Arrrrrrgh, My Heartsies.

[Paul]

Monday night dialysis and near the end (eight minutes to go) I got severe chest pains, so asked the nurse to take me off. Pain got worse so the nurse called for an emergency ambulance. The paramedics brought a portable ECG which showed no problem, but apparently an ECG does not always show a heart attack, so they took me into A&E as a precaution. Blood tests showed clear in all things except one test that showed a result that could be caused by a recent heart attack, but is sometimes caused by a knackered kidney (and I have two of those). So they kept me in for more tests. I was in hospital for two days, poked prodded, medicated, and various other stuff. Eventually they got hold of the "peddling while full of radioactive gunk" test I did a while back as the first "can I have a new (secondhand) kidney please" test. This showed a very healthy heart.

Their final diagnosis was that they had no idea what had caused the pain, but it cannot have been a heart attack because my heart is so healthy that it is impossible for me to have a heart attack. So they sent me home.

Wasted two days in hospital, but am bloody glad of that diagnosis because the heart is about the only organ I have left that is still healthy. Kidneys knackered, pancreas knackered, and brain never really worked properly. So I guess it is safe to eat another greasy pork pie and bacon sandwich.

Oh and liver, there will be 25cl of beer coming your way later!

[PrimeTimer]

Good thing they checked everything out. Better to be safe than...well, you know...  If you don't mind being asked, do you know what Blood Pump Speed they run you at during dialysis? Is it something like 400 or 500? I ask because in another of your threads you described the dialysis line as "juddering" when the needle starts to "hit the wall". I assume you are describing the arterial line (the line that sucks blood out of you). Sometimes the higher the BLP is turned up, the more the dialysis lines vibrate or "judder". Perhaps they are running you at too fast of a speed and this is causing you to faint or suddenly have low blood pressure or chest pains. Hope they can figure this out for you and that things run a lot smoother and soon!

[Paul]

If you don't mind being asked, do you know what Blood Pump Speed they run you at during dialysis? Is it something like 400 or 500?

I don't mind being asked, but the answer is complicated (well it can be simplified to "depends", but that would just be rude of me). My fistula should have been being used since Easter, but the cannula is quicker and easier, so most nurses find excuses to use that. The better nurses use the fistula but because this is rare (about once every two weeks) the fistula is not strengthening, and I have been "one and one" for months. Yesterday was the first time they successfully dialysed me with both needles in the fistula (they have tried once before but it did not work). So the speed is slow as I am "new" to fistula dialysis. On top of this, the pipes on the cannula are not working properly, so they cannot achieve full speed on this either. So speed wise: The doctor has prescribed a minimum of 400, ideally 450; but I get 300 to 390, sometimes only the high 200s when only the cannula is used (depending on how well it is working); 200 or slightly above if one or both needles are in the fistula. The problem you referred to obviously only happens when they use the fistula, so the speed is either 200 or slightly above.

As to the "juddering": I was not referring to the machine's lines, I was referring to the fistula. It is hard to explain, but imagine that instead of taking a smooth flow, the needle is taking sudden big gulps of blood with pauses in between, that is what it feels like (NB "feels like", I have no idea what is actually happening).

[PrimeTimer]

Perhaps the catheter needs reinstalling. A chest xray might could rule that out. Chest Xray could also reveal as to whether or not fluid or blood is leaking into the chest cavity, Maybe it has perforated something. Or become sensitive to something. It's good that they quickly checked you out in case of heart attack but hopefully they will give you some answers as to what caused all the pain to begin with. Here's an article that might be of interest to you. It's about right-sided chest pain but maybe there is something in it that is relative to what you experienced. My husband sometimes gets right-sided pain, more like a cramp. He swallows a small amount of tonic water with quinine in it and that helps, in addition to a short saline bolus in his return line. They slow the UF removal rate or stop it altogether until the cramp passes. Hope they get yours sorted out so that you can head it off before it comes on again. Good luck.


https://academic.oup.com/ndt/article/16/7/1493/1815271

[Paul]

Thanks for the information. I'm really hoping it is not the catheter as I don't want to go through that again. In fact I have told the nurses, who are stalling with the transfer to using the fistula, that if the catheter goes bad before the fistula can take over I will sue Fresenius.

They did give me a chest Xray but it showed no problems.

It was defiantly not the "chest cramp" you mentioned, I've had that, it was much more painful and in a different place.

Still hoping that the hospital will come up with something, but it is Mayday Hospital, so I doubt it (Mayday is known locally as Merde Hospital, that just about sums it up).

[PrimeTimer]

Still hoping that the hospital will come up with something, but it is Mayday Hospital, so I doubt it (Mayday is known locally as Merde Hospital, that just about sums it up).

That's pathetic! Where do hospitals get off being A-holes?! I try to be positive about things, I really do and generally I am hopeful but sometimes I feel as tho I am being beaten over to the dark side. 

[Paul]

Mayday Hospital is awful, they have had several tries at killing me, and given me plenty of bad information (eg "When your kidneys are dead, and you are a few months off dialysis, drink lots of water, at least four pints a day." - repeated by several nurses, some of whom tried to force me to drink more). My nearest dialysis clinic is in Mayday, which is why I chose the slightly further away Fresenius clinic instead!