Thursday Blogging

It’s Thursday, and it’s time to blog again. I haven’t filled anyone in since last week, so I need to keep the information up-to-date. As I told you last time, I found out my blood type is A Positive.

I got my thyroid function test results, and everything was normal. Everything has been normal for four or five months now, so the endocrinologist’s nurse said that if I would get tested again in October and in January, that I will not have to come back to see them. She told me to monitor my symptoms, and to be sure to call if I notice any problems.

My machine ran at 400 ml/min last Thursday using the 15-gauge needles. They tried to use them again on Saturday, but I had a slight infiltration. So, they had to use a 17-gauge needle for the upper needle in my arm, which meant that the machine could only run at 270 ml/min. Also, it left my arm kind of sore. Luckily, it has not bruised (as of almost a week later). It is still sore, but I can move it fully.

When I got home, I had low blood pressure and high heart rate, along with a fever of around 99.4. I felt bad for about an hour, and then decided to go to bed after it did not seem to get any worse. When I got up, I was feeling better, but I did not feel well most of the day at church. That’s probably due to the slower running of the machine.

Tuesday, they were able to use two 15-gauge needles again. The machine ran at 400 for the entire treatment without any problems. The only issue was that my heart rate was over 140 at the end of my treatment (when I stood up). The nurse had wanted to give me a hepatitis shot, but she decided not to, given my vital signs. They made me call Jenny to pick me up, though by the time she got there, I was fine enough to drive myself home.

I am hoping that today (Thursday) I will not have any problems. Maybe they will give me the hepatitis shot at the beginning of the treatment. Hopefully they will not have any problems sticking me with the 15-gauge needles. Hopefully I will not have any arterial or venous pressure alarms that make the machine have to slow down. And, hopefully at the end of my treatment, I will have a decent blood pressure and a decent heart rate when I stand up.

Well, I’ve got to go get stuck now. You all have a great day, and thanks for coming by!

A Positive Blood

I talked to my transplant coordinator earlier this week. She said that my status is back on (since I was placed on hold after having my gall bladder removed). I also asked her to verify my blood type, and she said that I am A POSITIVE.

I sent an e-mail to the remaining three potential donors in the Dallas area that had already had their blood work completed. I asked them to contact the transplant coordinator to set up testing appointments. I am hoping that she will be able to set up testing for all three of them so that we can find a match more quickly, but who knows. She may still want to do them one at a time.

I did not have a great treatment on Saturday. The machine ran slowly, and the charge nurse came by and told me I should consider moving up to the 15 gauge needles. I told her I would think about it. I went home at my dry weight (70.5 kg), but did not feel good with a very low blood pressure and a slight temperature. I stayed up for about two or three hours after my treatment waiting on my temp and pressure to even out. We ended up going to bed late, but at least we did not have to take a trip to the emergency room.

Tuesday, I did go ahead and use the 15-gauge needles. I have been using the 17-gauge needles for almost three weeks. I was hoping my fistula would behave before moving up, but the machine does not seem to like the smaller needles with my vein. The 15-gauge treatment went well. I had them only take me down to 71.0 kg, so I think that helped me feel better. I have also stopped taking one of my blood pressure medications to see if I can get my blood pressure to even out a bit. I guess I will find out at tonight’s treatment.

So, I am on 15-gauge needles now, which is good. The machine ran at 350 ml/min on Tuesday, and I think they are going to try the full 400 ml/min today. 400 is the rate that they prefer to go. I think the machine can run faster, but they don’t normally do that.

I have to ask for my thyroid function test results today so that I can send them to my endocrinologist. I have an appointment with him on Monday, and I’d like it to be the last one I have. I think my function has leveled out (according to my results) so I should not need to see him anymore.

Please pray for the potential kidney donors. Pray that their tests will be scheduled easily and that they right person will be found to be a donor. Thanks for coming by!

After My Vacation

Hello everyone. I realize that my last post was eight days ago, but I have not been around much. Last weekend, Jenny and I took a short trip to Arlington to celebrate our 2nd wedding anniversary. We had a good time, but I did not do any computing while we were gone, so I am a little behind on my blog. I have several updates to make, and hopefully I will not forget any of them.

I went to the nephrologist’s office after work on Friday, July 14. He took out the chest catheter and bandaged me up. This catheter had been in since March 24 (almost four months). They used it off and on, and even cleaned it out once. I am glad to be finally rid of it. I can now take showers (like a normal person) and sleep on my stomach again.

