Tuesday, April 25, 2006

Two Weeks Later: An Update

Hello everyone! I know what you are thinking. It has been nearly two weeks since I have posted to my blog. Just so you know, I have not died, so you don’t need to delete your bookmarks just yet. I have been extremely busy at work, and I’ve had my share of ups and downs with dialysis, so it’s been quite eventful. I will try to summarize the goings on today.

The last time you heard from me was on Wednesday, April 12. I had spent three hours (overnight) in the emergency room thanks to a terrible dialysis treatment. I was dehydrated, feverish, and nauseated (which is not a good combination). They treated me and sent me home. The ER doctor said that he really didn’t know what was wrong with me and was sorry that he could not help more.

On Thursday, April 13, I had another treatment. It went much better. We upped my dry weight from 69.0 kg to 69.5 kg, which seemed to help quite a bit. My heart rate was still higher than it should have been after my treatment, but I think that had a lot to do with my medication being wrong. When I stood up at the end of my treatment, at about 8:45, I had a blood pressure of 88/55 with a pulse of 151. They kept me for observation for almost an hour. They gave me some water and had me sit back down. When I left around 9:30, my blood pressure had gone up to 127/60 with a pulse of 104 (while seated) and a blood pressure of 90/51 with a pulse of 135 (while standing). I promised that I would go to the ER if there were any problems, and I assured them that I had a cardiology appointment the next day.

On Friday, April 14, I had an appointment with my cardiologist. I brought her a list of my blood pressures at dialysis, which showed that my pressure was low with a high heart rate at the end of my treatment (ever since I had stopped taking Toprol XL about two weeks earlier). So, my cardiologist changed my blood pressure medications, again. She told me to stop taking my 5 mg per day of Norvasc. She said to reduce my 320 mg per day of Diovan down to 160 mg per day. She also added in 25 mg per day of Toprol XL. In addition, she set me up with a 30-day event monitor to watch my heart for the next month to make sure I am not having any “real” problems. The heart monitor isn’t difficult, it just makes showering that much harder.

So, my dialysis on Saturday, April 15, went a lot better. My pulse was still in the 100’s when I left, but since it was not in the 150’s, so they were not as worried about me. The treatment on the 18th (Tuesday) went well, as did the Thursday treatment (April 20). The next problem I had, with dialysis, was on Saturday.

On Saturday, April 22, my chest hurt around my catheter all day long. Every time I moved my arm, or used the muscles in my chest, I had shooting pain go from the catheter out towards my sternum. I thought it might not be so good, so I decided to complain at dialysis. I went to dialysis, and they cleaned the catheter insertion point like they always do. While the nurse did this, I mentioned how much it hurt for her to touch it or for me to even use those chest muscles. She told me that there was not redness, swelling, or pus, so I should not worry about it. I told her that it still hurts, even if it doesn’t look like it.

At the end of the treatment, the nurse did quite a bit of tugging on the catheter tubes while unhooking me. This was very unpleasant (as you might imagine). I winced and decided to give it a few minutes to get better. I took some Tylenol when I got home, but my chest was still bothering me. I called the insurance company 24-hour, toll-free nurse line and gave them my symptoms. The phone-a-nurse said I should probably go to the ER, even though she didn’t think there was a problem. It’s one of those “better safe than sorry” policies that you are always glad exist when you DO have a problem.

Jenny and I went back to the emergency room (this time, it was only about 10:00 pm). The nurse at the registration desk was the same one who checked me in last time, so she moved me into a room within about 15 minutes, even though I told her that my chest pain was NOT heart related. I laughed when I saw the doctor, because he was the same doctor that I had seen a week before that didn’t know what my problem was with my elevated temperature and blood pressure. This week, he ordered an x-ray and had me sit for a while. When he came back, he told me that he was again dumb-founded. I had presented him with symptoms that he could not quantify, and he said to take some pain medication and get some sleep. I told him that I would try not to come back next week with yet another impossible problem.

That pretty much catches you up to today. I’ve got a few more updates, but I think I will wait and try and get those posted tomorrow so that this post doesn’t go too much longer. Look forward to a riveting account of my visit with my vascular surgeon, my endocrinologist, my April Lab Reports, and hopefully a fistula update.
Thanks for bearing with my long absence and long post. Enjoy your day!
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