One Step Closer to Peritoneal Dialysis

Today I had my peritoneal catheter externalized.  On December 3rd I had the peritoneal catheter placed, during the surgical procedure, surgeons implanted the catheter into the peritoneal cavity and imbedded it into muscle tissue.  The rationale for imbedding the catheter and not leaving any outside of the body is so that the muscle tissue will grow around two cuffs and provide a strong anchor for the catheter. This was different than my first experience with peritoneal dialysis, so I found it very interesting.  The hope, is that with such a firm anchor and since the body has been introduced to the catheter there will be less incidence of infection  (call peritonitis).  With today's procedure they numbed the skin and palpated the abdomen (pushed on my stomach) to located the end of the catheter. Once that was located, it took some convincing, but finally the end was flipped out and attached to the connector tubing.  The whole procedure too less than 30 minutes -- it was relatively painless (slight stinging with the local and pressure flipping out the end).  So, now with the catheter coiled on my stomach I have a constant reminder that I will soon be able to begin the training for PD. 

Above, I've posted pictures of my prior to externalization and post externalization.  The first photo show the incision and endoscopic 'stab wounds' for implanting the catheter  the second photo show the catheter outside the body.  No stunt doubles were used :)

Be-ware of the Chair



Today was my 9th Hemo treatment.  Except for one day's bumpy treatment, the overall experience has been positive.  In the two & one half weeks I have been on dialysis I have lost 20 pounds and regained my ankles!!  Cankles - no more :)  And as my prednisone dosage is decreased I am beginning to gain my face back -- you, that thing with cheek bones and one chin (hmm, well I'm afraid I get ahead of my self -- I still have an abundance of chins, but anyhoo....)  One thing I will miss about Hemo is the sense of community.  For those of you who know me and what a shy, delicate thing I am.... you know it takes me a little while to warm up to a crowd.  but Christmas has allowed me to get to know the staff and other dialysis patrons a little better. 

So as I was saying I've really only had one treatment that made me question if I was cut out for hemodialysis.

It was a Friday, the weekend was just hours away and I was itching leave my recliner behind and start my weekend early.  I followed the routine, when I arrived I paged the nurse and was 'buzzed in',  I weighed and found my assigned chair.  Let me tell you about this chair, it's big and cushy with a great head pillow and a reclining footrest.  Total comfort, right?  Well, you decide for your self.  When I sauntered up to the chair it was in a yoga position, the down dog I believe, yep, I kid you not....  That should have been my first inkling of foreboding.  but no, innocently I helped the chair back into a resting position ( I'm just sure I heard it say 'thank you').  Events proceeded normally enough, standing blood pressure, sitting blood pressure, dressing change and IJ catheter hook up. With the exchange underway and the 31/2 hours slowly ticking down, I put up my feet and prepared to find the answer to that nagging question.... deal or no deal?  

All of a sudden a tickle surprised me and I had to cough.  The cough subsided and I returned to my mental edification.  All of a sudden a whistle blew - awhoooo awhoooo and an alarm sounded beep beep beep beep and along came the reinforcements.  Amidst the voices I gathered that my arterial pressure was high and flow was low - apparently neither of which is appreciated by the medical team (and following this exercise it doesn't sit well with me either).  Fluids were pushed, lines were crossed and I was reclined further -- so, now I told you about that big cushy head cushion -- for most persons of average height this would have been a head's dream, but for those of us whose feet don't quite reach the floor -- you'll understand when I say the head rest was just that, resting on (and above) my head. Little did I know that this would come in quite handy, nearly life saving. 

So back to the events at hand.  Pressures got regulated and tensions eased, but the rest of treatment I had to periodically cough to ease the elevated pressures -- imagine a vacuum hose getting sucked against a wall -- you have to wedge the hose away to ease the pressue -- it was similar with my IJ (interjugular) catheter when it suctioned against my chest wall.  I settled back into a frozen position, head facing to my left, hands folded in my lap, legs crossed, but a gal can only hold that position for so long when the legs MUST MOVE. So I casually shifted my weight and my world turned upside down.  The chair with no warning and no command from me began to tip, tip, tip back.  I held on for dear life and rode ' the beast'. Most folks have on chaps and spurs for the kinda ride I took.  When the chair came to a quivering standstill I took inventory of my person. feet- check -- hmm I don't recall them over my head... head - check -- well don't that beat all, I can see my reflection in the floor tiles.... And do you know?  That big cushly above head cushion kept me from sliding out of the chair!

