"Houston, we've got a problem..."

It's been a tough two days!  One of those "just went you thought it was safe to go back in the water" days.

After months of relatively easy dialysis connections and treatment, it all fell apart.  Suddenly, I was not able to make the "cannulations" and we had to abandon the "blunt" needles and go to the "sharps." 

This meant that I had to start two new puncture sights above the old ones.  Not an easy task via telephone.  But we did it and things went fairly well.

Then we encountered high arterial and venous pressures and had to abort the treatment.  The second time it happened we ended up going to Madison and getting some help from the staff at our dialysis center. 

Even there they had trouble getting a venous connection (it made me feel a little bit better that it wasn't me as I saw the professionals struggle!).  Finally we were able to make the insertion and begin the treatment with the home dialysis machine in the center. But even there our troubles were not over and we had to terminate early when a perforation occurred.

So what's going on?  Problems with the fisula again?  Most likely.  We are being scheduled for a fistula gram at the UW Hospital to check for a blockage or other problems in the area.  And this morning, at home, I was able to use the new arterial site with a sharp needel and then use a sharp in the old buttonhole when the blunt needle didn't work.  Then the connections were make and we had a good "run."

These are the times that being a "marriage team" works!  We solve problems and take necessary action without bickering or yelling at one another.  At the same time, while I feel the stress of all this, it's not my arm that is getting the multiple needle sticks!  Sabine (again) has been a real trouper (but that's one of the reasons I love her so much, she's always been a great trouper!).

What's ahead?  We will have some hurdles to jump over in the next weeks and some problems to solve -- another in-patient hospital visist to look at the fistula, possible some intervention to clear the blockage, consultations, and then we will begin to work on creating two new alternate needle/cannulation sites and, hopefully, can reclaim those two blocked "buttonholes."

In the meantime, we are "watching and waiting" with regard to the cancer.  We would ask you to continue to pray for Sabine's healing and calm resolve as we wait for the six-week blood test that will determine how those nasty cancer cells are doing -- I pray they are having a tough time and will soon give up!

Thus ends our battlefield report!

Not As Easy As You Think!

As I mentioned earlier, I am making the "insertions" of the two 15 ga. needles into Sabine's arm three times a week at the dialysis center in Madison.  I have a great coach in Xin Lu, who patiently directs my big paws! 

You can see in the picture that I have drawn circles with my magic marker to bullseye the needle entry points and the direction of insertion. 

While the first three days went well, I sort of crashed yesterday missing the fistula both times -- but finally got a "flash" indicating I was in the fistula and the rest of the treatment went well.

We will be going to the Center again next week while I maintain the same angle of insertion (about 30 degrees) and the same entry "tunnel" to the fistula in Sabine's arm so that we can eventually establish the "buttonhole."

When the buttonhole is established, we will do the insertions (cannulations) at home with a blunt needle which will access the same tunnel I have developed over the past few weeks.

As soon as we develop the buttonhole and all systems are "go," then the tunnel catheter can be removed from Sabine's neck enabling her to get back into the water this summer!

You know, 15 gauge needles are REAL big!

p.s. There is a 4 minute video on YouTube in which a man shows how he uses his buttonhole during home hemodialysis: http://video.google.com/videoplay?docid=153372659747625126#

p.p.s. After reviewing the entire video I  have to let you know that my training at the Wisconsin Dialysis Center involved  more infection precautions: masking up and wearing gloves for both "putting on" and "taking off,", and using chlorohexidine at the buttonhole sites rather than betadyne.