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Kidney Dialysis
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1st Step

Today I will have surgery for the development of my blood vessels to start the dialysis process. The impurities in my body are starting to build up. I have several gout locations. A foot is swollen this morning and my face is puffy. I know all of these are signs that it is time to take this step. My pre-op blood work showed that uric acid is twice what it should be. Potassium has creeped just above acceptable and even though we do not use salt or processed foods my blood sodium is above range. All signs that this step is needed.

My primary doctor on Monday said I'm going to feel so much better when dialysis starts. So I have to take this step. The weather is in a deep freeze, as most of the country. All the schools are closed. A travel advisory is in place this morning. For a moment I wondered if they would call and cancel. I stopped my thoughts immediately - I have to take this step.

I have so many questions, little nagging things. I made a pot if soup, so my husband doesn't need to fix anything tonight. Will I be able to cook tomorrow? I did all the wash and will change the sheets before I leave. Will I be able to make the bed tomorrow? What are my limitations after surgery? For how long? Why didn't I ask the doctor? My 4 year old grandson comes on Sundays, will I be able to play on the floor with him? I sometimes don't heal well, will there be a scar? My GFR is 19 will my blood vessels be ready before my GFR plummets?

None of this matters today. The only way to do this is to stop the questions, put away the excuses and don't look back but forward to my doctors words. "You are going to feel so good" Then I remembered a cherished phrase and knew the only way to take this 1st step. Let go, Let God.

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I love reading your post as it identifies your fears so elegantly. This is the first step of facing our fears. You have also taken baby steps to overcoming your fears, for which I congratulate you. Remember your source of your fears and maintain momentum to continue to move forward. Trusting GOD in all your ways, acknowledging him as he will direct your path. Enjoy your life's journey....

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Thank you. I habe tried to name my fears so I can face them. Of course new ones pop up. Just before surgery yesterday I was informed about the buzz I will feel, the sound of blood swishing and to never let them put a blood pressure cuff on my left arm ever again. LOL.

Then today I learn that my brothe was taken to emergency yesterday. They chose not to tell me. All I can do is pray - so extra thank you for your response. I needed to be reminded to pray.

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Are you having a fistula or the chest catheter installed for dialysis?

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Fistula wa installed yesterday.

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I completely understand!!! I can only say take everything moment by moment. These steps are smaller than day by day and more minute than hour by hour. Your elegant expression of your emotions is what the kidney community needs. Take a peek at my blog Chronic Joy: robinsweetgrl.com

and I'll take you through my moments all the way to my transplant. FYI, I pray no one goes through what I went through with dialysis or transplantation, lol.

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Thank you for sharing. I read,1 post and I will return I'm not groggy from surgery.

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Did/has the surgeon said when your fistula would be ready for use? I had mine installed 6 months before starting dialysis. I was told that it takes time for the fistula to grow in order to be large enough for use. Not to freak you out or scare you, but I had to have a 2nd surgery on my fistula. The surgeon had to tie off some of the veins branching off the fistula. They were robbing blood flow and not allowing full development. 3 small incisions on either side of the fistula, nothing major.

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No he didn't. I don't go back until mid-March and I see the nephrologist in April. He didn't say what he actually did. Apparently he's pretty creative, the surgical staff referred to his "creations". There is a lot of bruising.

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Yes, there will be bruising there for quite a while. also you may see some clear fluid where they put the needle in and maybe some swelling. This is normal and you can use a cold pack for the swelling and to alleviate any pain around the site. 10 minutes on, ten minutes off. Also be careful not to lift anything heavy until your surgeon says it is safe. Read your discharge instructions carefully and be sure to follow them. If you see any bleeding from the needle site, call your surgeon's office or the hospital where you had it done. Also if you have redness, heat and swelling (this could be an infection). Also, the surgery is called the creation of a fistula. The fistula itself will probably take several months to mature (grow large and strong enough for use for dialysis). You can aid it by doing exercises like squeezing a ball (nobody told me that, so I ended up having an additional procedure to expand the fistula before it was ready to use for dialysis the following year.) Good luck to you! Oh, the bruising there is because the surgeon moved a vein to bring it to a position that is easier to access with the dialysis needles and he joined it to an artery (that's why it's called an arteriovenous fistula).

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Thank you. I kind of was avoiding the word fistula. They didn't mention ice, are you sure I can or should I call. The directions said to Tylenol and if ineffective to call doctor. Watching for infection.

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I always wrap my cold pack in a washcloth so it's not directly on the skin. It helps with breaking up the bruising, but of course you can just use Tylenol. A cold pack is most effective the day of the surgery, then in the days after you can use a heating pad, but always use on low wrapped for just a few minutes on , a few minutes off. I believe moist heat is best for a bruise, so I wet and wring out a hand towel and wrap it around the heating pad.

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Thank you, I applied ice last night. The pain is less today. We changed the bandaging today. Gross incision but I fell asleep in recliner with my arm above my head. The bruising looks better.

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You're welcome. I've been through this so many times with the creation of the fistula and several balloon angioplasties to open it up whenever it narrowed or clotted. The scar itself will fade somewhat and you'll hopefully get used to the look of the fistula. I try to think of it as my lifeline - if you think positively, it helps!

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