Like I said, we went out of town over the weekend. I had a dialysis treatment on Saturday, which wasn’t all that bad. The technician that I got on Tuesday was new (to me). Since I have not had a lot of success recently with my needle sticks, I figured it would be okay to let someone different have a shot at my arm and see if maybe she was better at sticking me. She was not. She had to go and get another technician to stick the arterial side of my access. I don’t think it was her problem. I have determined that there is only really one or two technicians that can consistently find my arterial access.

Saturday’s treatment had lots of struggles. So did Tuesday this week. I got a decent stick, but the machine didn’t seem to like it. According to the technicians, there is not quite enough stickable area on the fistula. They have to stay one inch away from the surgical site (on both ends) and try to keep the needles from being too close together. This is difficult, as the entire fistula is only about 4 or 5 inches long. It is also slightly curved, which leaves less spots in which to insert the needles. Fortunately, someone has been able to find a spot to go in each treatment so that I can be dialyzed.

Thursday’s treatment went fairly well. I got a quick, easy stick, and the machine ran at 300 ml/min for most of the treatment (and at 290 ml/min the rest of the time). My thought is that if I can get six good treatments in a row (no machine problems, and little to no sticking problems) that I will move from 17- to 16-gauge needles. The larger needles give a better treatment, but I do not want to try and use something larger until I can get the little needles to work properly.

In other news, I have been working with the financial department at Baylor to figure out who is going to pay for my father’s transplant evaluation. It turns out that the paperwork was initially misfiled, but that the current balance is $0. This is good news, and it means that I can contact my other donors and get them started. So, if you see my name pop up on your caller ID, then it’s time. I haven’t decided if I am going to do one donor, or have all three of the people that live in town and completed their paperwork to go at the same time. I might try that, just to confuse everyone. It should be fun.

Aside from that, I have nothing too interesting to report. I have an appointment with the endocrinologist on July 31. I don’t think I will have to go back to see him after that. My TSH levels have been normal for nearly a year now, so I think my thyroid problems have subsided. It would be nice to have one less doctor to keep up with. Maybe I should try and schedule a neurology appointment and get rid of her, as well. I haven’t had any stroke problems in over a year, and maybe she can reduce some of the medications she prescribed. I’ll have to get on that one.

I have a few prayer requests for you to consider:

• Pray that the technician at dialysis will get a good stick that works well for the next several treatments(by works well, I want the machine to run at 300 ml/min and to not have arterial alarms caused by being unable to pull my blood)


• Pray that we will find the right person with the right kidney at the right time to be a donor for me

I am currently searching my records to find out what my blood type is. When I get it, I will let you know. I have had many people as me about this, and I wanted to be able to give the right answer.

Back from Arkansas

Hi, everybody. I am back from my trip to Arkansas, and I thought I’d share some stories with you. I traveled to Fort Smith, Arkansas, last Friday night for my 10-year high school reunion. I called the Fort Smith dialysis clinic, seeking a spot for possibly Saturday morning. I was told that they had no open chairs in any shift all weekend. So, I called Poteau, Oklahoma, and they opened up a spot for me on Friday night. I went to the clinic, and was the only one there. They nice people in Poteau opened up their clinic just for me so that I would be able to attend my reunion.

My treatment went fairly well. They Poteau clinic did things a little differently. First, they measured your weight in pounds instead of kilograms. That meant they had to convert your difference to kilograms to input into the machine (which seemed odd, since their scale worked in kilograms). I just took my kg weight and subtracted my dry weight for a good UF removal. The other difference in treatments was how they administer heparin. At my clinic, I get 6700 units at the beginning of my treatment. In Poteau, they like to give some at the beginning, and then a little more during the treatment later on. Unfortunately, they didn’t give enough on the later shots, so my blood ended up clotting in the machine with 10 minutes left on my treatment. They returned as much as they could, but I ended up being a half kilo under weight (due to unreturned blood). That left me a little light-headed, but overall, it was a good treatment.

I was really happy that the clinic opened up for me. They didn’t have any other patients and did not have to stay open, but they did. They also told me that the Fort Smith clinic almost never opens up a seat for travelers. I think I’ll have to call one of the nephrologists in Fort Smith the next time I go back to see if they can get me a spot. So, Jenny and I went to the reunion activities on Saturday and had a pretty good time. I saw several people that I had not talked to in 10 years, and we had some e-mail exchanges, so I should be able to keep in touch with them at least for a while.

