Bob's Blog 8-1-15: #ohwowaflood

[BobN]

Bob Here.

I think it’s safe to say that dialysis patients are no more likely than “normal” people to be victims of some of man and nature’s more common unpleasant surprises.

You know. Such little inconveniences as wildfires, earthquakes, tornadoes, blizzards, tsunamis, pestilence, nuclear detonations, etc. etc.

There is a not-so-natural disaster where we just might beat the odds, however, and it would be one that makes it so we can’t “just keep our heads above water” anymore.

Yes. I’m talking about the almighty flood.

Oh yeah, sure, all you non-dialysis folks are probably thinking about streets with water up to your armpits, levees breaking, and needing a rowboat to pick up a quart of milk at the local C-Store.

And, you’re probably thinking that old Bob Here has finally gone over the edge. That his glue has finally melted. That his mental faculties have checked in with that big outpatient dialysis facility in the sky.

I mean, why would innocent little dialysis patients, just sitting there for hours on end minding their own beeswax be more susceptible to flooding than anyone else?

What, cause when the big one comes you guys aren’t gonna be smart enough to hit the clamps and head for the hills??

No, none of that, and if you don’t mind me saying, quit being so darn tootin’ narrow minded, k?

You see, there are many kinds of floods other than nonsensical rainstorms or the Army Corps of Engineers sleeping off a bender when they should have been fixing our levees.

Dialysis floods can come in many forms and some of them don’t even directly involve water.

I’ve had many instances of nearly needing scuba equipment while I was in-center.

But I’m here to tell you that the big fluid boof can also take place while you’re doing home treatments.

Just this past week, as a matter of fact, the wife and I were setting up treatment and everything seemed just hunky dory.

None of the usual catastrophes that befall a home hemo patient came about on this seemingly fine day.

You know, your machine crapping out, a badly timed power outage, you herniated yourself trying to get your needles in but they just wouldn’t budge, the cat knocking your saline bag onto the floor. You know the drill.

Nope, none of that stuff happened and our treatment was underway, I was diving into my ebook and the wife was attacking her latest knitting project.

Then, out of the blue, she uttered a phrase that shall now forever be part of the list of things you never want to hear while you’re on dialysis.

She said, “What do I feel splashing on my leg?”

I looked over at her in a fog, hoping that she was kidding or that I just imagined that she said anything.

“What?” I muttered.

She looked me square in the eye and said, “Something’s splashing on my leg.”

“Ha ha. Very funny.”

“I’m not kidding bozo. Oh crap, what the [*#@**%$*] is leaking??”

We looked at the machine and there was a flow of fluid coming out that made Niagara Falls look like a leaky faucet.

The top of our Pureflow was completely engulfed and, sure enough, there was so much coming out that it was splashing up off the floor onto her lower leg.

Now, you know how when you’ve been married a long time you do cutesy things like finishing each other’s sentences? (I know all the guys are thinking, yeah, she interrupts and clarifies whatever incorrect statement I was about to make…)

Well our symbiosis at the moment was a (not so cutesy) looking at each other in panic and uttering, “Oh Crap!” at the same time.

So the scene that ensued later put me to mind of the Keystone Kops putting out a fire.

Even with my limited available movement, we started pulling lines up, yelling at each other, and examining our setup to identify the source of the flood.

Anybody listening in would have heard a frenzied flurry of questions and accusations.

“Check the saline line!”

“It’s not the saline line! I attached that myself!!”

“Check it anyway!”

“I’ll look under the cycler!”

“I already looked there…”

“You’re an idiot!”

“It’s still coming out!”

“Did you think it was going to fix itself??”

“We’d better hurry of we’re all gonna drown…”

And so on.

Well, after several minutes of histrionics, we finally found the source of the leak.

It seems the yellow waste line connection had malfunctioned and the volume that normally flows neatly out into the drain was now not so neatly dumping out all over the place.

Then another Instance of oh-so-not-cute symbiosis.

We both looked at each other and said at exactly the same time,

“What the hell do we do now?”

I thought that was kind of funny, but I kept that to myself because:

1. The fluid was still leaking, and

2. The wife looked like she wanted to haul off and whack me one.

So, after a series of solutions were suggested that ranged from pure genius to certifiable, (Wife: “I really don’t think sticking the line out the window is the answer…) she decided that she would put the line in a waste basket, let it fill to the point where she could still lift it, then rotate another basket underneath and repeat the process, periodically emptying the baskets in the sink.

