A new chapter starts tomorrow
by Robert Joseph Baker | November 6, 2016 6:27 pm
Nearly seven months ago, when Dr. Cain’s nurse called me just hours after my initial appointment with him and told me my kidney function was 22 percent, I had Stage IV Chronic Kidney Disease and would soon be in End Stage Renal Failure and need dialysis, I was floored and sick to my stomach.
The more they talked about eventual dialysis, the less I wanted to hear. At least for the first month. But then, as I usually do, I decided to educate myself, and I became more and more comfortable with the idea. June 1, I had my peritoneal port placed. Following a challenging summer of non-flushes (I think I only had one that went completely well in 14 weeks), I had a manipulation in mid-August. That never worked, and I had the port redone in late September.
So, here we are, on the even of dialysis, one of the things I was probably more terrified of than anything else. But I’m more comfortable with it now, at least with the peritoneal kind.
Some have asked me to explain it, so here goes:
I have a 24-inch long tube extending out of my abdomen. It has been inserted directly to the left of my navel, if you’re looking from my perspective. When not held firmly in my dialysis belt, it hangs down to about my knee. I’m 6-feet tall, so that should tell you how long the thing is. The tube goes inside my abdomen and rests down toward the Vagus nerve, or so an ultrasound has shown. This nerve runs from your bottom to the top of your spine, and it’s an idea place for the port exit inside the body.
During each dialysis treatment, I will manually – or by machine, depending on my preference that day or night – fill my port with a liquid solution made of dextrose (and sometimes and chemical to help prevent clotting and the build-up of fiber). If manually, the solution bag will hang from an IV pole, to which my port is connected. Gravity will do its thing. The machine works in much the same way, but without the gravity part.
After I’m full of the liquid, two liters of it at least, then comes the “dwell.”
That’s roughly four to six hours of letting the dextrose solution work with the peritoneum to leech all the chemicals out of my body that my kidneys are failing to filter themselves. Potassium, phosphorus, magnesium, sodium, all of these will be excreted through dialysis just as they would if I had normal kidney function.
After that set of hours – there’s sort of a trial and error to figure it out, hence the training in the clinic – I will then hook back up to the IV pole or machine and do the “drain.” If all goes well, that part should take only about 15-20 minutes.
And then, you do it all over again.
Now, if I’m on the machine – or cycler as they call it – then this will all be happening at night while I’m asleep. I will have only hooked up myself and set up the bags needed. If doing it manually, I will do this every four to six hours all day long.
The only thing I haven’t mentioned yet is the handwashing and disinfecting. You have to wash your hands for a solid minute – looking at the clock while doing it – with Dial soap – before you can touch anything. After that, you can opt for gloves, which I probably will. Then, you have to sanitize your port by washing it with this solution and a piece of gauze for one minute. Again, looking at the clock. After that, you then have to place another piece of gauze soaked in this disinfectant around the port and let it sit for a minute. Again, looking at the clock.
And it has to be a clock with hands. No digital clock allowed. Can’t be a watch either, cuz it could contaminate something.
After this, only then are you allowed to begin.
And if during any of this time you touch anything else, it’s back through all the steps again.
It can basically take up to 10 minutes before you’re even ready to start.
And at the end, when it’s time to drain, you do it all over again.
I am going to have the driest skin ever.
So, yes, I’m more comfortable with it. Writing about it has helped. I ask that you think of me and pray that peritoneal goes well, because I’m still flat scared of hemodialysis (where your blood is filtered and put back in your body). I got woozy just typing that. They talked about it for five minutes one day, and I had to lie down. Kirby said I started talking all funny but I was trying to tell them to stop talking about it.
I hate blood, so I need this to go right.
When I was a kid, I always loved school, right on up through high school. Probably other than middle school, I was always excited for the first day. Particularly in elementary school, I was so excited to see my old friends I hadn’t seen all summer and see what they were wearing. And, of course, it was all about who had the best school supplies and judging them accordingly.
It’s odd, but I have that same kind of excitement about tomorrow. I know dialysis will be no picnic, but I’ve been waiting a long time to try something that I know will ultimately make me feel better. It’s the next best thing to a transplant, and it’s finally here.
I have a feeling, until I have a transplant, that life will be divided into “before dialysis” and “after dialysis” for a while. This past year – late 2015 into all of 2016 – has been a rough ride, but you have all helped me through it in the best way.