Bob's Blog 11-1-14: D-Days: The Battle Begins

Bob Here.

My introduction to dialysis didn't end with my stormy stay in the hospital after discovering that my kidneys had gone splitsville from the land of the working body parts.

After that seemingly interminable visit (which I'm sure was no bed of roses for the staff either), I began what was to be a long stretch of in-center dialysis treatments. And, since I had behaved so badly in the hospital, I didn't want the team in the center to feel left out, so I continued to exhibit somewhat sketchy manners when I first started there as well.

In addition, as a new dialysis patient, I still had a lot to learn about the treatment, how it worked, what I needed to do, side effects, and interactions with the different players in the center.

And, to put it mildly, there were a few rocks in the road during my learning process, some of which could be directly tied back to the fact that I hadn't adjusted very well to the concept of needing these very long sessions on an ongoing basis.

So, as I was getting ready to leave the hospital, it was probably my imagination but it sure seemed like everyone I had been dealing with was in an exceptionally good mood. I jokingly said to one of my nurses, "Ah, you guys will all miss me when I'm gone."

She just snorted a "Yeah right," and left my room in near hysterics.

I thought, geez, at least you could pretend a little bit.

Anyway, I still had to deal with a social worker who was going to identify the center where I was going to be treated. Like everything else about my stay, it turned out to be more difficult than one would expect.

I explained to her that I was going to be working full time and that I kept a rigorous schedule, so the center would have to have an evening shift available and would have to be flexible as to my start time.

I soon found out that, as they say in that esurance commercial, "That's not how this works. That's not how any of this works..."

I listed all my specific needs and thought we were all square when she went off to her little social worker world, wherever that was.

Then about an hour later she cam prancing in, seemingly happy as a monkey with a peanut machine and told me that the center closest to my home had reserved a morning shift and that I was to be there at 6:30 sharp on Mondays, Wednesdays, and Fridays.

I just sat there staring at her.

"Funny," I said. "I had a conversation with someone who looks just like you that I needed evenings and flexibility. Any idea what happened to her, or where she went?"

Now it was her turn to look at me uncomprehendingly.

Then she said, "Oh no. That was me."

I took a really deep breath.

Then she continued, "It seems the center doesn't have any evening shifts open, so you'll have to start mornings."

I lost it a little bit. "Okay listen," I said a little louder than I intended. When I saw she was taken aback, I softened my tone and went on to explain why I needed evenings.

Again.

This time I spoke verrrrry slowwwwly.

When I finished, she said, "So, are you saying you don't want the morning shift?"

Another, even deeper breath.

"Right," I said as softly as I could manage. "No morning shift. Working mornings. And afternoons. Need evenings."

I thought, when did I started talking like Frankenstein's monster? ("Hate living. Love dead.")

Then she said, "You're going to be working? Full time?"

It reminded me of Cool Hand Luke.

"What we have here is a failure to communicate," I thought, but didn't say.

"Well," she went on, "it's just that these centers usually tell you what's available and you have to abide by it."

That reality started to sink in. When you're doing in-center hemo, you have to take what you can get in terms of treatment times.

Anyway, after a continuingly painful back and forth with Ms. Social Worker, we finally determined that she would look for another center nearby that could accommodate my need for an evening shift.

I eventually landed at a center about 35 miles from home that had an evening shift opening.

And, of course, since I was driving there after work, I had to make my way through rush hour traffic.

So the first time I reported for a treatment is not exactly a day that will hold fond memories for me.

After fighting about an hour's worth of traffic, and knowing that I was in store for another of these marathon treatment sessions, I was in a particularly raw mood.

I went into the lobby of the center and a pleasant looking lady came over to me. (She turned out to be the social worker in the center. Seemed like lately I couldn't swing a dead rat without hitting a social worker.)

"Can I help you?" she asked.

"What's your blood type?"

"Excuse me?"

Ever since I got a lesson on transplantation, I had adopted the more-than-a-little annoying habit of asking everyone their blood type. Mailmen, grocery clerks, strangers on the street. Nobody was immune.

"Well, since you asked if you could help me, I just wondered if I could talk you into parting with one of your kidneys."

She had a hint of a smile. "Are you a new dialysis patient? Or just new to the center?"

"Yes."

She smiled. "Both huh? Okay, come with me."

"What? We're just going to do the surgery right here in the center?"

She snorted and took me into the dialysis room. There were probably a couple of dozen chairs. And, as often happens when somebody new walks in, everybody stopped what they were doing and turned their attention to us. To me.

I had a wild impulse to do something crazy. Like start tap dancing. Or flapping my arms and clucking like a chicken.

But I managed to suppress that impulse despite my discomfort.

"Know what?" I said. "I changed my mind. Nice meeting you. Take care." And I made for the exit.

My social worker friend grabbed my hand. "Come on. It's not that bad. Let's go meet the charge nurse."

"Do you know her blood type?"

We went to the main desk and introductions were made.

"Okay," the nurse said finally. "Your chair is over here."

I said, "Can't we go to a sports bar instead?"

She laughed, got me seated, and a few minutes later, we were ready.

But, of course, the first in-center treatment couldn't go without a hitch. That would be against the overriding dialysis rules.

I was using a chest catheter, as the fistula vessel in my arm wasn't ready yet. But when she tried to get a blood draw from one of the tubes with a syringe, nothing happened.

She pulled really hard, but there was nothing. No blood. The nurse looked worried.

She said, "Bear down. Push hard. Like you're going to have a bowel movement."

I said, "Right now, that's a definite possibility."

She laughed a little, but after what seemed like an eternity, we finally got a draw through the catheter.

My problems didn't end there though, the cath was jicky throughout the entire treatment. After a series of alarms, the nurses pushed the head of my chair back as far as it would go so that I was essentially hanging upside down. Low and behold, the pressures improved so they left me that way for a while.

I can't even tell you what was going through my mind with this first in-center treatment spent mostly in an inverted position.

Suddenly, a familiar voice asked, "How are you doing?"

It was my social worker/new friend.

I said, "You have a run in your stocking."

"Huh?" she looked down.

"I wouldn't have said anything, but it's pretty noticeable from this angle."

She cleared her throat a little. Then she said, "One thing you'll have to start doing is bringing something to keep you busy. Can I bring you a magazine or anything?"

I thought for a second. "How about 'Vampire Bat Monthly'?"

"What?" she asked laughing.

"Well, I just thought that if I have to hang upside down like this, I might as well be up on the current trends."

She laughed again, then we had a pretty good conversation about all things dialysis that made the time go by faster.

At the end of the treatment they sat me up and disconnected me, the whole while I was on a diatribe about how there was no way I was going to hang upside down for every treatment, they were going to have to figure something else out.

The nurse assured me that it was normal for the cath not to work perfectly the first few times and that she was sure things would get better going forward. Then she told me to rise so they could get a standing blood pressure.

I just kept up my tirade while I stood up. "Well that's good. We all better hope so, because if not...."

Seems they hadn't exactly known my correct dry weight as yet and had pulled too much fluid off. So in the middle of my speech, I went down like a sack of potatoes.

When the nurse revived me, I just continued on my train of thought.

"....I'm just gonna forget about this whole thing."

The two nurses standing over me just laughed while hauling me back into my chair.

So, a bit of a rough first in-center treatment.

For the most part, the sessions did get easier going forward as I learned more about what to expect and how to live the dialysis lifestyle.

I didn't even have to train for the Vampire Bat Olympic Team. I was sitting upright for the majority of the six years or so that I spent in-center!

Thanks for reading. Take care.