Tag Emergency Room

Caution: Rough Road Ahead

Michael 9 Comments

I don’t think I’ve ever started a post apologizing for not posting. As much as I find myself an interesting fellow I can’t imagine any of you (if there are any of you still reading) working yourself into a lather because I’ve deprived you of my drivel these many days. But that’s just it. It’s been many days. Many more than I’ve ever gone without posting unless I was unconscious in a hospital bed. That’s just plain rude so for that I apologize.

Technically though, I have been unconscious in a hospital bed but just for a couple of hours. And I’ve been awake on a hospital bed a few days but not any of them in a row. Let me start in the middle for you and maybe that will clear things up.

When we last left our kidney transplant journey there were potential donors being poked and prodded, tested and vetted. They still are but all are nearing their finish lines. Will any be found as able as they are willing? The best I can say is we’ll see.

Until then, dialysis continues to be the means by which my own, slightly overworked and underappreciated kidneys are given a hand doing what they used to do best. Smoothly is generally not a term used to describe how dialysis goes. And it isn’t. Three weeks ago at an anything but routine dialysis session (routine also not descriptive of the dialysis procedure) my fistula imploded. You remember my fistula. It’s a pair of blood vessels surgically connected then anchored just below the skin so the dialysis nurse can shove two needles about the size of ball point pen cartridges into the arm to get the blood to and from the dialysis machine. Repeated stabbings cause scarring and plaque to build up inside the fistula and about every six months the surgeon runs a catheter through my arm by which he can clean things up in there. There is a fairly descriptive description (which is truly the best kind of description you can have) along with a couple truly disgusting pictures (and when describing a fistula, disgusting is truly the best description you can make) in a post from earlier this year.

Even with careful maintenance, sometimes the fistula just fails. That’s what happened to mine on November 6 which just happened to be the day after the last day I posted anything. Coincidence? Umm, not really. After repeated attempts to get a needle seated properly in the fistula with nothing but resistance to show for it, the nurse declared my arm a no dialysis zone. Unfortunately that did not give me carte blanche to swap the dialysis recliner with a seat at the Chinese restaurant down the road although lunch would have been welcome since I rushed through breakfast in order to participate in the American election process. Instead I was able to swap that chair for a bed at the hospital outpatient surgery area and await an emergency clearing of the fistula.

To make a long story short (I realize I’ve already exceeded that marker but it sounds good and I rarely get to use that as an opening line), after two more attempts with equally poor results, everyone admitted that the fistula was no longer a viable and a temporary catheter was tunneled into the right external jugular vein. It was during that procedure I had my previously noted period of unconsciousness in a hospital bed. (I get to be awake during the cleaning procedure, known as a fistulagram, and can actually watch the progress. It’s fascinating stuff but I’d still rather see a Bond, James Bond movie any day of the week.)

CVCThe unfortunate thing about dialysis catheters is that unlike say administration ports one might receive chemo through, they terminate outside the body and do so on a pair of tails. I’m posting a drawing so you can better see what I am trying to describe. (I could take a picture of my actual catheter but it’s not a selfie I’m anxious to snap and if you just type “dialysis catheter” into your favorite search engine you’ll get no end of new disgusting pictures to peruse at your leisure.) The part of the catheter inside floats and can actually be felt depending in where the tip resides at any particular moment. Reaching for anything higher than one’s shoulder, which given my modest height is anything off the counter, means moving the catheter around in there, also rather obviously noted. And because there is really no good way to anchor the outside tails, any movement or position change comes with a reminder that there is a part of you that isn’t really a part of you.

Fortunately I have the opportunity to be unconscious in a hospital bed again next Thursday when a new fistula will be fashioned into my other arm and I’ll get to have the catheter removed as soon as the new fistula completely heals and toughens enough for dialysis use. That shouldn’t be much after Ground Hog Day.

Just because I was having so much fun at the hospital, last Thursday when I was preparing to return to the world of blogging, I received a call from the dialysis center. The labs drawn earlier returned with a critically low calcium level endangering my health on any number of levels and I was instructed to return again to the hospital, this time to the emergency room where orders would be waiting to repeat the test and administer IV calcium if still returning a lower than normal level. It was, they did, and I got to recline on the sixth hospital bed (but conscious for five of them!) in 11 days.

And you thought getting on a transplant list was going to be boring between the listing and the planting.

Related Posts:

Transplant Journey Posts

First Steps (Feb. 15, 2018)
The Next Step (March 15, 2018)
The Journey Continues (April 16, 2018)
More Steps (May 31, 2018)
Step 4: The List (July 12, 2018)
Step 1 Again…The Donor Perspective (Sept 6, 2018)
And The Wait Goes On (Oct. 18, 2018)

Other Related Posts

Walk This Way…or That (March 9, 2017)
Looking Good (May 18, 2017)
Technical Resistance (May 25, 2017)
Those Who Should Know Better (July 24, 2017)
Cramming for Finals (May 3, 2018)

 

 

Bloody Hell

Michael 1 Comment

It’s nice to have memories. Pictures are good reminders of things fun times and people. Certificates bring back the pride of recognition. Scars are my reminders of usually something stupid I did.

