Tuesday, November 22, 2005

More Surgery?

I have a lot to update everyone on, so today’s post might go a little long. This is just a warning in advance in case you don’t have a lot of time to read right now. You can always come back when you have more time … thanks to the Internet saving everything.

My treatment Saturday went well. Another four hours of dialysis with no problems. My heart rate at the end of the treatment was 120+ again, but they let me go home when I promised that I would see my cardiologist on Monday (which I did).

Monday afternoon, I saw my cardiologist. She rattled off a bunch of heart disease words that I was not familiar with about what might possibly be causing my racing pulse (both seated and after dialysis). She decided to take me off of Norvasc (which is for blood pressure) and to put me on Toprol (which is for blood pressure and also has the side effect of slowing the heart rate). She also gave me a 30-day heart monitor to watch my heart rate for the next month. The only bad thing about this thing is that I have to wear it and it’s not exactly the most comfortable thing I’ve ever had on. The monitor records your heart all day long, and then you transmit the results at the end of the day to the monitoring company. There is a button you can push when you have a problem so that it will be marked on the test.

Earlier on Monday, I saw my vascular surgeon to ask about my dialysis access flow rate. The last test at the clinic has my flow at around 330, but they really want it to be over 400. He did a sonogram on my arm, and saw exactly what the fistulagram earlier this month showed: that the vein in my upper arm is too small to support good dialysis. He did find another vein (above the elbow, but farther around the arm) that is large enough to support dialysis. He wants to do a second surgery to connect my fistula to that new vein. He wants to do this on Monday. I have dialysis tonight, so I will check with the doctor and see if he thinks that this surgery is a good idea. Doing surgery on my access will require that I have a temporary catheter put in my chest to facilitate dialysis while my fistula heals. (That is not a fun thing, from what I understand). So, I am going to check with the doctor and find out what he thinks, and if he says to go ahead with it, then I will be having another surgery on Monday (I’ll let you know what I find out).

Okay, to illustrate what is being proposed, I thought I would break out my camera phone and Microsoft Paint and give everyone an idea of what the surgeon wants to do.

This first picture is of my left arm (where the fistula is).


The next picture is the same image, with some lines and text put on it to help explain what you are seeing.



The blue line is about where my fistula is now (you can compare the two pictures for a better look; you can even see it in the upper picture once you know where to look). The green line is a larger vein in my upper arm. The yellow line is where the surgeon intends to cut me open and connect the fistula to the upper arm vein.

So, for prayer this week, here is what I have:

  • Pray that the cardiologist will be able to learn something from the heart monitor and that we will be able to do the best thing for my heart
  • Pray that whatever will be best for me (God’s will) will be decided about my fistula. I have desires, but I do not want them to get in the way of God’s will. I would prefer that whatever He wants done to my arm gets done.

Thanks!

1 comment:

Anonymous said...

Nathan,
Was sorry to hear your news. What you heard about the perm cath is right but somtimes it is necessary for some patients to receive dialysis that way. It will be placed in your chest. We have an office patient who is receiving a perm cath on Monday and will be starting dialysis on Tuesday. This patient has a fistula placed but it is not mature yet but he is pretty sick and needs to start dialysis. We try to prepare our office patients about a year before they need to start dialysis so that they can go to the options class @ the dialysis unit and get a fistula or graft placed so that they have time to prepare for needing dialysis and don't have to start with a perm cath. I was sad today because I now have two regular office procrit patients needing to start dialysis next week. I also had a favorite office patient start pd dialysis a few weeks ago. I have heard of the Toprol XL we have quite a few patients on that bp med as well as Norvasc. I will say a prayer for you Have a Happy Thanksgiving.
Barbara