In March of 2004, when my kidneys went on that storied trip to the corner store for a pack of cigarettes and never came back, the doctors in the hospital installed an AV Fistula in my left forearm to be used to connect me to a dialysis machine. This fistula is created by sewing together an artery and a vein to increase blood flow for the dialysis process.

For the past three years my AV Fistula has functioned flawlessly, having never gotten infected nor clotted. This streak came to an abrupt end last weekend. When I woke up on Sunday morning, I noticed something wasn’t right. Having just woke up, it took me a minute to figure out what was wrong. Slowly, I placed my left wrist up to my ear and was shocked to hear complete silence. The now normal sound of the blood pulsating through my fistula, which can be likened to listening to your heart through a stethoscope, was missing. Obviously, some how or another the blood flow to my fistula had been cut off.

First thing I do is call my doctor and ask if I should go to the Emergency Room and have it looked at. Surprisingly, he says that I can go if I want, but usually what happens is that you go to your regular dialysis appointment and the personnel there will take care of it. I am skeptical; to me this is very serious and it should be taken care of immediately. Finally, the doctor tells me that in a situation like this, I couldn’t hurt anything if I go to the ER. So, my wife and I pack a bag and head off to the hospital, certain that I’ll be admitted and spending a few nights there.

First, we go to the main Methodist Hospital in the South Texas Medical Center. We figure a hospital as large as Methodist would certainly have a vascular surgeon or two handy to fix me up. We show up at the check-in desk and explain the problem to the triage nurse. She politly asks me to fill out a couple of forms and then return to the check-in desk. So, my wife and I grab a chair and fill out two or three forms, and I return them to the nurse. She takes them and asks me to have a seat until she calls me to the back. As I am sitting in the chair, I start realizing that about every five minutes or so another elderly person is wheeled into the ER to be treated until it starts to resemble an old folks home in the lobby. We’re definitely in for a long wait.

Four hours later, the nurse calls us back. She takes my pulse, blood pressure and gets a temperature. Then she asks me to tell her again what is wrong with me. I explain what happened and asked what will be done. She says she has no idea, but that we should go take our seats again and that she’ll speak with a doctor to see what they should do. So my wife and I go back to our seats and wait another hour with no results. Old people are still flooding into the ER like five years olds in a candy store. We finally decide that there is no way I am going to be seen by a doctor before dawn, so we leave.

Our next stop is the Methodist Specialty and Transplant Hospital. This is the hospital that I go to for my transplant exams. It has a real small ER that is seldom busy, so we get in right away. Less than an hour after arriving and being seen by the triage nurse, we’re talking to a doctor. He looks at my fistula and asks who the vascular surgeon was who put it in. I tell him and he says that he’ll give the doctor a call to see what he wants done for me.

About twenty minutes later, the doctor returns and tells me that the vascular surgeon wants me to just go to my regular dialysis appointment the next day and they will send me to an out-patient center that will take care of the problem. So, we head home having wasted most of the night waiting to see a doctor only to be told to go home.

When I show up at the dialysis clinic the next day, I tell the charge nurse what happened, she looks at my fistula and listens to it. Then she says, “No problem. We have a place just around the cornor that fixes these all of the time. In fact, that is all they do.” She makes me an appointment for 10:45 that morning, so I go and eat some breakfast and then go home to rest before going to the appointment. Turns out that having breakfast was a really bad choice.

So, I end up going to a place called Crown Interventional. They specialize in de-clotting fistulas using a process call fistulaplasty, which is similar to angioplasty. Basically, they place a probe into your fistula, dissolve your clots and then use a tiny balloon to widen your vein and artery. However, what no one knows is that my vein is infected, so each and every time they inflate that tiny balloon to widen my artery, it hurts like hell. In fact, it hurts a hell of a lot more than that. I am literally screaming each time that tiny little bastard is inflated. The doctor realizes what is happening, so he asks the nurse to sedate me. The nurse turns to me and asks me when the last time I ate was. I tell her about an hour ago and she frowns. Turns out that they can’t sedate you within 8 hours of a meal, so I’m SOL.

The torture continues for another hour or so until finally the doctor is finished. He has successfully restored the blood flow to my fistula and repaired the vein. He apologizes for my “discomfort” but assures me that by the next day the pain will have subsided. I take a seat in a recliner in the back room and sit for about 30 minutes to settle my stomach, which has become quite upset from all of the pain and screaming. Finally, I am able to leave and go straight to dialysis, where they………….immediately stick two 15 gauge needles in my arm.

I just couldn’t win.

The doctor is right, however, and by the time I wake up the next morning the pain is gone. My arm itches like crazy because they shaved a lot of my arm hair off before the procedure. However, everything is now back to the way it should be, except that my beloved cat, Ernie, can no longer sleep the way he is used to — on top of my left arm, with his head on my pillow next to me. Now, he has to stay beneath the covers and sleep next to me, or come out from under the covers and sleep on my wife’s pillow until she decides to come to bed. Either way, he isn’t happy about it. After all, nobody asked him.

This entry was posted on Friday, March 23rd, 2007 at 9:39 pm by Nick, and is filed under Health Stuff. You can follow any responses to this entry through the RSS 2.0 feed. Both comments and pings are currently closed.