Diabetes and Dialysis #2
Just got back from the first surgical consult to setup getting the "plumbing" installed so that I can start dialysis. The surgeon was one of those doctors that I generally really like talking to. He was very outgoing and loved to talk and crack jokes. That is usually right up my alley.
Now please don't get me wrong. I like this surgeon. At least it first impressions are any indication. But today I just wasn't into that. I have come to terms with the fact that I am going to have to have dialysis. I guess that I am still feeling the fear of the unknown.
There are three types/ways they can setup the access that will be needed to hooked up the dialyzer, the machine that will act as my kidneys for the rest of my life.
First is a good old fashion central line. This is an access that is exterior to the body and is put in the upper chest. I had to have a central line done once when I was in the hospital. It is no big deal really but the problem with that type of access is that with it being exterior to the body there is a much greater chance of infection. You have to keep a dressing over it and it must be kept dry (aka no showers). This type of access can be used immediately and is generally only used as a temporary measure while one of the other methods is done or if they cannot do the other types of access for some reason.
Second is a graft. Incisions are made in the lower part of the non-dominant arm and a graft is placed that connects the artery in the lower arm to the vein. This type of access is below the skin so there is a lower chance of infection. It can be used in about two weeks. The down side here is that it only lasts a couple of years and then has to be redone. There is also a much greater risk of developing clots.
Lastly is the fistula. In this type of access an incision is made similar to the one made for the graft only in this case the artery and vein are actually stitched together. This type of access is also beneath the skin and is the type of access that is preferred. Less chance of clotting and the fistula access lasts for many years. The problem here is that is takes about twelve weeks for the fistula to "mature" and strengthen to the point that it can be used.
I have decided to get the fistula done and if I must get dialysis treatments before the access is ready then I will have to get the exterior access installed temporarily.
The next step is an ultrasound on the veins and arteries in my right arm to see if I have enough flow for the fistula to work. That procedure is scheduled for next Monday.
I have still had no one tell me that I need to change my diet or fluid intake. I have read some on it and it does concern me some. One of the big things is that orange juice is not allowed and I love me some oj. That is my treatment of choice for a low BG. Guess now I either use another juice (if allowed) or I used the tablets.
So the dialysis car is in gear and the trip has started. If I said I wasn't scared and worried I would be lying to you and to myself. I am a bundle of nerves at the moment.