On Sunday, we went to church with my mom. I was able to talk to many, many people that have been praying for me. It was really heartening to see all these people that have been praying for God to help me be healthy again. I am thankful for such a wide group of people that lift me up. Thank you to anyone that has been praying for me.

I think I probably will have put on a lot of fluid weight over the weekend (since I will go four days between treatments instead of two). I suppose I will have the clinic take off 3500 ml per treatment until I get back down to my dry weight. The bonus of that is that I will not get dehydrated during dialysis this week!

The nephrologist did not come to the clinic last week. I need to ask him this week to write an order to remove my catheter. They haven’t used it in several weeks, and it is an easy way to get an infection, so I want it removed. The doctor has to order it, but I hope he can do it soon. I also have to get my TSH blood work results back so that I can send them to the endocrinologist. They are checking my TSH levels to make sure my thyroid is working normally again (as it is supposed to). I just have to get the results and send them to the endocrinologist, since the dialysis clinic can’t seem to do that.

Please pray this week that my treatments will all go well and that I won’t end up at the hospital. Pray that the doctor is able to get me in to have my catheter removed soon. And, pray that I can talk to the insurance company and figure out the payments for transplant testing.

By the way, today is my 2nd wedding anniversary! Thanks for reading.

April 2006 Lab Reports and More

As promised on Tuesday, I am bringing the rest of my long-overdue update. I apologize for the wait, but I have been quite busy at work and at home, so I haven’t had a lot of time for blogging recently. I will try to be better about it in the future (isn’t that what they all say?).

• ALBUMIN: 4.3 (goal is 3.8 to 4.5)My albumin (blood protein) is normal.


• POTASSIUM: 4.3 (goal is 3.5 to 6)My potassium level is normal. I am doing a good job with the potassium in my diet.


• CORRECTED CALCIUM: 8.7 (Goal is 8.4 to 9.5)My corrected calcium is normal.


• PHOSPHORUS: 6.6 (Goal is 3.5 to 5.5)My phosphorus is high (up from 4.3 last month). The dietician recommended that I watch my diet and make sure to take my phosphorus binders with all meals and snacks.


• HEMOGLOBIN: 11.2 (Goal is 11 to 12)My hemoglobin is normal, and my anemia is under control.


• AVERAGE FLUID WEIGHT GAIN: 2.31 kg or 3.3% (goal is 3 – 5 % of dry weight unless you have sign and symptoms of fluid overload).This is Acceptable.


• HEMOGLOBIN A1C: 4.9 (Goal is less than 7.5) My hemoglobin A1C is well-controlled. This means that my average glucose (blood sugar) has been normal for the last three months.


• PTH: 415.6 (Goal is 100 – 300)The parathyroid hormone is too active. This means that I started receiving Hecetor (Vitamin D) during dialysis.

So, the lab report was not all good news like it normally is. My phosphorus was way up, which is not a good thing. Too much phosphorus can make your bones brittle. The other problem was the parathyroid hormone, which I have no control over. Hopefully the Vitamin D that they inject into my blood each week will help balance that number out. The only negative side effect is that it can cause your phosphorus to go up. I guess I’ll find out in May how I did with my diet and see if I can get off of that Vitamin D shot.

On Monday, April 24, I went to see the endocrinologist. I actually just saw a nurse practitioner who wrote me three prescriptions for blood work to be drawn at dialysis. They want to see my thyroid hormone levels in April, June, and July, and then to follow-up with me after that. She said that since I have not been exhibiting any symptoms, that I am probably doing okay, but she needs to see the lab reports to make sure.

On Tuesday, April 25, I went to see my vascular surgeon to follow-up, one month later, on my new fistula surgery. He removed all the stitches (not so pleasant) and then ran an ultrasound over the fistula. He said that it looks like it is healing nicely and is developing at a good rate. He scheduled another appointment for one month later, and said not to use the fistula before then. I guess he will check it at the end of May to see if it is ready for dialysis. If so, then I can get off of the chest catheter, and I can go back to using a fistula like a normal dialysis patient. The fistula is a little easier to care for, and gives you a better treatment, so I ultimately want to get back to using a fistula.

