Vascular Access

To gain access to my veins I  had to have created a fistula which is the grafting together of a vein and an artery in order to accommodate the amount of blood flow during dialysis.  I had the fistula first created in September 2012.  In May 2013 when I first started dialysis they (my Training nurse) couldn’t find my access although it is easily felt but is tough to find.  My initial needle sticks with sharp needles were very painful and excruciatingly long.  It seemed like everyday day it was in a different place.  She would put in two sharp needles a day – 15 gauge 1 inch long – one to take the blood out (Arterial Line) and then to return the blood (Venus Line).  The goal is to create a button hole which is a track that goes in at the same angle and depth every time so that I can be trained to access my veins using Button Hole needles – still 15 gauge, although not nearly as sharp, but still pretty sharp.  After two weeks of this I was sent to a Vascular Surgeon for a series of 3 Fistula-grams.  This is where they enter my fistula and shoot dye up it and then X-ray it and then put a balloon up it and inflate it (kind of like an angioplaste )  with the goal of moving the whole vein.  This is very painful.  They did this three weeks in a row in May into June to improve access.  Then my training nurse could establish a button hole (actually 2 button holes) with ten consecutive sticks in the same place at the same angle with the sharp needle (very sharp).  Then I was trained to put the button hole (not nearly as sharp) needles into these tracks.  Despite this I have to go back to the vascular surgeon again every three to four months to maintain my access.  I have since had this procedure done in August and again in November and am scheduled back for March.  Despite this it remains challenging to put in my Arterial Needle every time I dialyze.  It takes 15 -20 minutes to get this needle in while my Venus Needle goes in very easily.

Today was my last day at the BSA.  I cleaned out what was left at the office, turned  in my keys and lap top computer and said my good byes.  It was very difficult after working for the BSA for 26 years to say good bye – although I do hope to return, the light at the end of that tunnel is very far off.  I don’t know what my new life will be but I know it will be very different the life I have knows for the past 26 years.

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