Home > Uncategorized > Dialysis Day 83, Infiltrate, Rash, Work

Dialysis Day 83, Infiltrate, Rash, Work

Not a very good start to dialysis today. Since the lower part of my fistula is so bruised from the procedure, they stuck the first needle halfway up the fistula, and the second at the top. The pressure on the venous (top) needle was high (340), but came down to 300 (ideal is, I believe, about 200, and max is 500). The doctor came over, and had me lean forward to listen to my lungs (since I have the rash; more on that later), and my tubing got stuck between the bag of bicarb (fluid) and the chair. I moved my fistula arm to try to untangle it, and got excruciating pain. I’m not sure if my needle moved and pierced through the fistula, or whether the pressure caused the insertion site to infiltrate. I immediately called for help, and it was about 20 seconds (at 400cc/min) before they were able to run over and shut it off (which is quick). I have a painful huge “gooney” on my upper arm, and no doubt will have a huge bruise there tomorrow.

I told the Nephrology fellow about the rash, and he looked at it. He hemmed and hawed, and decided it was a drug rash from the IV dye that I had Friday, and that I should take Benadryl and Prednisone before getting dye again. This is the same doc that told me that I should get a Colonoscopy before my transplant, since I was at high risk for polyps, being that I have PKD (my Neph nixed that, since that isn’t true; diverticuli are common with PKD). I realize that he’s still learning, but I don’t have much confidence in him at this point (although he is a nice guy), which was bolstered after dialysis, when I talked to the Radiologist who did my Fistulagram. Dr P told me that 90% of drug reactions to IV dye occur within 6 hours, and 100% within 24 hours. Since mine started about 40 hours after my dye, he was confident that it isn’t a dye reaction (which was my thinking before I even brought it to a doctor’s attention).

Dialysis went well after that. Beginning wt: 94.4 kg. End wt: 91.9 kg.

Dr. P didn’t have my Fistulagram images ready; he’s going to “anonymize” them, since I’ll be publishing them to the internet. No big deal; I’m thankful that he’s nice enough to offer to do this for me.

Work is getting to be frustrating. I feel like I’m spinning my wheels with the patients of 1 doctor, and it’s not their fault. There is one of the doctors who NEVER looks at his phone messages, and has been slacking off BIG TIME with prescription requests. There was a request from Friday that the parent called 3 times for, and he didn’t do it. I believe he was there on Friday, and I know he worked the weekend and Monday, and yet he still didn’t do the rx. While that was only one, there were 6 others from last week that I had to remind him about, 4 or more days AFTER the request was put in. It not only makes for extra work, it makes for a lot of FRUSTRATION for those of us who have to deal with the patients calling in asking for their prescriptions. As for the messages, I print them out and put them on his desk, but he just moves them to another pile until I go up to him to tell him AGAIN about it (the other doctors actually read my messages on the computer the first time I send them, as it should be). There is no solution to this problem, which is even more aggravating.

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