I have had dialysis on Tuesday and Thursday this week already. The treatments have been going fine, right up until the very end. After I have finished my treatment and have been removed from the machine, they like to take one final blood pressure with you standing up. On Tuesday night, the pressure was only 93/61, and they wait about fifteen minutes for me to get up to 110/69. Thursday night, my pressure was 94/58, and they waited about ten minutes to get me up to 113/60. My standing blood pressure (at the end of dialysis) has been low since Tuesday, the 18th. I wish this would balance out so I could go home when dialysis is finished.

My gastroenterologist called this week. She thinks that my stomach-ache problems might be caused by my gall bladder. There is a test that can be run (inject a dye and watch it go) that will tell her if the gall bladder is the culprit responsible for my pain. I have this appointment scheduled for Monday.

Here are my prayer requests for today:

• Pray that the gall bladder scan goes well, and that the GI doctor will learn what she needs to learn to help me


• Pray that my blood pressure will get to where it needs to be at the end of my dialysis treatments


• Pray for my dad as he is being scheduled for testing as a kidney donor.

Thanks for coming by to read. I’ll try to be better about updating next week.

Friday, February 17, 2006

Well, I have not updated my blog in a while, so I think I am going to make myself do it. I have been quite busy at work this week (which is great). They have me working more on the stuff I enjoy doing rather than the data entry that got me in the door. I am enjoying my job more and more each day, and that is always nice when you do not have to be motivated to go to work.

The site where my catheter was removed has almost completely stopped hurting. It only bothers me now if I run into it with something. The shower does not hurt, and there are only two steri-strips left on it. They stick to the wound to hold it closed until you heal. They put them on my abdomen when I had my staples removed this summer. They stayed on about two weeks. I expect that these will be on about one more week.

I have an appointment with my endocrinologist on Monday. I am hoping that he will have looked at my lab results and decided that I am not doing badly. I hope that my thyroiditis will not require any further medications. I am still working with the cardiologist to try and fix my blood pressure. She has changed my hypertension medications every two weeks for the last six. She doubled my Diovan, then she added Norvasc, and this week she doubled my Toprol XL. Hopefully this last change will fix me so that I can know what I need to have prescribed.

Dialysis continues to go well. My fistula is working great (still). They should take another flow rate test next week to get a comparative reading. I don’t foresee any problems. I still have a strong thrill, and that’s a good thing. The thrill, for those of you who don’t know, is the feeling of blood rushing through the fistula. It is always supposed to be very easy to feel. Mine always has been strong, and now I can feel it in my elbow.

I am still having problems with my stomach. When I eat right after dialysis, I feel hot and sick for about 30 minutes. But, if I don’t eat, I feel hungry. So, which is better? Also, I get pain in my jaw for about a minute when I first start eating, but only right after dialysis. I have another appointment with the GI doctor next month, so I will ask her my stomach questions again.
You can continue to pray for my health and for the kidney donation process. I do not know when I should hear anything, but I am sure they will tell me when they are ready.

Thanks for reading!

Thyroiditis

I went and saw an endocrinologist on Thursday afternoon. He told me that I have what appears to be a simple inflammation of my thyroid. I guess this is not uncommon, and he made it seem like my kidney disease may have been the cause, though they could never tell for sure what caused it.

You might be asking, what does the thyroid gland do? Well, I went and searched for that answer, and found it at: http://www.bestdoctors.com/en/askadoctor/b/blum/mblum_061200_q1.htm
The gland produces a hormone -- thyroid hormone -- that regulates the metabolism of the body. That is, it influences the ways oxygen is utilized at a cellular level and in many of the body's organs.

This in turn is expressed in various ways, including effects on a person's body temperature, excitability and mood, pulse rate, digestive function and other processes which are required for the support of life.

So, my thyroid is sick (or, was sick). It got inflamed and spit out all of the hormone that it was holding. A normal thyroid gland will produce hormone, and store it until the body needs it. Then, it releases that hormone in a timely manner, and produces more to always have a full store. When the thyroid gets inflamed, it releases all of the hormone that it was storing into your blood stream. That causes your thyroid hormone level to be too high, and then the thyroid stops producing hormone. That is where I am right now. My level of hormone is too high, and my thyroid is producing almost no hormone to refill its stores, as it does not think that I need any more in my body. Once the levels in my blood stream go down, the thyroid will have to play catch-up to get my levels back to normal. This may involve my thyroid hormone level going up and down around the normal level for about one year until it is settled out.