Simple, right?

Seems that it’s always the things you take for granted that give you the most trouble. Of the list of possible disastrous occurrences that can happen at home, a bad wasteline hookup ranks pretty low on the totem pole.

Anyway, one of the more serious types of floods associated with dialysis is, of course, the dreaded blood leak. And I’m not just talking about when your insertion sites let go after you get taped up and head to the scale, although that would surely set a vampire’s heart aflutter.

No, I mean a leak during treatment, which is much more rare, but does, in fact, happen.

Usually, it takes place around the needle insertion site.

Sometimes a needle might move a little bit, or the fistula/graft is immature.

When it does happen though, because of the increased blood flow, it can cause a scene reminiscent of those old slasher flicks, you know where one kid gets fileted and the other ones all decided to just hang out anyway?

I can think of one instance where a guy sitting next to me, who was relatively new to dialysis, had such a blood leak, and his reaction was one that would later have us both in stitches (not literally.)

Now I don’t know exactly what happened, but suddenly there was a flood forming from under his bandages.

It took him by surprise and he shouted, “SWEET MOTHER OF JESUS!!”

The nurse at the time was a rather prim and proper type and, I thought, looked rather disapproving as she came over to help.

“Now just relax,” she said to him, calmly. “We’ll take care of everything.”

“Ok, thank you,” he said. Then he looked down at his arm and it was really a mess.

“F— ME,” he bellowed.

The nurse actually gasped, but to her credit, kept on working.

She got the bandages off and was diagnosing the problem, when the guy took another glance and saw his arm pretty much covered.

“HOLY S—,” was his next reaction.

I thought, well, at least he working his way down the cursing scale.

The nurse had a stern look about her as she re-positioned his needles slightly and re-bandaged the arm.

Everything seemed calm, but when she picked up the bloody remnants of his original dressing, his eyes grew as big as saucers one more time.

He sputtered, apparently trying to find a way to exclaim his alarm without having to make another contribution to the nurse’s swear jar.

“DAMN!” was what he ended up with.

After a while, when everything was again copacetic, I asked if he was ok.

“Yeah, just took me by surprise, I guess.” Then he thought for a minute. “I think I shocked our nurse a little,” he added with a smile.

Before long we were both in a fit of laughter, while our nurse was sending dirty looks across the room.

We did call her over and my friend apologized for his outbursts, but we had to wait for our laughing fits to subside.

Now, I’d love to tell you otherwise, but the fact is that a blood flood during or after dialysis is not that unusual. As I said earlier, my neighbor was relatively new to the Big D, hence the reaction. I’m sure after being on for a while, the same guy would be like, “Oh. Ho hum. Come on over when you get a minute…”

Just goes to show that, after the flood ebbs, everything can, in fact, get back to normal.

Thanks for reading. Take care.

[Vt Big Rig]

I look forward to the first of the month and Bob's Blog posting.

The amazing parts are that we get used to some of the "catastrophes" he talks about and can laugh also.

[obsidianom]

Why do you think Noah built his ark???
He was the first known dialysis patient and a boy scout.  He lived by the motto , BE PREPARED.
When the big dialysis machine in heaven spouted a BIG leak ,  HE WAS READY!   (God was the first tester of Nxstage).

[Michael Murphy]

I was involved in a in center almost disaster. About 2 hours into a treatment the construction crew working out side of our clinic suddenly took off running.  That was strange till the smell of gas began filling the room.  I asked to be taken off but the nurses were saying wait.  I spoke like the person you described and finished with if it blows it take us all.  So we evacuated.  In zero weather I felt sorry for the older patients and since I grabbed by bags ang coat I gave up my blankets to the wheel chair bound elderly. That's when it got bizarre the building also has a outpatient surgical center.  In the freezing cold people were running out in those stupid gowns that close in the back.  I be never seen so many frozen butts.  Lucky fo us not only cold but windy so the gas never concentrated enough to explode.  By the way the construction workers never came back the company was replaced by an other.

[Alex C.]

Yeah, I remember how I freaked out a bit the first time my venous needle leaked down my arm. Luckily, the 'chuck' got most of it. I just ask for a couple extra gauze pads now at the beginning, in case I start leaking. That way, I can manage the flow until the attendant can get over.

