I have infiltrated my husband for the first time…

I feel like a total looser. I, for the first time in my life, infiltrated my patient. Not only my patient but my husband, which for me seems to be much worse. We started with a normal start, blood pressures temp etc…. the arterial went fine. In like butter, no laggs no pressure on the syringe. Then I went and inserted the venous line. I am establishing button holes so I was trying to follow my previous track. I felt the first pop and saw the flash. As I advanced the needle into what I call its “seat” I felt an additional pop. I didnt think I perforated but… well ~sigh~. I hooked up the lines to the machine and started it and that is when I noticed the pressures. Ron noticed the tell tale swelling, looks like a huge lump, and thank God this wasn’t as bad as I think it was. My rational mind says it wasnt bad, my irrational mind says “Oh my Fucking God I screwed up! I hurt my husband!”. After I took care of removing the screwed up line and inserting a new needle in a different portion of the fistula, I broke down. I still feel wierd, chest hurts head is dizzy and I feel sick. I have never, and I know it sounds pompus, but never missed a vein in my whole career as a nurse, phlebotomist, or medical assistant. I am just sick about this. Now this is the real stuff, this is what partners have to deal with. Esspecially when your the one sticking needles in your spouse. I would rather go back to working in the Urologists office, at least I didnt have a personal relationship with patients. This is the hard stuff, my patient I love more than the world or my own life. To hurt him is like getting stabbed in the chest.

Just a note!

We had our second home dialysis treatment post Fistula repair. The first one was normal and all except he was clotting up.  We got through it.  Today we increased his initial Heparin to 5000U, which did decrease alarms by doing so however there are still some serious clotting going on in the filters.  I think were going to end up with an addition of heparin during treatment. Taking pics of the filter for the nurse…  Leave a note if you wish and Welcome back Home!!

Love,  Ron and Patience!

The Over Used Excuse – Bi Polar

In the past 10 years you have heard in the news that some people who have done absolutely nutty things, from stealing a plan in Washington (the Barefoot Bandit) to killing their children, to walking down a street.  It is used as an excuse by the Law enforcement Officer who killed the man who was “Bipolar”. It has been an excuse for people to commit crimes and plead insanity, or mentally unstable.  I am sorry it is not an excuse, you can live a normal life, you should live a normal life. Your morality isnt affected by bi polar disorder.

Bi-polar disorder was formerly known as Manic Depression.  Manic Depression is also a song that Jimi Hendrix made popular in 1967.  It is a mood disorder that is caused by a chemical imbalance in the brain and is controllable with medications or just plain will power if it is not of a more pronounced type.  I have bi-polar disorder, and I am completely normal.

There are and have been for decades, people who are living and have lived great lives.  Actors, Writers,  Politicians, Entrepeneurs, major business moguls, CEO’s, CFO’s, and Presidents.  Now Presidents and politicians… that explains a whole lot! There are so many more!  A lot of the song writers, screen writers and entertainers who keep our imaginations occupied.  Not to mention the people who have created some of the worlds most delicate art sculptures and paintings.  As well as the most intelligent computers and software that we know of… nano technology man!!!

The point I am trying to make, and I do have one, is life should be lived with no excuses.  You were mad and you whacked a guy, don’t blame it on bi polar disorder.  You’re an idiot and killed someone! You’re a witch who was so narcissistic that you killed your kids not that you were having a bipolar moment! Come on world stop making excuses and start taking responsibility for your actions!!!

Needles, Technique is Unique…

Hi there! Today I went to clinic to stick Ron’s fistula as normal. I set up my stuff and of course we were in the Show Boat chairs, so I put on my best Nurse Professional look. A Tee shirt and a pair of black coulotte pants Ron hates. Slapped on some beautiful non latex gloves and started my work.

I begin by sizing up his fistula and finding my landmarks. You do this by feeling up the fistula feeling for bumps or thickened areas, this tells you where scar tissue has formed. You want to avoid scar tissue as that will hurt the patient. You also want to avoid previous puncture sites from previous treatments (obvious sites that still are scabbed). For Ron’s fistula it is almost the same as before. Just watch depth. We used to say “Go For Bone” now I try to visualize in my mind the pictures of his fistula when they did the veinogram. His fistula is now the depth of a hot dog or so, used to be more like a Polska Kilbasa. So a 45 degree angle is appropriate now.

I had an audience today and I heard them exclaim as I drove in the first needle,”Ohh!”. I thought that was weird since it was a RN floor supervisor that exclaimed. I asked her why she was surprised. She said she had never observed someone go so fast when cannulating. I explained to her that if I went slow Ron would complain. I also told her if I felt that I was not in control of depth or sure of the site I would have not continued and searched for a different spot. The first site I chose was rather close to the apex of his arm and I should have went a tad bit higher up. The second site, the venous side, was way up on his arm. I had discussed with Lori the possibility of using this site and she felt it was the best suited for a needle. It provided enough room for flutter and if the needle moved it would have less chance of hitting the side of the vein. It worked like a charm, needle went in quickly and found its seat well. I left Ron to do his treatment and went home to finnish up getting the house ready for inspection.

I returned to find Ron had an uneventful treatment, which is wonderful. He completed a whole treatment, which was becoming a problem prior to using this upper site. All in all the best treatment day of the lot so far!!

