There are these huge biohazard bins at the dialysis center that gets replaced every so often. I think the waste deposited in the bins are incinerated; not sure if it’s done at the hospital or offsite. There is a lot of hazardous waste since almost everything in the clinic is contaminated by patients’ blood. For me, it’s double the waste since I’m using both access points: catheter and fistula.

For the catheter, first they have to pull the leftover anti-coagulant, in my case it’s argatroban, which uses two locking syringes. These get filled with blood and tossed.

When the fistula is used, the needles are also disposed in the blue bins after dialysis. On Tuesday, the tech had issues inserting the needles in my arm and had to used up four needles instead of two. There’s also the small syringes used to inject lidocaine. Finally, all the tubing and dialysis filters go into a bigger red bin for disposal. There is a crazy amount of waste with dialysis. This was also true when I was on peritoneal dialysis at home.

The tech who has been sticking me consistently had problems today with the needles. He ended up using four needles to get good flow on both arterial and venous connections. There is also a difference of opinions on what I should do. My nurse and (assigned) tech has been harassing me to go see the vascular surgeon. I’m not sure what he is going to do when I tell him the dialysis center is having problems. I don’t want another surgery on my arm. At the same time, the head nephrologist came by today and asked me to get my chest catheter removed. The same vascular surgeon said he will remove it in his office. The last time I had to go to the hospital; it was just the pre-op area but still took 4-5 hours.

Ugh. I’m so done with doctor appointments.

My dialysis center rotated techs this week so there are two different techs in my area. I know all of them since they rotate every three months but since the person assigned to my chair has not seen my fistula before, she wanted to try and stick me. Also, they don’t even bring out supplies for hooking up the chest catheter; it’s all stuff for the fistula.

She tried Tuesday and was not successful so she called over the tech that has been sticking me for the past few weeks. Likewise, she was unable to hit the vein yesterday so she call the other tech to help again. However, since she made several attempts already, when the other tech finally hit the vein, my arm was already pretty sore. He also had some problems with the arterial needle so my arm was hurting pretty noticeably for the entire four hours.

At the end of the session, when the tech pulled out the needles, the arterial wound would not stop bleeding. I was applying pressure with a gauze pad but blood kept flowing out of the hole and made a mess. I’ve seen this happen to other patients but to experience it was weird. We finally managed to stopped the bleeding and I sat for 20 minutes applying pressure to the needle sites.

Happy 4th of July!

This is my 3rd anniversary for dialysis. I started hemodialysis on July 5th, 2017.

A different nurse tried to stick me today and came up dry. Shehad to call the recharge from another unit to finish inserting the needles. Since he had to dig a bit, it hurt a lot more than the two previous day’s.

The same tech was able to get both needles into my fistula today as well and we ran the machine at 350 mL/min. He did mention that starting Saturday, another tech will try to insert the needles so hopefully he has good luck as well. They have been using the standard 16 gauge needles that should sustain higher flow rates so I’m going to ask them if we can run at 400 or 450 mL/min and possibly cut down on the dialysis time.

Woohoo! One of the techs that was the first to try and insert needles into my fistula tried again today. Since everyone thinks my veins are both deep and moves around a lot, all the techs try to push the needle perpendicular to my arm to go deep, then dig around to get the blood to flow. This is weird since you can clearly feel the vein right below the skin layer. Anyway, the tech went shallow and got both needles to flow on the first attempt. One of the needles did hurt for the four hours if I moved my arm slightly but they were able to run the machine at 350 mL/min. Sigh… finally. I’m hoping this trend continues so I don’t have to have another surgery on my arm, and they can take out my chest catheter so I can take showers again.

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The arterial “wound” is still bleeding after an entire day. I swapped out two band-aids and it has soaked both of them. I think it’s finally stopped bleeding. I’ve seen “accidents” at the dialysis clinic where blood is squirting out of the arterial needle prick point resulting in a huge puddle of blood on the floor. I hope I don’t get that at home.

Another day another person trying to stick a needle in my fistula. Today, it was one of the senior nurses; my regular nurse is on vacation today. She ended going up further on my forearm and was able to get a good stick. It did hurt when she tried to push fluid back so we’re using it to draw blood and use the catheter to send back.

Also she didn’t use lidocaine so it hurt a lot when she jabbed me.

Two needles in my arm today. Machine flow rate is set at 250 mL/min.

One of the older techs came by to insert the needle in my fistula. He was on vacation for the past two weeks and I heard he’s been at that dialysis center the longest. Anyway, it still took him about 3-4 tries to get the right vein. They still used only one needle at 250 ml/min, but dialed the time back to 3:45. My nephrologist was doing rounds today and she didn’t want to bother with the extra 15 minutes.

You can kind of tell the vein is getting larger in my arm. There is a definite bump in my lower arm where you can feel the blood rushing by all the time. And it’s noisy. If I sleep on my right side and my arm is anywhere near the pillow, I can hear the blood whooshing by.

My dialysis clinic tried to stick my arm again today. The tech tried a few times but was able to finally hit the vein. However, it hurt a lot, even with lidocaine. The needle was only in for five minutes but hurting more and more, and the machine was giving low pressure alarms. Finally, the decide to pull the needle since the vein may have collapsed. Right now, both tubes are connected to the chest catheter. The needle insertion point also has sharp pain when I cough. That’s new.

This is my arm yesterday. There are two post-op scars and a bunch of pinpricks. The two higher up in the arm were the original attempts. Then they moved down the arm and you can see at least seven needle scabs.