On my way to Radiology I actually saw my Vascular Surgeon in the hallway. He later told me that when he saw me there he thought to himself, "Hmm. This can't be good." He also to me to call his office if needed.
Well, I was about to do the procedure when the Radiology physician learned that I was allergic top the contrast dye and immediately cancelled the attempt as they were not equipped to deal with this contingency.
By this time my wife was with me and took me over to the office of my Vascular Surgeon. I saw him, again, in short order, and he sent me back to Day Surgery so we could unclog the graft.
The whole check-in and pre-surgery thing was hectic as I was needing dialysis. The chaos around me reminded me of my paramedic days. The best way to describe the madness is "Organized Chaos." Just like a major trauma call, or an ER scene when a severe trauma case comes in and every is chaotically doing their jobs, talking over each other, instructions given, IV's inserted, blood drawn, patient prepped for surgery amidst everything...
So, within ten minutes of checking in, I was ready for surgery. Unfortunately (once again), the whole contrast dye allergy thing came up and forced my surgeon to only insert another chest catheter so I could get my dialysis treatment that day; which I did once released from the hospital. I was scheduled to do the graft thing on Monday, 02 May. In the meantime, I had my usual Saturday dialysis session, then ran a short course of Prednisone (a Parabolic steroid generally used as an anti-inflammatory) on Sunday night and early Monday.
Once Monday arrived my wife and I showed up at Day Surgery again ready to do the graft procedure. We were ready and waiting in the pre-surgery when I was told that my Potassium level was far to high. Apparently, I had a nasty spike in my K+ and was charted at 7.70--2.50 over the top end of the acceptable level. So, the surgery was off. Instead I was admitted to the hospital so I could do a session of in-house dialysis using the K1 solution (to draw out additional potassium).
In the middle of everything that day, the entire hospital was going through the pains of a new paperless system that was implemented that day...which we already knew was happening, so we were expecting things to be slow. Everyone, nurses, techs, doctors, etc were all bogged down trying to input orders on the new system. It took over two hours just to get admitted to the hospital! Anyhow, the dialysis commenced with zero issues. I then had to be released from the hospital, which took another hour plus.
The next day was my normal Tuesday dialysis--again using the K1 solution--and later that evening, another course of Prednisone ahead of the surgery.
On Wednesday, 04 May, I was again at Pre-Op ready to have the graft worked on. My potassium was taken, and it had fallen to a terrific 4.6. Once I awoke from surgery, the Vascular Surgeon stated that things didn't go as planned. The Arterial side of the graft cleaned up nicely, but the venous side did not. He had to detach the venous side and replace it with a new tube that was also moved to just beside my elbow. This meant three new incisions on my arm instead of just one, and a longer healing time. Also, he had to use a small amount of contrast dye, so I had to do dialysis for the third day in a row to avoid any potential anaphylactic reactions from the contrast dye. That was fun.
Then on Thursday, I again had my regular dialysis treatment (Tx) making it four sessions in a row! Other than my ridiculously numerous dialysis sessions, I spent my time recovering from the surgery.
The following Wednesday,11 May, I met with my Vascular Surgeon for a post-op follow-up. Everything was great at that time. The bruit was excellent and the surgical sites looked healthy and free from any infections of irritations. Although still swollen (from the surgery) and still bruised, the arm is in great shape.
In the days since that appointment, I continue to recover. My arm is much better, but I still cannot lift more that about 5 pounds, and only for short periods. Anything more or longer and my arm weakens, starts to ache, and then turns painful. A few more weeks should see my arm stronger, with no swelling and decreased bruising.
So, hopefully around mid-June I will begin using the Artificial Graft once again. A week or two later I will have the chest tube pulled...again. I did learn a terrific bit of info to help the graft, which is that a slightly hypertensive patient has an easier time keeping the artificial graft open. So, I immediately increased my dry weight (currently at 99.5 Kg's--an increase of 6.0 Kg's!)
My body hasn't really enjoyed the much higher weight, but so far, I have no fluid in my lungs, no obvious swelling in my legs, arms or torso. My BP has stayed above 110 Systolic following each dialysis session, which is the minimum I need to attain to keep the graft flowing.
And there you have it...the latest in the long saga that the Phoenix trip has devolved into. If this graft fails, I am seriously considering just staying with the Central Line until I have my transplant. Especially when considering that my transplant is very likely to happen between this Fall and the end of the year.
What fun this has all been!
I will catch up with my regular blog in a few days, so be looking for that as well.
Until then...
Good Health to All!
ScottW