I am supposed to get blood work done in January and February to check my hormone levels, and then go back to the endocrinologist to see if everything is working out the way he thought it would and to see if I will need any medication (in case my levels get too far out of sync).

I have received two comments recently that I would like to share with everyone:


http://nmccart.blogspot.com/2005/12/pre-transplant-orientation.html
At 6:18 AM, Joeski said...
I too have PKD, and found your site thru google's blog search. I went thru dialysis via the chest catheter for 10 months before I was transplanted. That was almost 4 years ago- yet your words make is seem like yesterday. This is the first post I have ready, so I will look back to see more of your story before I comment further.
At 11:17 AM, Joeski said...
I have just read your entire blog since yesterday. Your situation is very much like what I went thru before my transplant almost 4 years ago. I too have PKD. I had one kidney removed in 1995 that was as large as the ones you posted. My other one limped along until 2001, when it had to be removed also. Same size. I was only on dialysis for 10 months before a match came up. My blood type is B+. I live in the Richmond, VA area. The transplant is well worth the time and testing involved. I did not like dialysis at all. I was constantly fighting to get my dry weight increased, as I lost a lot of weight in the hospital while they tried to save my last kidney. I just want to wish you good luck, and you will be added to my prayers. Remember to thank your wife every day for the support. I would never have made it thru everything as well as I did without my wife's love.

It is good to hear from someone that also has PKD and has had a successful transplant. I have only been in dialysis for about five months, and I would love to be able to get a transplant that quickly. I am guessing that Joeski had a living donor (which is the best way to get a transplant, as far as I can tell). I’ve had the fights with getting my dry weight increased just 1.5 kg since I started at the clinic. I am also waiting for my fistula to heal so that they can go back to using it for dialysis. Thank you for your prayers, they are much appreciated. And, I am also very thankful for my wife. She provides me with physical and moral support on a daily basis. I do not know how I would be coping in all of this without her.


http://nmccart.blogspot.com/2005/12/perm-cath-placed.html
At 8:44 PM, Anonymous said...

I am 24 and have ESRD. I also have a catheter in my chest and have a fistula. I've had problems every dialysis session with the fistula, so I've been using the catheter for four months, which is how long I've been on dialysis. Good luck with everything.

For me, the dialysis in my fistula was going great (as far as I was concerned). My nephrologist was the one that said I needed to get it revised so that I could receive a better dialysis treatment. I am only hoping that once my fistula heals, it will work even better than before. I know that since this second surgery, I have been able to feel the thrill in my arm above my elbow, which is new for me. I do not enjoy my catheter, as it makes it hard to shower and to sleep. I imagine that they will leave it in for a while even after they start using my fistula, just so it will be there in case of any problems. Thank you for writing and for coming by to read my blog. I hope that my experiences have been helpful to you. Hopefully your dialysis will get better soon.


Okay, everyone, thank you for coming by to read today. I know that today’s post was a little longer than normal, but that just makes up for the last two posts which were really short. Thank you all for reading and for continuing to pray. Merry Christmas!! (though, I will probably post again between now and the 25th).

Still Going

I am continuing to have dialysis through the perm-cath in my chest. Saturday’s treatment went well, and I expect today’s treatment to be fine, too. I have said it already, but I much prefer the perm-cath in my chest to the temp-cath in my neck (yuck).

I have a call in to my doctor to ask about my thyroid. She said that I have thyroiditis (which is an inflammation of the thyroid gland). She said that she will have to get me in to an endocrinologist to get it looked at and to decide what needs to be done. I’m sure that it will be okay. At least the thyroid only controls just about every function in the body (boo).

Tomorrow is my transplant orientation meeting. I am going to find out about the transplant process, and I should get set up for my tests to help get me on the list. This is a very exciting time (everyone should cheer now). Hopefully it will be a quick process to get me tested and put on the list so that I can start the search for a kidney. All of you potential donors out there, get your driver’s license up to date!

I realize that today’s post is short, but I don’t have a lot to say. I guess that’s a good thing. There isn’t really any bad news. My fistula revision is healing nicely (I think). I go back to see the surgeon in a couple of weeks. Maybe I’ll start using the fistula again soon. Who knows?

Thanks for coming by!