Shinzon’s got his own Blog!

Please come visit Shinzon’s vey first blog page. He insisted on speaking his mind after seeing a friend post on his masters page. So we decided to let him use the computer and make his own page! He hasn’t posted his first blog but give him time! www.deafdoggie.wordpress.com

GUB and Other Maladies

Lead-Buttitis – condition caused by sitting in a dialysis chair for more than 10 minutes. (In Center)

 

Shoulder-crampitis- Condition caused by not being able to move your arm due to needles being in it. Again being stuck in a dialysis center chair.

 

General unit boredom – obvious isn’t it?

 

Although the centers try to provide us with entertainment it is not enjoyable.Today as we sit watching FoodNetwork, 40 min. into treatment and 2 alarms later, here we go with the sucky part of dialysis. Only 1/10^th of the time is under our belt for this treatment today and I am ready to get the hell out of here. Today they set me in the Spotlight chair.

 

The spotlight chair is one of two chairs that are set apart from the “bank” of chairs that most people sit in. Others can watch you, be amused at your torment and pain. I am positive every eye in the place was watching my wife stick my needles today. After all no one I have seen has done this except us. Mind you I wouldn’t have it any other way but I am sure it made Sherrii feel like she is in the spotlight and on stage. Thank goodness we didn’t have any problems, or any of the nurses staring over her shoulder making her more nervous. I know my fistula is different now, so it has to be different for her as well. There are only 2 others I would trust to do this, one being our RN for the home program, and the other being a floor RN here in the unit, she taught Sherrii how to stick me. I would not have her stick me however Sherrii trusts her and well Sherrii Rocks!

 

The last couple of treatments have really kicked the shit out of me. I seem to be more tired, my headaches are worse, and the after dialysis hangover is just generaly worse. My gains have been relatively low for me so I really do not understand why this is happening. As a result I have been more cranky and moody which I know has been particularly hard on Sherrii and that’s not fair to her. But she sticks with me and holds me and makes me feel better. She’s a trooper through it all. Soon though and hopefully we will be home once again.They say that September 27^th is the last in-center treatment for me. I am counting the days literally. Monday we will have the home hemo nurse come out and re-evaluate our home dialysis area, take water samples to get recertified and once that is done were off to the races. I got to say that day is coming far faster than I expected and we have to get cracking the whip to get the house cleaned, carpets shampooed and everything dusted and wiped down with bleach and water. Sherrii will be thrilled with a once again cleaner house. I have to admit I am a piss poor housekeeper. I barely manage to keep the dishes done! Sherrii tries to do it but she is just too tired after vacuuming the floor, or dusting the shelves. Her PPH is a pain, but she tries at least. It kills me that I can’t do more for her. It scares me to death, the things that are going to be coming for her and the things we will have to endure. Sooner or later she will be either gone, or a heart transplant for her, or maybe both. As a Buddhist I am supposed to “roll with the punches” and accept, but how does one accept watching their best friend, someone they love with every fiber of their being, go through all that pain and suffering? I don’t know. If anyone has a solution I would like to know it. But I will, and she will, and I will hold her hand and stay by her side. Ok enough sadness for one blog…    

I saw my mother for the first time in 16 years. I don’t think she understands what I have to go through every day for the rest of my life. She had open heart surgery and is fine now. I think she feels that dialysis is not hard on a person, its like getting a shot. Well its one hell of a shot. I also do not think she understands what is up with Sherrii either. She didn’t really want to hear anything other than why my wife had oxygen. She doesn’t realize that either one of us could die within a very short period of time, without treatments for me or oxygen for Sherrii. But I am still happy to have seen her and had the opportunity to sit down and talk. I hope she enjoyed the visit and wasn’t too judgmental. If there was ever a time in my life I needed my family to accept me for who I am, the person I have become, its now. So we will see what comes of all this. In the meantime, I will continue to sit here with my lead-buttitis, and shoulder-crampitis, and GUB and survive. Maybe next time I will sound happier when I write?!    

　    

Good News Good News!

We got the green light to start using Ron’s fistula again and have had success in our first two treatments (in-unit).

Wednesday we went to the Access center.  This is a surgical unit in a doctor’s office setting.  The only thing they do there is check fistulas.  They take a needle similar to a fistula needle and insert contrast dye into the fistula.  Then they take x-ray pictures of the flow of the dye in the fistula to see how it sets, see if it healed properly and watch the flow into the heart.  I received pictures of the fistula too!  Unfortunately I do not have a scanner or there would be pictures today, sorry bout that.  That day Ron went to dialysis and they used needles for the first time since the surgery.  Success!

All went well and he was able to run at a 400 flow rate, which is almost to normal for him (500 fr).  Yesterday I began sticking him.  The first needle into the arterial side of the fistula went well.  The venous side was a bit more tricky and I infiltrated the first stick.  I was able to re-stick him and had great success.  There is hardly any change in the fistula as far as needle placement.  The fistula does sit a bit more closer to the skin and is not such a deep stick. 

We are hoping to be back on home hemodialysis in time for the wedding trip to Washington as this will be easier to travel with. All in all a great trip to the unit and that light is looking brighter at the end of our tunnel!