written on September 1, 2014
Several people have asked what I do while I’m sitting in dialysis three times a week. It gets me thinking that I don’t think anyone really knows what goes on in the chair in general. I tend to sit here and play games on my phone, or write blog entries, or watch movies on Netflix. Some times I’ll sit here and google various things that I’m going through (I try to sound like I know what I’m talking about in my blogs).
But I’m here for 3 ½ hours now, three times a week. That’s a lot of Netflix movies! The truth is I don’t have the whole 3 ½ hours to myself. There are a lot of nurses and techs who check up on me and the entire prep for the dialysis takes a few minutes.
My appointment time is currently 12:30, so I try to show up at 12:15 or so. I put my stuff for dialysis in the chair (sweatshirt, blanket, computer and charger, phone and earbuds), put my bags behind the chair, then I have to weigh myself. My dry weight is listed as 78 kg at the new center, which is nice. At the old place it was in the computer at 77 kg, which always annoyed me because I knew it was really closer to 78 kilos but the doctors I talked to never wanted to change it (hence the fluid imbalance problems – they always want to take fluid off to get me to 77 kgs, even though I would get a migraine every time).
I give the tech my weight and he or she (usually a he) programs the computer with how much fluid to remove from me. I sit down, they put a blood pressure cuff on me and take my BP right away. Then they make sure the machine is ready for me (the dialyzer, or artificial kidney, is hooked up and fluid is passing through it, no air bubbles in the fluid chambers, the IV bag with saline ready to go).
Then the nurse puts a face mask on me and removes the bandage from my catheter. At my new center, they tend to clean and redress the catheter site first, then they move on to cleaning the catheter and preparing me for the dialysis tubes. Before they can hook me up to the machine, they have to pull some blood out of the catheter (to make sure the passageway isn’t blocked), then they put heparin in (to make sure the blood doesn’t start to clot while I’m dialyzing) and then they hook up the dialysis machine (if they need to draw blood for lab tests, they do that before the dialysis machine is plugged in).
The dialysis machine has two tubes – one with a red tip and one with blue tip. I believe the blue tip is the outgoing tube, the one that carries my blood to the machine, and the red tip is the return, bringing back the blood that’s been cleaned. The catheter itself enters my chest just under the clavicle bone, follows along the clavicle up to my neck, then turns down, enters my jugular and continues down into my heart. As I’ve mentioned before, you don’t feel anything. Although when they’re pulling fluid off of me, I can feel my hands start to dehydrate. Other than that, no feeling whatsoever. And thank goodness for that – I think I would totally lose my sh*t if I felt this.
Once the tubes are in place, they press a button on the dialysis machine that starts the process – pulling the blood from my body, circulating it through the machine and then returning it back to me. This process continues on for the full 3 ½ hours. While it happens, sometimes they’ll give me shots of epogen or iron (to offset the anemia) or whatever other drugs I might need. It’s nice when they give you shots in your return line – you don’t feel anything. Anytime they have to give me a vaccine or something (like the flu vaccine) that still goes in the arm. Oh well. Can’t be completely needle free!
After my dialysis time has passed, a tech comes over, turns off the dialyzing part of the machine, returns the rest of my blood to me, then calls the nurse over (techs can’t work on catheters, only fistulas (I don’t know why)) and the nurse proceeds to remove the tubes, clean the catheter and tell me if I’m okay to leave. Usually I’m sitting there in silent pain (due to the migraines) while the clean-up is going on, but I always have to give a standing blood pressure reading before I can leave. Let me tell you, on days when the migraine has gotten bad, it’s particularly challenging to stand up and wait for the stupid blood pressure monitor to finish. I also check my weight, then pack up my stuff and look forward to the next day, when I don’t have to dialyze.
And every day I still look forward to getting a pre-owned kidney from my wife in October, so hopefully I won’t have to go through any of this again.