Inova Fairfax Day One
As I was waiting to sign in to the hospital, a middle aged woman walked in to the registration area carrying a takeout tray of food. She had signed in before me, and then had walked off for food. When her turn came to meet with the admitting person, she started whining like a child. She had been there from 10 to 6 yesterday waiting for a bed. The "chinese" doctor who had admitted her was no longer there and was no longer her doctor, she was hungry and had left for food. She was very nearly crying. The admitting person calmly asked questions and determined that she had a bed and had left her room (I'm guessing from the psych ward). The crazy lady walked out of the office and then started to tell me her life story, beginning with her day yesterday; by the way, did I want her food because she had barely touched it; and all she really needed was a beer (did I mention it was 8:15 am?). She then wandered off and was soon chased down by the admitting person and a supervisor.
I was starving and had asked for a breakfast tray as soon as I got to the room. I met with my Nephro, then I ate and was immediately taken up to dialysis. My Nephro met me again at the dialysis clinic, it was a good thing too, I was really nervous and it was very reassuring having him there.
It's one thing to visit a dialysis clinic or to read about the process, it's quite another to actually be wheeled in to a room full of machines that are whirling, pumping and beeping away. The staff go about their work in a serious fashion, but they make light hearted conversation to diffuse the tension. They explain every step of the way to reassure and calm me.
Across from me is an old man who looks like he's dying. Along with dialysis, he's got an IV and what appears to be a feeding tube; he alternates occasional convulsions with low moans. His mouth is wide open and his eyes are shut tight. Next to him is a younger man (still older than me) who also appears out of it. His eyes are open, but often they roll up into his head and all I can see are the whites of his eyes. Physically, his body looks healthy, but he moves less than the old man and seems just as near death. I secretly want to ask my Nephro if I'm staring at my future.
The nurse hands me a needle and tells me it's the smallest they use. It looks three times larger in diameter than any needle I've ever been stuck with and about twice as long. They keep telling me how much its going to hurt. They give me a shot of lidocaine to numb the area first. One of the staff recommends against the lidocaine, because I won't get it later, and he thinks its better not to get used to it. The nurse gently tries to insert the huge orange needle into my new fistula, but she immediately has a problem. The walls of my vein aren't strong enough yet. I'm grinding my teeth trying to will the pain into submission. It's not working and long after the needle has been removed, I'm still in pain.
Since the fistula isn't ready, I must get a permacatheter placed in my chest for access, unfortunately, since I had breakfast, they won't be able to do the surgery until my stomach has had a chance to clear. The Interventional Radiology department wants to do the surgery tomorrow or the day after, but my Nephro won't be able to justify the extra days to the insurance company, so it has to happen today, IR relents and schedules me for 5pm.
I'll be missing lunch, but I should be able to get dinner. I'm wheeled down to IR Pre-Op just before 4pm, so I'm thinking maybe they'll get me in and out quicker, but no such luck. I fall asleep waiting to get moved into an Operating room. I'm wheeled into an operating room well after 5pm. They take my necklace and my glasses, shave my chest, and give me Oxygen and possibly something else. It appears that they are giving me a little bit of Anesthesia, checking my state, then giving me more, so I try to stay coherent as long as possible, in the hopes they will really knock me out. There's nothing. Then I feel needle sticks. More nothing, then I feel the painful incisions. More nothing. Then pressure as the catheter gets placed. It feels rough and painful, but once it stops I've fallen back into nothingness. I spend the next hour trying to shake the groggy feeling.
I was able to get dinner, which is a good thing, I don't do well on an empty stomach, but the portions weren't as filling as I'd like. A couple hours later, I was hungry again and had the nurse bring me some snacks.
Labels: Catheter, dialysis, inova fairfax hospital
Dialysis Tomorrow
With two emergency room visits, and perpetually big feet, I'm well aware that it's time for dialysis. When I went to see my Nephro last week, I found out my creatinine was 9.8, basically at the 10 threshold for dialysis we set last year. I told him it was time. The first time around when my kidneys failed, I resisted, but this time, the writing has been on the wall.
So, I'll be going in to Inova Fairfax Hospital for three days to start treatment. From what I understand the treatments will be very mild, they don't want to give me a full dose of dialysis right off the bat. I'm guessing that they want to keep me in the hospital so they can monitor my intake and output more closely. My blood is getting pretty toxic right now, (just a little bit dangerous), so maybe they want me at the hospital to monitor my other organs. There's also some question as to whether my AV Fistula is ready, so they may need to surgically place a catheter to start.
I'm still not sure what this means for my everyday life. I know I'll be going to a clinic three days a week (every other day). I know I'll need to follow a stricter diet. I don't know how much exercise I'll be able to do. I don't know what my energy level will be like. The list of side effects and possible side effects of dialysis is too long to list here.
I was just as scared and just as clueless when it came time for my transplant, and I was pleasantly surprised by the results, so maybe dialysis will also surprise me. Either way, I'll adapt.
Labels: dialysis, inova fairfax hospital
