about it. She stated it was normal, and was a result of the fistula trying to compensate for the blood being removed from my body.

 There was nothing to worry about.

While I was dialyzing the clinic Charge Nurse came to talk to me about several things. Mostly more education about the whole process. I was also given a TB test (Tuberculosis), and was informed that I would be receiving inoculations for Influenza, Pneumonia and Hepatitis C. If I want a transplant, I must have these inoculations.

My Nephrologist also dropped by to see how I was doing. He told me I no longer have to take the diuretic--bye-bye Bumex!--because of the dialysis. No arguments from me.

When my time was up the nurse took my BP (standing and sitting) both while on the dialyzer, and then while off of it. She then removed the needles from mjy fistula.

The cannulation sites were tightly taped down to prevent leakage.

(My arm after cannulation needles were removed 6/10/12)

I was instructed that the bandages must stay in place at least four hours. If bleeding still occurs, re-tape the sites and check on them every couple of hours. If severe bleeding happens, occlude the sites with your hand and call 9-1-1. I had the proximal site bleed significantly when I removed the bandages, and I taped it secure once again.

Lastly, I was weighed once again (107.7kg's, or 236.94 lbs...a loss of about 2.33 pounds), given instructions for things to be aware of after my initial Tx, then sent on my way. The dialysis center recommends you use a wheelchair to get to the vehicle you are riding in just in case you have any dizziness...I walked. I felt OK.

As expected the dialysis left me quite exhausted. I spent the remainder of the day dozing on and off, and feeling as if I were in a hazy fog. Around 830p I finally became mostly lucid and was able to think clearly for the rest of the evening.

On the downside, I had a nasty headache. It was incredibly intense and took three t3's to get under control. I don't know if this is a one-time thing--let's hope it is! Just an awful headache. I haven't felt a headache like that since my TMD was out of control. On a scale of 1-10, that was a solid 15+. No kidding.

On waking today my energy was up a fraction, the headache was reduced and I felt sort of clear headed. My calves both ache painfully today, and walking only exacerbates the issue. I have nothing else to report about in regards to the dialysis.

So there you have it, folks! The first of many dialysis treatments to come. My schedule will continue to be every Tues-Thurs-Sat at 545a. If anything new comes up I will certainly pass it along.

Good Health to All!

ScottW