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Dialysis is hard - or am I just overly sensitive?

As she removed my needles at the end of today's session, Nurse Josie confirmed with me that I knew what do should my fistula start bleeding again.

"Put pressure on it," I said (I've seen Casualty).

"That's right," she said. "Or ring 999, if it won't stop."

I smiled. "I don't think it will ever get quite that bad."

"Oh, you'd be surprised - we've had patients who's fistulas have blown when they rolled on their arm in their sleep and they've just bled all night. Not to scare you or anything," she added. I rolled down my sleeve. Carefully.

This alarming conversation served to: 1. Freak the bejeezus out of me and 2. Make me very grateful that my fistula has given me a pretty easy ride. It's mammoth proportions are certainly an issue, but it has worked well for two and a half years I have used it and even performed admirably a mere day after surgery last year.

Ah, but there's always a But. A few months ago, having moved the top needle site further up my arm as a result of the aforementioned operation, it started to get itchy. Really itchy - chicken pox itchy - and it was compounded by knowing that I really should not scratch it because getting an infection in the fistula is nobody's idea of a fun night out. Whilst conscious, self-restraint proved difficult but not impossible; unfortunately, I had no such compunction when I was asleep and would wake up to find myself clawing at my arm.

Long story short, after some consultations from a range of equally over-wrought on-call doctors, it was established that I had, inexplicably, become allergic to...something. Possibly the alcohol wipes - the same ones we had been using to clean the fistula, with no ill-effects, at every session for the last thirty months. Maybe the tape. Perhaps this was my body telling me that in fact I don't really like needles after all. Whatever it was, the third doctor prescribed some cream and it seems to be helping; it would probably clear up the redness conclusively if only I could stop rasping the area with my massage sponge like I was trying to sand a skirting board.

So everything was on the up. Except...when I got home on Friday, I noticed that the skin down the sides of my arm was itching too. The sensation was not around the needle site, it was less localised; I was itching where the tape had lay. As I scratched, I felt a rash. When I looked, I saw that I had indeed come up in little bumps all over my arm. Admittedly, I am slightly allergic to a certain type of surgical dressing, but I have been exposed repeatedly to the surgical tape we use to tape up the dressings post-dialysis and it has never caused such a reaction.

I have concluded that I have obviously become allergic to dialysis.

There is probably no explanation for these weird, itchy goings-on. The doctors and nurses who provide me with such excellent care are prone to searching for a definitive reason for any anomalies that arise as I undergo this treatment. I have come to realise, however, that one is not always there to be found: sometimes dialysis sessions make me feel awful, sometimes not. Sometimes my blood pressure will be elevated, at other times it will be perfect despite the fact I have taken precisely the same amount of medication. This latest instance is no exception: there is no discernible reason for my suddenly having developed an allergy to substances I have had no trouble with previously and yet there it is anyway. Quite the mystery, but I shan't be losing sleep over it. Just have to hope that I don't roll onto my arm whilst slumbering so peacefully.

The point to be made is that it's just a rash. It is irritating (in every sense) but it is not disabling. I consistently find that one of the most difficult aspects of a life on dialysis is maintaining a realistic sense of perspective. Sometimes I find kidney failure very, very hard and on a bad day, perhaps a little harder still. But when I consider my situation in relation to others - is it really? Are my complaints legitimate, really? We all of us have our crosses to bear, this just happens to be mine. Admittedly, the last few months have proved the toughest yet, but perhaps this says more about my own ability to persevere because the circumstances have remained quite constant. Everyone is finding it rough-going at the moment: it is dark and cold, Christmas is a memory and we are all back to work with no near respite. Dialysis will continue unabated and time spent agonising over it is surely time wasted. The rash will clear; the weather will get warmer; a transplant will come eventually. All that's left to do is keep my head up...and try not to scratch.

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