Chest Catheter on Thursday

I finally have my procedure scheduled to have the temporary dialysis catheter removed from the right side of my neck and to have a new longer-term dialysis catheter placed in my chest. I am set to go in early Thursday morning to spend a half day sedated and to come out of the hospital with new and different tubes in my body. I know this sounds pretty exciting to you all, but I am actually pleased. The dialysis catheter in my neck is very difficult to deal with. I cannot get it wet, and it does not support a very good dialysis treatment. The machine has to run much slower than normal, and I cannot move (at all) for the entire four hours.

I also went to the hospital this morning for my “thyroid scan with uptake.” They radiologist gave me a radioactive iodine tablet, and wants to see me after four hours. I imagine that they are going to scan my thyroid to see how much iodine it has absorbed or possible used up. They told me not to consume any iodine for the next 24 hours. I also have to go back tomorrow morning to get a 24-hour reading on my thyroid. Hopefully, by my next update, I will have more information about my thyroid problems.

I have one more dialysis treatment tonight using the temporary catheter in my neck. I am not really looking forward to it, as it is a giant pain. I don’t like not being able to move, and my neck usually ends up hurting during most of the treatment due to staying perfectly still. I made it about two hours on Saturday before I was setting off the machine alarms every fifteen minutes. I guess I just can’t quite hold still for that long.

In other news, the surgery on my arm seems to be healing well. It is still a little swollen, but the bruising has gone down quite a bit. The stitches are starting to loosen up, and I am guessing that they will be gone in the next couple of weeks. The surgical scar itself seems like it is healing and staying clean, so that is good. I will be looking forward to when it does not hurt at all, as it still has some pain if I move it too much or too quickly.

Please pray for my procedure(s) on Thursday. Pray that it goes well and that there are no problems. Thanks!

Answering Blog Letters

It’s time once again to dip into the old blog mail-bag. I get comments from time to time (all of which are e-mailed to me so that I am sure to see them). However, I know that if you are just reading along through the blog on a regular basis, you may not get to see the comments. So, I am going to take a little time today to read and respond to the comments.

As for dialysis Thursday, all went well. My after-dialysis standing pulse was 129 (which is a little high). I am talking with the radiology department at the hospital about getting the catheter taken out of my neck and having a new one put into my chest. Julie (the scheduler) said that she may be able to squeeze me in as early as Wednesday, but I won’t know for sure until she calls me back (after confirming with the doctor exactly what he wants me to have).

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11/26/2005 at 1:05am, Stacy Without an E said…
I was searching for other Dialysis patients and I stumbled on your blog.I've been a Dialysis (I have to capitalize it or Dialysis gets angry) patient for the last 18 months. I'm using a graft (similar to the one you're scheduled for) that's over 10 years old.I wish you nothing but the best for your surgery. I have a venomous love-hate relationship with Dialysis, but lately it's been ok. The problem I have is related to pain issues.Sometimes it burns, but that's probably related to the graft's age. When I used it ten years ago I don't remember having any pain issues, so you shouldn't have anything to worry about.Good luck to you. Are you on the transplant list?

Thank you, Stacy, for taking the time to peruse the blog-o-sphere (I don’t think that should be a word). I am glad that you stumbled across my musings. Well, the fistula revision surgery went great. In fact, it's been about a day, and it hardly hurts at all.Now, I'm not pleased with the catheter in my neck (and I think it will soon be exchanged for a chest catheter), but I guess that its okay.As for the transplant list ... I’m working on it - another slow process I have to deal with. I have a meeting on December 14 that should get the official list-process started.

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11/28/2005 at 10:19am, Conservative Conservationist said …
I wish the best for you today, in your surgery.

The surgery itself went well. You can read the posts Update I and Update II for more information. Thank you for the well-wishes!

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12/01/2005 at 7:41pm, Barbara said …
Nathan,
I was so sorry to hear about your ordeal this week. I hope that you aren't mad at the rest of us in the medical field. I have a question did you make the appointment with the vascular surgeon or did your unit? You might want to ask your nephrologist to recommend another surgeon who treats patients better. The hospital sounded pretty crappy too. I understand that each hospital and states have different procedures but the docs in Canton and here put the perm caths in the chest wall and not the neck. Your surgeon could have easily consulted either your nephrologist or a covering nephrologist at the hospital to do the procedure. Our docs receive consults from surgeons all the time. Was your intact PTH level elevated? Do you have to go see an endocrinologist for the hyperparathyroidism? Our docs have put patients on medicine for elevated PTH before. I can't think of the name of the med now though it might be rocaltrol but I'm not 100% sure.

