on 22 January, I went in for either the Artificial Loop Graft, or a Basilic Vein Transposition. When speaking with the surgeon in pre-op, I mentioned two things:
1) The slow flow I was seeing in dialysis treatments of 200 of less (it should flow between 350-400). Right then my Vascular Surgeon decided to swap out the lumen for another one.
2) The area of the failed Bovine Vein graft was still swollen, deep purple in color and extremely sore. He said he'd also look at that before proceeding.
And that is how my surgery came to naught.
The lumen in my chest was swapped out, as planned. A good thing, too. My blood was clotting the lumen from the inside out. The surgeon stated that my clotting factor was naturally high, so this was not unexpected. Now, instead of my lumen being packed with Saline between dialysis sessions, it has Heparin, a blood thinner/anti-coagulant. And so far, since getting the new lumen, my flow is at 400 every time.
Upon examining the area of the last surgery, the surgeon found puss all over the site. He cleaned that up, the looked at the Bovine Vein itself and decided to remove the vein. After severing both ends, the vein slipped out without any real effort. This is because my body totally rejected the vein--for whatever reason--and had not integrated it at all.
So, because of the infection, the surgeon closed up mu arm, infused me with antibiotics, and concluded the surgery. Afterwards, I was put on a one week regimen of Ansef (antibiotic), then retested for infection about ten days later, which showed no infection. I really dodged a bullet on this one. The risk of systemic infection was extremely high, which could have jeopardized my standing on the Transplant List. As it was, because of the infection in my arm, I was placed on a soft hold on the Transplant List until cleared by my doctors--which has since happened. I had to do bloodwork verifying I was free of infection, supported by a letter from my surgeon, which was all faxed to my coordinator.
So, after all of this, I still must have another surgery. While looking at my arm, the Vascular Surgeon confirmed the next step, which will be done on 26 February. On that day, I will be receiving the Artificial Loop Graft in my lower R arm. While the Basilic Vein Transposition is still a viable option, my surgeon wants to save that in the event it is a needed access point down the road. In the meantime, the vasculature in my lower R arm can sustain the Artificial Loop Graft. There's something about the vasculature in my arm that is not normal, and inserting the loop graft will not compromise the blood flow to my hand which, of course, would be very bad; while also not compromising the vasculature needed for the Basilic Vein Transposition. It's an odd situation, and I'm not explaining it very well because I was still groggy from the surgery when it was explained to me.
Anyway, since 22 January, I've been recovering and growing stronger. Only today have I felt well enough, strong enough, to sit down and get this typed out for you.
I will do another entry before the next surgery; but this is all for today. We are getting the Phoenix debacle moving towards its end. It's taken a lot of time, and a lot of surgeries to come to its conclusion...but we're getting there.
Stay tuned...
Good Health to All!
ScottW
1) The slow flow I was seeing in dialysis treatments of 200 of less (it should flow between 350-400). Right then my Vascular Surgeon decided to swap out the lumen for another one.
2) The area of the failed Bovine Vein graft was still swollen, deep purple in color and extremely sore. He said he'd also look at that before proceeding.
And that is how my surgery came to naught.
The lumen in my chest was swapped out, as planned. A good thing, too. My blood was clotting the lumen from the inside out. The surgeon stated that my clotting factor was naturally high, so this was not unexpected. Now, instead of my lumen being packed with Saline between dialysis sessions, it has Heparin, a blood thinner/anti-coagulant. And so far, since getting the new lumen, my flow is at 400 every time.
Upon examining the area of the last surgery, the surgeon found puss all over the site. He cleaned that up, the looked at the Bovine Vein itself and decided to remove the vein. After severing both ends, the vein slipped out without any real effort. This is because my body totally rejected the vein--for whatever reason--and had not integrated it at all.
So, because of the infection, the surgeon closed up mu arm, infused me with antibiotics, and concluded the surgery. Afterwards, I was put on a one week regimen of Ansef (antibiotic), then retested for infection about ten days later, which showed no infection. I really dodged a bullet on this one. The risk of systemic infection was extremely high, which could have jeopardized my standing on the Transplant List. As it was, because of the infection in my arm, I was placed on a soft hold on the Transplant List until cleared by my doctors--which has since happened. I had to do bloodwork verifying I was free of infection, supported by a letter from my surgeon, which was all faxed to my coordinator.
So, after all of this, I still must have another surgery. While looking at my arm, the Vascular Surgeon confirmed the next step, which will be done on 26 February. On that day, I will be receiving the Artificial Loop Graft in my lower R arm. While the Basilic Vein Transposition is still a viable option, my surgeon wants to save that in the event it is a needed access point down the road. In the meantime, the vasculature in my lower R arm can sustain the Artificial Loop Graft. There's something about the vasculature in my arm that is not normal, and inserting the loop graft will not compromise the blood flow to my hand which, of course, would be very bad; while also not compromising the vasculature needed for the Basilic Vein Transposition. It's an odd situation, and I'm not explaining it very well because I was still groggy from the surgery when it was explained to me.
Anyway, since 22 January, I've been recovering and growing stronger. Only today have I felt well enough, strong enough, to sit down and get this typed out for you.
I will do another entry before the next surgery; but this is all for today. We are getting the Phoenix debacle moving towards its end. It's taken a lot of time, and a lot of surgeries to come to its conclusion...but we're getting there.
Stay tuned...
Good Health to All!
ScottW