The above facts are true. Actual events may have been exagerrated for the reader's enjoyment. No chairs were injured during the course of events.

Two new hook-ups and still no cable reception????

Since my last post, life events have been topsy-turvy.  I’ve been hesitant to put the month’s events into words, because well, I’ve been less than thrilled with the order of events…. I guess if I’m totally honest with myself and with you, my readers --- I’ve been pouting….   I’m sure spiritual pouting is as heinous to God as tantrums, neither of which are terribly grown up or mature…. I would like to interject here that the above is in past tense…. I am beyond the kicking and screaming and poochy-lip (most days) – I share these less-than stellar trials – because you can’t fully appreciate where I’m going until you’ve seen where I’ve been.  So – here’s my “reader beware” disclaimer – the events described below depict a real person, events described won’t be pretty – please locate designated exits, keep arms and legs inside vehicle at all times, stop, drop and roll…. Uh – yeah, you get the point J!

Thanksgiving was fabulous!  I spent the day with family and a fawey pwincess ;)  It was a blessed day – it also was the peak to a very low valley.  Friday brought with it a case of stomach flu – it layed me low and I couldn’t bounce back.  Nearly a week later – Thursday, December 2^nd with my most recent labs reflecting my ill health and the last living donor ruled out – I made  the call.  My nephrologist and I agreed that it was time for medical intervention.  By 2pm I was in the hospital, where I had an IJ catheter placed and by 10pm I’d had my first Hemo treatment.  On Friday, the third I went under general anesthesia to have a peritoneal catheter placed. 

Fast forward to the present – I’ve got 6 Hemo treatments under my belt, my PD catheter is floating around in my tummy and my incisions are all healing nicely and itching like crazy!  In the whole scheme of things the procedures I had were minor…..  But in my little piece of Ness-Ville  it rated a 7 on the richter scale.  I’m not one to make waves, I don’t like confrontation and when feasible I tend to go with the flow – BUT  the events, minor or not left me feeling dismayed, frustrated and wrestling with questions of “why”.  Why now?  Why this?  I seriously think I could have picked much better timing.  How does this timing work into God’s purpose for my life.  I never would have scheduled dialysis to occur two weeks into my new job or two weeks from Christmas.  

Do you have a firm grip of the whiner I can be?  It’s not pretty, I know – So let me move on --  I am less than thrilled to be on dialysisis – I didn’t want this and I definitely don’t like the timing – BUT here’s what I know….

               * God doesn’t make mistakes

               *God’s timing is perfect

               * God knows me, loves me, created me and desires His best for me

               * My life has purpose and even when I don’t know what it is – God Does

I have found amazing reassurance in the words of Paul in 2 Corinthians 12:7-10 – He had something in his life that He asked God to take from him, but when God didn’t remove it, Paul accepted it and sought to use it to God’s glory and his edification. 

So I’m choosing to trust God with my present and my future because He has proven His faithfulness in my past.  I am pocketing my poochy lip and instead filling my lips with His praise.  I don’t know what purpose dialysis achieves for eternity, but I want to be a pliable vessel .  I have chosen to focus on the positive possibilities.  Being on hemo dialysis hasn’t been nearly as bad as I imagined it to be.  3 days a week I have multiple hours to sit and think and its given me time to pray and talk to God and catch up on other errands.  I am being weaned off of some of my harsher medications and if I am off steroids long enough – I might be able to have a steroid free transplant!  The last week of December I will begin training for Peritoneal Dialysis and then I will be able to lead a nearly normal life in the daytime! 

So when it comes down to it – life is good –  I still tire easily, but I’m having more days where I feel good – I am blessed~  Thanks so much to those of you who are praying for me – I know that there is amazing power in prayer and I am encouraged and humbled by the outpouring of love from so many!!

2 Corinthians 12:7-10  Therefore, in order to keep me from becoming conceited, I was given a thorn in my flesh, a messenger of Satan, to torment me. ⁸ Three times I pleaded with the Lord to take it away from me. ⁹ But he said to me, “My grace is sufficient for you, for my power is made perfect in weakness.” Therefore I will boast all the more gladly about my weaknesses, so that Christ’s power may rest on me. ¹⁰ That is why, for Christ’s sake, I delight in weaknesses, in insults, in hardships, in persecutions, in difficulties. For when I am weak, then I am strong.