No, Barbara, luckily, I am not the type of person that will blame an entire group for the actions of an individual. Sadly, the vascular surgeon just seems to be a busy person that isn’t always so good at providing information when unprompted. I made the original appointment with my vascular surgeon for the revision surgery, and he said that my nephrologist should have made it so that he could have also requested the perm-cath in my chest. The hospital isn’t really the problem; I think it is just the surgeon. I am probably going to keep dealing with him until I am finally done with my fistula (after transplant). I guess the surgeon just wasn’t thinking about how long I would need the catheter when he requested the clavicle catheter. The radiologist that put it in did mention that they normally do the chest catheters on patients in my situation. I have not seen any of my lab reports for the thyroid problem, yet. Once the doctors figure out what the problem is, I will probably ask to see the labs just to look over them for myself. My family doctor said that if it is overactive, they can medicate, and if that causes it to be under active, then they can medicate permanently to fix that problem. Thanks for the comments!

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That is all for today. I am in the process of trying to set up my appointment with the radiologist to have a permanent dialysis access catheter placed in my chest (soon, hopefully) and to have the temporary dialysis access catheter removed from my neck. Also, I talked to UniCare today, and they said that I will only owe $4,000 total to the dialysis clinic (as opposed to $16,000) which is what I had hoped to owe them.

I would love any prayers on:

• Getting the dialysis access catheter surgery scheduled and completed without complications


• My fistula healing quickly and easily so that I can go back to using it for dialysis access. Even though it hurts more than the dialysis catheter, it is safer to use and easier to keep clean and safe.


• That the best thing (according to God’s will) that can be done for my thyroid problem will be done.


• That the next 57 dialysis treatments will go even better than the first 57 did

Thank you all for stopping by and for always reading. And, of course, Jenny and I really appreciate any and all prayers that come our way. Thank you!

Nathan's Post-Surgery Update - Part II

If you have not read the Post-Surgery Update – Part I, then you should go ahead and scroll down to it and read. Or, just click Post-Surgery Update – Part I. After you finish, then you can read the Part II posting.

I had an appointment for a follow-up with the vascular surgeon on Tuesday afternoon. I went in to his office and he was confused as to why I was there. He said that there was a mistake in scheduling and that I would not need to come back until January. I was not too pleased by this information, as it means that I am going to have tubes hanging out of my neck for the next six weeks. This is a problem, especially since the radiologist that put the catheter in said that it was temporary (only for a week’s worth of use).

So, disappointed, I returned home to prepare for dialysis. They finally moved me to a chair where the machine is on my left just like my fistula (not that I was using the fistula Tuesday). The nurse laid me down in the chair, and hooked up my temporary catheter to the machine. It did not work nearly as well as a fistula (it ran very slowly from what I could guess) and I could not move during the entire treatment. If I moved my head, then the dialysis machine went into alarm. So, I got to lie still for four hours (not fun).

The nephrologist came to visit Tuesday evening. He asked why I had a catheter in my neck and not in my chest. I told him that I was not sure, but apparently I was supposed to schedule my own surgery (and know what to ask for) when the surgeon scheduled my fistula revision. So, the nephrologist said that he would get a hold of the hospital to set up an appointment to get the neck catheter taken out and have a long-term catheter placed in my chest while we wait on my fistula to heal.

So, all in all, Monday was quite frustrating. The surgeon did not tell me when to arrive for my surgery, he did not tell me that I needed to previously schedule my own catheter insertion, and he did have me properly scheduled for a follow-up appointment.

So, now it is Wednesday. I am back at work today and am waiting for a call from the hospital to schedule me a time to have my neck catheter removed and a chest catheter inserted. It looks like my fistula won’t be ready to use for about six more weeks. The only nice thing is that my elbow really doesn’t hurt too much, and it looks like it is healing well (from what I saw).

I apologize for this post being two posts long. I did not intend for there to be this many problems or for me to end up looking like I didn’t go to medical school. I guess if I had, then I would have known what to do for this surgery. Oh well, better luck next time.

Oh yeah, I just remembered. To top it all off, my cardiologist called on Monday and said that my blood work made it look like I have a hyper thyroid problem. So, that’s one more thing that I have to take care of this week. I am supposed to set up an appointment for a thyroid check with uptake (whatever that means). Hopefully this will not be a major problem. I know that I don’t need any more of those.