Touching The Wall

[Paul]

OK, so I understand why it is bad when the needle touches the wall (blow out, pain, etc.) but I cannot understand why I get some of the side effects. Nurses at my clinic now know to remove any needle that touches the wall INSTANTLY, as the first time it happened they didn't, they just moved it a bit, and the results were bad, very bad. Ended up with: all the nurses from the entire ward working on me (to the annoyance of some of the other patients who wanted/needed attention) one even thought I was dying; a nurse having to catch me when I collapsed on the way to the toilet; a nurse having to clean me up because I was too weak to wipe my own ass; I had to go home in hospital scrubs because I had soiled every item of clothing I was wearing except my socks. Oh, and I made such a mess of the toilet that it was closed for half a week before they found someone brave enough to clean it!

Yesterday they took no chances. I felt that "glug glug" feeling that told me the needle was touching, and got the nurse to remove it. He tried "one and one" (I still have the catheter in my shoulder, so they could do one needle in the fistula and one pipe). My blood pressure continued to drop, the machine kept alarming, and I felt "weird". So the nurse took the other needle out, and I was dialyzed via catheter alone.

So with the offending needle long out I would expect the effects to go away. But I still got diarrhea and had to be taken off the machine briefly to go to the toilet. I made it without collapsing but my BP was so low then that the nurse walked beside me ready to catch me, and stood outside the toilet in case I passed out in there. Then back on dialysis, I had to argue with the nurse not to decrease the fluid takeoff and although he did what I asked, he was not happy. After that I felt my blood pressure drop even further and eventually I passed out.

Although, obviously, my blood pressure goes down during dialysis it does not down as low as it drops after a wall touching incident. I have no idea how low my BP went yesterday, but I have remained conscious at 79, so it must have been lower than that. And this was well after both needles were removed from my arm. Does anyone know why "touching the wall" causes this drop in blood pressure, or why it causes such extreme diarrhea? And why this happens even after the problem is "fixed"?

[cassandra]

O Paul what an ordeal, and I remember you only just washed those cloths 


I don't understand at all why touching the wall would have such an effect on you.


How is your potassium (K+) before D?


Love, luck and strength, Cas

[Paul]

How is your potassium (K+) before D

My potassium levels on the monthly blood test are within the safe range. They used to be pretty near perfect, however now they are at last using my fistula they have had to reduce the pump speed while the fistula strengthens, so it is a bit higher, but still within the desired range.

[GA_DAWG]

I don't understand why touching the wall would make this reaction. I have a graft, not a fistula, but I can tell when it is against the wall. I tell them and they pull it back a little to reposition it, and all is well.

[Riki]

I have never heard of that kind of effect from the needle touching the wall.  Perhaps your fistula is "snakey" and you need to use a shorter needle.  Do they use an ultrasound when putting your needles in?  With that, they can tell where your fistula is and where the needle is going, perhaps minimizing the needle touching the side of the vessel at all.

I can feel when the needle touches the wall.  it stings when anything is running through it.  I usually get them to pull the needle out just a little bit, and that normally will fix the problem.

[Michael Murphy]

The fistula is a strange beast, when I started I saw the bumps (aneurysms) on the patients who had been doing dialysis for a while.  I knew that I did not want any bumps. However as I started I had monthly infiltrations.  I was afraid to move.  As time went by my bumps started as they grew mu infiltrations became fewer and fewer, I had some movement without the infiltrations. Now as the bumps have grown i am scheduled to have the vascular surgeon evaluate them to see if it’s time to have the reduced.  Now I like my bumps since they make my Dialysys easier.  Last year I was in the hospital for a MI and had dialysis in the hospital.  They take you bed and all to Dialysys. I fell asleep, rolled over and flipped my needle from down to up. Hurt like hell but it did not effect my dialysis.

[Simon Dog]

Depends on the hospital.  The big high end place where I had my hip done in Boston brings the bed to dialysis.  The local community hospital brings dialysis to you.