Last week I was reminded of a scar as I was conversing with a friend. She had mentioned the previous night, actually early that morning, unusual activity in the house across the street from her. Lights were on at a time they shouldn’t have been and cars were in the driveway that shouldn’t have been. Immediately my mind went to activity at my house that shouldn’t have been.

I once ended up in the emergency room seven stitches to close a cut that I got from walking into a cardboard box. I don’t know why nobody could understand how a piece of cardboard sliced my leg open so efficiently that I had left a trail of blood from the living room through the dining room into the kitchen where it collected into a pool of blood rivaling what one usually finds beneath a freshly slaughtered chicken. And I use that animal as the example because I was scared like the proverbial chicken not just at the thought that I might die of massive blood loss on a newly laid kitchen floor while all the sharp objects lay safely nestled in their holders, but that if I lived long enough for someone to try to close that gash it was going to involve other sharp objects like scrapers and needles and undoubtedly a tetanus shot. Maybe it wasn’t a chicken I was channeling as much as a scaredy cat.

What happened that one morning I was up early roaming the house with only the light coming through the windows to guide me. There wasn’t much light because it just shortly after five in the morning but it was an August morning so full sunrise wasn’t that far away. Besides I had gone down that hall to the living room for 29 years and I was certain where to step. Except this was that period of time between having a contract to sale the house and actually moving out and closing on the deal. More specifically it was at the moving out stage and that’s why there were boxes hither and yon. One of the ones in yon was right next to my chair where I had planned to plop myself and watch the morning news. As I rounded the bend I walked into the box catching a top corner with the outside of my leg and I knew immediately I had done something unpleasant. I knew immediately because that’s how long it took for me to feel blood running down my leg.

TheBoxI thought at first it was just a scratch and I started a hobble back down the hall to the bathroom to wash and dress it. Then I saw how much blood covered my hand when I brought it back up from checking what I’d done. I altered course for the nearer kitchen sink and by the time I got there I had left a trail Dracula could have sniffed out from his home in Transylvania. I grabbed a towel and tied it around my leg, grabbed the phone, called my daughter for help, and went back to apply as much pressure as I could to the outside of my leg.

I should mention that all this was happening about 8 weeks after I got out of the hospital for the marathon four month stay and probably hadn’t the strength to apply sufficient pressure to stop a paper cut. By the time my daughter got to the house I looked like the victim of a mugging. I was on the floor with my leg elevated on the lower rung of a kitchen stool. I was whiter than the towel that continued to get redder. I held the phone in one hand trying to dial 911 with just that hand while the other was feebly twisting said kitchen towel around my calf. Between the calling of the daughter and her arrival I decided we weren’t going to be able to staunch this flow and navigate our way to the required help ourselves and opted for professional assistance.

Not much later were in the ER, an IV running to replace my lost fluids, a clean dressing covering my first stitches not associated with surgery, and awaiting the dreaded tetanus shot, we discussed where to go for breakfast. It was after all still morning and my kitchen was busy doing its imitation of a crime scene. Not much gets between me and food.

So that’s what I thought of when my friend had seen activity in the early hours across the street and as I ran my hand over the scar on my lower leg I wondered what my neighbors might have thought on my unusually active morning.

Incidentally, if you ever want to get the front of the line at an emergency room, show up in an ambulance and bleeding.

If Only Restaurants Did Outpatient Surgery

Michael Leave a comment

Regular readers noted that there was nothing to read on Monday. Unfortunately, I spent Monday at the hospital and hadn’t had time to schedule a post for then. Nothing horrible, just a little procedure. The last time I wandered into a hospital it was five months before I wandered back home. Thus I can be a little skittish about returning there.

While I was waiting there my mind wandered. It almost always does. I got to thinking about a post we did more than three years ago, “If Only the ER Served Margaritas,” a tale of an adventure we had at a local restaurant comparing the level of activity to that of the local emergency room. While I was thinking of that, I started noticing how much the hospital resembles one’s regular eatery. Stay with me here.

You know how at a restaurant or tavern where you might be a regular there will always be a place for you. And when you get that place you will always be handed your menus, served your usuals, or surprised with an appetizer. Well, when I got to the hospital I was greeted by name by the surgery gatekeeper, bypassed the waiting room, and led directly to the first prep room inside the pre-op area. There my doctor was already waiting for me and went over the procedure like I had never had it done before.

Back at dinner where they know you, all of the wait staff will drop by, say hello, and give you their opinion of the best entrée of the evening. Your waitperson knows if you want ice or not in your water, will make certain that you haven’t changed your favorite beverage, and knows just how long you’ll chat over the starter before bringing your main courses. Back at the hospital where they know you, the phlebotomist knows what vein to use when you’re normally a “hard stick” for anybody else, the pre-op nurse just has to fill in anything new to your history, and the anesthesiologist knows exactly how much is enough. Those not directly involved in your care that day will still stop, say hello, and see how you’re doing as they walk by your area.

After the main course at the restaurant you don’t even get a dessert menu, those taking care of you will tell you the best available and all you have to decide is one portion or two. After the main event at the hospital you wake up to a can of ginger ale and some saltines without ever having to ask.

Ok, so it’s not as much fun as dinner and a margarita but coming off a five month hospital tour I had to make it some fun!

Now, that’s what I think. Really. How ‘bout you?
(Read the original, it’s a lot better if I say so myself.)