After Tuesday's Treatment

I am posting today to let everyone know how Tuesday night's treatment went. The technician brought out the 17-gauge needles, and was ready to stick me. I had prepared my arm with the Emla cream, and it had a small numb area. The technician put in the first needle, the venous, and it did not pulse. This is a problem, as the blood needs to flow in order to have dialysis. So, she poked around for a little while, and finally pulled that needle out.

She decided to give the arterial needle a try next. She stuck it in, and some black goo oozed into the needle. This isn't good, she said, it's already clotted. So, we pulled that needle out and decided to start again. By this time, the first spot had stopped bleeding. The technician decided to run both needles in an "up" direction, since there didn't seem to be enough room to go down. I'm not exactly sure why there would be room to go one way and not another, but I guess that's what makes me a patient and not a dialysis technician.

So, the tech stuck in the first needle facing up instead of down. This is alright, but does not give the best treatment. She had to quickly flush the line with saline, because my blood wanted to clot right away. It was very thick Tuesday night, and I am not sure what caused that. I wonder if it had to do with all the bruising that has recently gone down in that area.

She ended up finding a spot to put in the second needle, also facing up. She had to quickly dilute that needle with saline as well, since my blood was still attempting to clot. She got some Heparin into my line, and then hooked me up to the machine. She ran the machine at 230 ml/min for most of the night with no problems. My only real complaint was that my arm still does not quite bend all the way out, so it wasn't exactly comfortable to sit in the chair with my arm at a funny angle.

So, thank you all for your prayers. Keep praying that they will be able to stick me correctly and that my blood won't try to clot the second that I am hooked up. I'd also enjoy having the machine slowly run a little faster, so that my blood gets a more thorough cleaning. Thanks for checking in on me. E-mail or comment if you have any questions!

Special thanks to Connie Parr for letting me know that she was praying yesterday!

Tuesday, 6/20/06

Well, today is Tuesday, June 20, and I have another dialysis treatment tonight. The treatment went slowly all last week, and on Saturday, the nurse suggested that it might be time to go back to my fistula on Tuesday (today). The bruising went down quite a bit over the weekend, and I can stretch my arm almost all the way out today. I imagine that, barring any problems, it will be fully healed by next week. That's only three weeks of pain for one bad stick, I guess that's okay.

I brought my numbing cream with me to work today. It contains Lidocaine 2.5% and Prilocaine 2.5%. I put this cream on my fistula approximately one hour before my treatment. It numbs the area under it which helps with being stuck. When I was using my fistula on my lower arm, it did not hurt too much. But, on my upper arm, the skin is more sensitive and is hurt more easily. So, I am using this cream to help reduce the pain of the needles going in.

I am praying that the treatment today will go well. I am praying that the technician will be able to get a good stick and that there will not be any problems with the fistula. I plan to use the small 17-guage needles for at least two weeks, to help the fistula mature (but at a slow steady rate).

If you read this Tuesday before 4:30 pm CDT, then please pray that I get a good treatment and good sticks tonight. If you read it after, then just pray that my fistula will work properly all week and that there will not be any problems.

Thanks for coming by!

June 2006 Lab Report

Well, it is time once again for lab reports. This month, everything sounds like good news, so be glad (and thank you for all of your prayers).

Albumin – 4.6 (goal is 3.8 to 4.5)

enPCR – 0.59 (goal is greater than or equal to 0.8)
Your protein catabolic rate (protein intake) is low. Eat more: fish, seafood, chicken, turkey, lean red meat, lean fresh pork, eggs, or cottage cheese.

eKdrt/V – 1.28 (goal is greater than or equal to 1.2)
Your eKdrt/V is adequate. You are receiving enough dialysis.

Potassium – 4.7 (goal is 3.5 to 6)
Your potassium level is normal. You are doing a good job with the potassium in your diet!

Corrected Calcium – 9.4 (goal is 8.4 to 9.5)
Your corrected calcium is normal.

Phosphorus – 5.0 (goal is 3.5 to 5.5)
Your phosphorus is normal. Great job limiting high phosphorus foods and taking your binders with meals and snacks!

Hemoglobin – 13.3 (goal is 11 to 12)

Average Fluid Weight Gain – 2.23 kg or 3.2% (goal is 3 – 5% of dry weight unless you have signs and symptoms of fluid overload).
Your nurse will discuss this with you. (Acceptable)

So, as you can see, my lab reports all looking great this month. My phosphorus went down from over 7 last month to 5.0 this month. This is a good thing, as I do not want to have squishy bones when I grow up. So, I will keep watching my phosphorus levels, and I’ll try and keep them low. I want to watch all of my labs, but that is the one that I’ve had the most trouble with.

Fistula update: my arm is still quite bruised and sore. I cannot straighten my arm out fully, yet, due to the pain. My bicep is bruised from the elbow to the clavicle (all the way over the bicep muscle). I’ve been using a heating pad and an ice pack (though not at the same time) to try and reduce the bruising and swelling. My arm has gone from a very dark patch to a big brown area of pain. I did not let them stick me on Tuesday, and I do not plan to let them stick me until my arm feels better. Thankfully, my catheter worked fairly well Tuesday night, and I was able to have a treatment at about 270 ml/min (which is not fast enough, but it’s better than the machine stopping every two minutes).

I guess that’s all for today. Keep praying that my arm will heal quickly so that I can go back to using my fistula. And, pray that when I do go back to using the fistula that it will work properly and not have any problems with the needles. Also, keep praying that we will get the payments for the transplant testing worked out with the insurance company so that I can get some more people tested. Thanks for coming by to read!