Tuesday, April 26, 2011

Trying to get it right

Dialysis.  Sounds simple, right? Just hook up and away you go! 

I wish it was that simple and easy.  Sometimes the body does not want to do what the operator (me) is intending to do. 

On each of our five days of dialysis each week I must place two needles (arterial and venous connections) into Sabine's arm to begin the dialysis.  I cannot hook her up to the hemodialysis machine and start the run unless those two "connections" are made. And that "connecting" means putting a needle into her arm squarely into the vein, getting a "flash" back indicating it's "in;" flushing the needle and plastic tube and then connecting the machine (artificial kidney) to the tube in order to being the process.

Now even if all this looks good (connected, a flash, and flushed) if the pressures are too high we might have to reposition the needles, start at a slower speed (and longer process) and constantly re-evaluate the procedure based on machine pressures.

The connection goal is to place a "blunt" needle into something called a "buttonhole" in Sabine's arm. The buttonhole is made by inserting a sharp needle for a number of weeks into the same site and same angle each time -- thereby creating a "buttonhole" which can be accessed by a blunt needle through the same "hole" (which, obviously, is a better method than using a sharp needle at a different site on her arm each day!).

But of course, the body is not like working on a car engine.  Machines are predictable and usually if you have to connect a hose to a machine it's fairly simple; that it, the site nor the angles don't change from day to day.

We have been struggling with connections this past week.  The week before everything went "textbook." When problems start to happen, we either have to make the connection with a sharp needle in the buttonhole (something we want to try and avoid) or discontinue the treatment cycle.

When this occurs, it causes a lot of tension (and frustration) on my part.  Why can't I get this to work?  What's wrong with me -- or my technique? 

Sabine seems to do much better than me in these situation.  She is always calm and re-assures me that her body is simply not cooperating today and it's not me or my technique.  Still, I feel bad when all this doesn't work.  Sometimes I have to call the clinic in Madison for reassurance and we go through my actions and talk about "options" like discontinue for today, use a sharp, or (worst yet) come on down to the clinic and they will give it a try.  Thankfully, we haven't had to do the clinic option for some time!

So, that's our life as patient and practitioner.  Most of the time dialysis goes like a whiz.  But on days like this, when things don't go right, when I simply cannot get the needles into the "fistula" and have to try again and again and then resort to a "sharp," I feel the pressure (and it's not from Sabine, it's the pressure I put on myself and the frustration I feel). 

What's the spiritual lesson?  I know.  It's being calm.  Accepting what is. And being grateful for the fact she is still here with me and I am still able to hold her and love her!

So what am I complaining about again? Life is good.

Peace.  Spring is coming -- I see Robins, wet and cold Robins!

Soon we will all dry out.

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