Hospital...again!

OK, so I'm on kidney hemodialysis. It is now August 29 and I've been on it since April 2004, getting dialysis treatments three times a week, Monday, Wednesday, and Friday, year in and year out, on holidays and all, except Christmas and Thanksgiving when they juggle the schedule around a bit. I went through two fistulas and I just had a third one installed last Tuesday. The two failed, and I'm currently being treated with a set of catheters placed in my chest. It's not too bad. It's not convenient when you want to take a shower but you just have to work around it.

On Tuesday, August 19, I was scheduled to have a fistula placed again. Since I already went through two of them, I knew what to expect. I would probably be on conscious sedation and half asleep through the whole procedure. The procedure is to connect an artery and a vein which will eventually develop into a arterial vein where blood will be able to be cleansed by running through a dialyzer, taking out the impurities, toxins...and vitamins. Take your vitamins or meds after dialysis.

I was put into short term care since I would be going home the same day, or the day after. I undressed and dressed into a gown, with a heating unit no less! The nurse took my medical history, from the time I was born, in my case. During the questioning we heard a baby cry. The nurse said she didn't see any baby in the rooms. To be humorous I suggested that one could have been born while waiting.

Since I was a little cool she hooked an air hose to the gown and a stream of warm air made it all nice and cozy. It would be cold in the operating room, she said.

She took me to the holding room, and on the way we saw the source of the cries. It was a woman who was perhaps frightened at the suspense of waiting. Others around her were trying to console her. It reminded me of my own fright years and years ago, but I was only three years old at the time. This woman was at least 60.

I waited in the holding room until it was my turn. I still get a rather sinister feeling whenever I enter an operating room, and even the holding area threatened to intimidate me. But I'm a big boy now and I intellectually rose above it, if not entirely emotionally.

A nurse came around and, in the quietness I suggested that they should have music playing. Mozart would be nice. She thought it was a good idea; it would relieve any anxiety patients might have.

There were a couple of other patients in the room and they gradually disappeared as their turn came up. Then it was my turn.

I was wheeled into the operating room proper where it was decidedly cold. They had given me warm blankets so I was cozy enough, but I remembered from my government inspector days that bacteria slows down at 40 degrees. It wasn't 40 degrees but I was glad for the blankets.
It's amazing what medicine can do these days. I had an IV placed on the back of my hand earlier which would administer the anesthesia. When I lay on the table an anesthesiologist administered the medicine and the next thing I knew I was back in recovery. I don't even remember falling asleep, if I even was asleep.

I had a bandage wrapped around my left arm, a little above the elbow and I was told to keep my arm straight for awhile. They gave me a pillow for my arm to rest on.

Since this was a "creation" operation (new fistula), the doctor ordered an overnight stay. I was given an antibiotic, as is the usual procedure, and I waited for everything to heal. And tomorrow the hospital would give me a dialysis treatment.

The hospital has a new procedure now for ordering lunch. You are given a menu and you dial a number and order off of it, and the food comes to your room in about a half hour.

The second meal I ordered was lasagna. I was told they couldn't give it to me. I'm on a renal diet and the tomato sauce is not good for me--too much potassium.

Potassium is one of the elements that can increase to dangerous levels because of the lack of proper kidney function. Phosphorus is another element that can be harmful, and processed foods are loaded with it. There are not a whole lot of options in a renal diet. There's enough, but the real good tasting stuff is off-limits. Or you can take binders to keep the phosphorus from assimilating into your system.

I settled for tilapia. I like fish. A couple vegetables, a cup of fruit, a dessert, a cold drink, and I was all set. Some hospital food is not bad at all.

I was there overnight, and I thought I would be scheduled for an early dialysis, but I ended up waiting until 2 p.m., which did not sit well with me at all. But I had not choice but to wait. Meanwhile they gave me IV antibiotics.

In the course of time I saw that part of my body was turning red, bright red. It was mainly on my upper legs and on my lower back. This happened a few months before and I had an awful time with skin peeling at the time. This looked like the same thing, but this time I spotted it earlier. The nurse checked it out and found the extent of it. I suggested it could be the antibiotics they gave me. So now I put another allergic reaction on the list. They didn't give me any more, and she told the doctor. He said it shouldn't be the antibiotics because it didn't happen before. She told him it did happen before. She listed it as an allergen.

Finally I was wheelchaired down to the dialysis room. I sat in a recliner chair and waited for my treatment. There were other patients whom I had seen before at the dialysis center. I was just another one of them.

They hooked up the lines after administering a dose of blood thinner to avoid clotting, and started the machine, and I was set for the duration.

Because of all the waiting around I was not in a very good mood. On top of it, a nurse started teasing me about the length of time I was going to be in treatment. It was not a professional approach to nurse/patient care and I was not amused. Apparently, she has a habit that way so when I made a remark in return, the others knew she had met her match.

When you're waiting four hours for treatment to be completed, you need to have something to do, unless you just sit there watching what is going on, or sleeping, or watching television. I had all three options going.

I had asked a friend, Mel to take me to the hospital but I didn't know how long I would be there. Since I was there overnight I called him up and asked he could pick me up. He was going to pick his brother up at six but he said he could be at the hospital at 5:45. I noted how much time I had left and started thinking about the logistics of being done on time, and not having Mel wait too long, and letting him pick his brother up on time. Sometimes I just need to take the bull by the horns and create my own reality. I asked the technician if she could let me off early. I could sign papers. She said they don't sign papers here, they would have to call the doctor. I was not about ready to have bureacracy take over so I just waved my hand in resignation and hoped for the best.

She took me off a little early, bless her. She also told my nurse that I wanted to leave as soon as dialysis was finished. So it was all ready except...the IV loc that was still in my hand had to be removed by the nurse. Rats!

I called Mel, who was waiting outside, and told him there would be a delay. He was gracious enough to wait.

It all worked out OK at my side of things. Mel took me home and it was well after 6 p.m. but at least I had a ride home. I wasn't allowed to drive for 24-48 hours because of the anesthesia I was given.

But I had an appointment with a doctor at OSU in Columbus on Thursday so I drove the 7o miles, had the interview, and came home again without incident. It was close though. I didn' feel good part of the time. Medicine takes it time to wear off, and it can be tricky driving. I felt comfortable enough behind the wheel, but when I got out and walked a short distance it was not the best feeling. When I got a bite to eat at Wendy's I felt a little better.

I know I have a sense of adventure in dealing with a lot of this but it can get old sometimes when you have to go through the paces every couple of days. Dialysis is a growing necessity for a lot of people these days. It has increased exponentially over the past decade and there are dialysis centers all over the country, plus the world. Kidney disease is a symptom of many factors in the scheme of things. Check it out here.

I don't know if you cared to read all this mundane stuff but this is just an inkling of what hospital patients have to deal with, and dialysis patients in particular.