Why does my tunneled line bleed so much?

[cariad]

Is this normal? Yesterday, the two pieces of gauze that had been laid down on Thursday went dark red and stained almost the entire top layer. I phoned the on-call vascular fellow (per discharge instructions) and he was great, phoned me back really quickly, and talked me through pressing on it "exactly like they would do in the ER." If you're familiar with these lines, you know that the dialysis access hangs down from your upper chest, but that a line from that point of entry winds around to end near your neck. He told me to press on my neck, above the clavicle, with the line termination between my second and third fingers, in an upright position. As I did that he told me that it was probably one of three small leaks - either in a vein or artery - but that these scenarios were unlikely since it has been so long since my placement surgery (nearly two weeks).

Well, I stopped the bleeding and my husband and I donned face masks and actually changed the dressing ourselves. (I hope not to have to do that again - we are terribly squeamish people. Terribly.) The fellow phoned me back to check in, and I told him that about an hour after the change, the dressing was still completely white. No more bleeding. That lasted until around midnight (maybe 10 hours) and a small drop of blood appeared as I was getting ready for bed. I woke up with little change, but now it is slowly soaking through the dressing. I would say the spot is now 1cm in diameter. I can feel it pulsing at the exit site at times, and then I look and usually the spot has grown bigger. Do I need to worry about this?

[monrein]

Mine did that when it was first "installed" but never afterwards.  What about heparin or coumadin or aspirin?  Fish oil?  Things that could cause bleeding?  I think I'd want to have it seen and explained...never the answer we want to hear I know but precautionary trumps regret I always feel.   

[KICKSTART]

I feel mine pulsing and nagging especially after dialysis , but i have never had any bleeding. Not even when it was done. I should get someone to check that out properly.

[billybags]

I agree with kickstart. next time you go for hemo get some one to look at it.

[cariad]

Thanks, everyone.

Rather than go to Urgent Care (which I believe my insurance charges a $100 co-pay for) I called the research RN line for easily the tenth time. When I told the research coordinator where the leak was, she phoned the surgeon and he has asked to see it tomorrow. Oh, hell. I mean, I am terribly grateful that he would even bother, but blah. Another 2 hour drive each way, and possibly another access surgery. I guess the thinking is that if there is a leak in the vein, this could be a real problem during dialysis, which I start around March 12. I wasn't even thinking about the effect of a leak on dialysis, but that seems kind of obvious now.

Can I blame my slowness on my low GFR? (Of course I can. I blame everything on my low GFR.)

[sullidog]

I just got done with this exact same issue. I went to the er and what they did was put alastic plasto dressing over where it was tunneled for a while and that got it to stop. What was causing it to bleed was they were using lots of heparine after surgery in it and you aren't suppose to, but since you aren't on dialysis yet then that shouldn't be the problem.
As far as feeling a palse I've been able to with both catheters I've had depending on how my neck was turned so I think that's normal. I mean I wasa gushin blood with this thing!
Troy