[cattlekid]

Since I drove myself home after my in-center treatments (I lived five minutes away from my center), the staff there gave me a bunch of 4x4s and some tape to keep in the car just in case.

I never thought too much about it.  Fast forward a year after transplant....I was driving home after one of my monthly blood draws and felt something warm on my arm.  Blood from my little teeny tiny puncture site was slowly dripping down my arm.  Thankfully, I had the presence of mind to remember the gauze and tape in my glove compartment.

Come to think of it....I should probably replace those with my leftover dialysis stash....just in case.   

[Jean]

bob, sometimes I just cant keep a straight face. This is one of those times.

[Michael Murphy]

Actually I cou!nt my reactions, 1 chuckle 2 laughs and 1 guffaw.  This one placed a smile on my face for a solid hour.

[Simon Dog]

In Ghostbusters the important admonishment was "don't cross the streams".

With the PureFlow, the warning is "don't cross the blue lines".    Seriously.    I shit you not.

There is a short length of blue water line that runs from the sediment filter to the unit.  It is possible, and easy, to position the longer water supply line so it crosses this line (by "crosses" I mean "touches").   When water flows through these lines, they vibrate.   Over the course of many months, the will erode each other to the point where one of them springs a leak, and you have a flood.

Been there done that.

I also had one of the floods like Bobs from the orange connector coming disconnected draining the residual out of the SAK however, I was able to spot that immediately.   The "blue line flood" was a pinhole leak that poured water on the floor for an entire day before discovery.   

One important thing they do not cover in home training - keep a bottle of h202 (Hydrogen peroxide) handy - it's great for cleaning up blood.  Get the consumer grade 3% stuff at the supermarket - the higher concentration lab grade stuff is highly corrosive and not good for your health.

[PrimeTimer]

I used the same choice in words (**#@**%$*) when I heard the sound of water trickling after draining/flushing a SAK. Know that little white thingy connected to the blue water line in the back of the Pureflow unit? I didn't put it there, it was set up with it. It's called a "quick disconnect" and that's what it did alright.

[Simon Dog]

I used the same choice in words (**#@**%$*) when I heard the sound of water trickling after draining/flushing a SAK. Know that little white thingy connected to the blue water line in the back of the Pureflow unit? I didn't put it there, it was set up with it. It's called a "quick disconnect" and that's what it did alright.

Actually, it's a one way check valve to prevent reverse flow of water.  That's why there is a little arrow on it.

[PrimeTimer]

I used the same choice in words (**#@**%$*) when I heard the sound of water trickling after draining/flushing a SAK. Know that little white thingy connected to the blue water line in the back of the Pureflow unit? I didn't put it there, it was set up with it. It's called a "quick disconnect" and that's what it did alright.

Actually, it's a one way check valve to prevent reverse flow of water.  That's why there is a little arrow on it.

Thanks. NxStage said sometimes vibration or if it's pulled on, that can cause it to become loose and leak. Luckily caught it in time before it made a big mess. Also what helped, is that I have clear vinyl floor runners/mats underneath and around our Pureflow unit. Had to sop up a little water but at least for the most part, the carpet was spared.

[kristina]

Thanks againBob ... I really admire your ability to turn near catastrophies into little giggles,
together with a nonchalant shrugging off the shoulders !
... I still don't know how you do it ...  but I certainly admire it!
Thanks again from Kristina.

[del]

I laughed when I read this.  We use a fresenius @home machine instead of nxstage(supposed to be trained for next stage in the fall) and we have had several "floods"!!  Not nice to get out of bed in the morniong and you feet hit water!!! When hubby was in center one older man in his 90s who had dementis pulled his needles out during treatment.  There was blood flying everywhere!!!  Another day one of the staff moved a bed and hit the water line and broke it.  That day there was water everywhere!! 

[BobN]

Thanks everyone.  Stay dry!

[Charlie B53]

I'm using the Baxter Cycler on PD. 

I sleep very well when it is raining.

I use a drain bucket.  Not just once, but TWICE in the past year I somehow have managed to forget to empty my bucket in the morning.

Do you know what it sounds like when your drain bucket over-fills?  A gentle rain,  in your bedroom,  on the carpet,  it gets VERY wet.

We now own a carpet shampooer,  and my shop vac works pretty well to suck up most of the fluid before using the shampooer.

That section of the bedroom carpet is the cleanest in the whole house.