Dialysis Tomorrow

There was no easy way to break the news. The doctor gave it straight and I tried to do the same. He said I think we’ll start the Dialysis on Monday. The first day we’ll do it in the ICU because it’s a high risk business the first time, but the second and third day you can stay in the ward and we’ll take you to the dialysis unit for the process. I tried to do the same to my friends and family that I wanted to keep in the know, but they were literary blown by the news. Those who had other family members on dialysis or had some medical history took it better but the rest were really finding it hard to find a footing.

The biggest problem being a patient is not the bad kidney or the ordealing dialysis or the sudden rush of emotions and reminiscences of life, but the questions of the not so close friends and acquaintances who want to know everything – including what are the options for transplant. They don’t mean bad, it’s just that they don’t realise that it’s already too much to take in and pointless questions around the same things will do more harm to the mental state of the patient than help cope with the situation.

I made a few phone calls to close family and left text messages to a few close friends who deserved to know the situation incase things went sideways. The biggest challenge with your first sitting of dialysis is going to be your fear and apprehension towards the whole process. Although the first dialysis can have unexpected changes in the chemical composition on the body, it is the fear and anxiety that makes it worse. So this post is about my anxieties and what happened because of that.

The first day, I was a victim of misinformation. I believed that the two dialysis needles would be pricked into a vein and an artery. Hence I was scared, as arteries are high pressure pipes and deeply placed. So I thought this was a huge challenge and was anxious about it. I was wrong – the pricks are made on the single vein created by the AV Fistula.

Since I didn’t know this, I was scared, and once the dialysis was complete and the technician removed the arterial cannula, I so thought my artery was bleeding and went into hypotension. It felt like a medical TV show where everyone surrounded my bed and we’re shouting things like BP is falling! there’s no pulse! 3 cc of dopamine! The doctor yelled at me to cough as I started going out – I coughed – once, twice, thrice and a 4th time when I could see my eyes brighten – the BP suddenly rose and I was coming out of the hypotensive shock. All this could’ve happened either way – but if I wasn’t scared the chances of it happening was very less.

So remember this:

They are not poking your artery, arteries are deep and are high pressure tubes. Poking it would send blood 2 floors above ground. The high pressure bleeding is due to the Fistula and it stops if a piece of gauze is help up tight at the point of the prick.

Second day, I learnt this and was much relieved. I had parted ways with my phone, hence was much at peace. But there was yet another apprehension, the first day they pricked using local anaesthesia, will they do that today as well? And what off the swelling? My arm was swollen from the dialysis.

Answer:

If the hospital is good enough, they always give you local anaesthesia for cannulation. Or atleast till the vein increases in size enough to not give you much pain even without the local.

Swelling is ok, the dialysis is not dependent on it, unless it’s a huge swell, the technicians can perform the cannulation vis a vis the swelling.

This done, I was much less apprehensive or scared for my third sitting. But not entirely as there was another problem.

I couldn’t perform a full stretch of my arm as it was sore from the previous dialysis. So I was scared they might make me stretch it and hurt me. But luckily, the technicians are so well trained that they can perform the cannulation with a half streched hand and after the cannulation they even let me fold my hand and place it on my belly for the entire dialysis sessions.

So as we saw, there are lot of apprehensive situations that may arise from time to time. But it’s important to remember to keep your cool. You are in the hands of professionals who know what they are doing.

That said, the most important thing to be able to handle things is to have a support system. It’s essential that you talk to your friends and family about your condition. Because eventually the truth is there are only 2 treatments to this,

1. Dialysis

2. Transplant

Dialysis is a process that people can handle and make a part of their daily lives – in the words of my technicians we become like family members – that said, it’s still an ordeal and ties you down to a place and definitely changes your life to a less flexible and less comfortable situation.

Transplant is hope, if you receive a perfect match kidney then you can get back to your life as it was in less than 18 months. Finding a donor is the key – which is why you need to talk about your condition with people. You may never know when or where you might find your donor.

The downside of talking is most people would be taken completely unawares and wouldn’t be able to react in a stable or mature manner. This is worse if you are a middle aged patient. Hence prepare yourself mentally to be bombarded with questions about your “future” and “long term solution”

The only solution that I’ve seen working for myself is to take one day at a time. As in case of my apprehensions on the different days of my dialysis sittings or about planning for the future. Take one day at a time – it makes it really easy.

What else?

Support system. All of us need a coping mechanism. I’ve been doing better for myself and it’s because I believe I have the following 4 things nailed to perfection and that has made all the difference.

1. God’s grace

2. Family’s unconditional support

3. Well meaning Friends and well wishers

4. Confidence in self to face challenges

These are all you need to cope with CKD and Dialysis for now.

Ofcourse, don’t forget – one day at a time.

~*~

PS : sorry this post doesn’t have a descriptive account of my experience, can make a post for it if anyone wants.

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