Cramp is an occupational hazard for dialysis patients, just as it is for Olympic athletes - and clearly we have plenty more in common besides. I know not the scientific ins and outs of the origin of cramp - Google it - but I would imagine having a large amount of fluid sucked out of your body within the space of a few hours is a reliable trigger, and during dialysis it is a symptom that you are somehow removing too much, despite having calculated the appropriate amount and programmed it into the machine before starting.
I have had cramp during dialysis before, usually in my toes as I wriggle them around in an effective pain subversion technique that has stuck from childhood. I now do it automatically whenever there is a needle three feet from my person.
Until Wednesday, this minor ailment had never been anything a gentle foot rub couldn't relieve, but during my mid-week session this week I had a cramping experience the likes of which I am not likely to repress any time soon. The session had started well: I managed to get some work done so treated myself to the latest episode of The Great British Bake-off (and as I said to Siobhan, no I don't think Brendan was hard done by; the task was to construct a magnificent, complex gingerbread structure, not the shell of a basic house, finished off with exuberant icing. It was fondant over substance, I'm afraid, and as for the Shredded Wheat on the roof...) As I approached the final hour, however, I felt a bit of cramp in my left foot. It was of little concern...until it started creeping up my calf. I rubbed myself vigorously for a while (make of that what you will) but it didn't help; the cramp was actually getting worse. It eventually became too much for me to deal with on my own and I resorted to calling over to Maud.
Maud is one of my favourite nurses, and I am confident that I am one of her favourite patients; it is she who has trained me in the art of needling we have a good relationship. I was very glad, then, that it was she who came to my aid. The cramp in my left calf had progressed from uncomfortable to outright painful. Maud straightened my leg and rested it in her hand, rubbing and beating it like a Persian rug. The pain would ease for a moment or so before even a minute movement sent the muscle back into spasm. The pain was by now barely tolerable. I was still attached to the machine but Maud was able to stop the fluid from being removed and in theory this should have helped; it didn't, and neither did the 100mls of fluid she infused into me. The pain was now getting so strong that I couldn't remain still any longer: I have a visceral reaction to pain, I try to physically distance myself from it by moving away from it, but this is tricky to do when you are connected to a dialysis machine that is in possession of a lot of your blood. Maud counselled that my cramp would ease if I put my leg on the cold floor, so I sat up and swung my legs over the side of the chair. This was a mistake.
I have never experienced cramp like it. The pain was unbearable. I was crying but was so overwhelmed by shock and agony that I was unable to release any sound, so I sobbed furiously on Maud's shoulder in between some very undignified episodes of flailing and saying "fuck fuck fuck fuck mother-fucker fuck". It was intensely embarrassing - there were five other patients watching me have my little melt-down. But Jesus Mother of Christ - it would have been less traumatic to simply chop my leg off. I couldn't think, I couldn't speak, I couldn't urinate because the surgeons took my kidneys some time ago, but boy if I could I would have pissed myself for sure. By now my blood pressure had dropped because of the excess fluid removal so in addition to the searing pain in my calf I was now so dizzy that if I was about to end up on the floor whether I wanted to or not. Except, of course, the cramp - have I mentioned the cramp? - impeded me from any movement beyond the flapping of my arms, so Maud had to lift me back into the seat of the chair and manoeuvre me to horizontal. The whole thing was about as humiliating as it gets without the added elements of a blow job and/or your parents. Maud infused me with yet more fluid - a dialysis no-no in most cases, but desperate times....and with a little more rubbing, the cramp very, very gradually dissipated.
Maud stayed with me as a I rubbed mascara from my cheeks and apologised for having the resilience of a walnut. She was exceptionally compassionate and only once she was sure I was alright did she leave me to attend to the other patients as I watched the remnants of a West Wing episode and trembled with PTSD. The moral of this story? There isn't one, I'm afraid: this sorry tale should highlight the importance of setting the correct amount of fluid to remove of a session - and yet I had. It was simply a quirk of dialysis, because even after a extra 300 mls of fluid I still managed to end my session 0.1kg under my dry weight. There are many, many things I hate about dialysis, and it's unpredictable, often inexplicable nature is one of them. I can't do anything to negate the risk of cramp at hospital, but I might have to shelve my dream of running the 1500m in Rio. I have now lived the life of an Olympic athlete and I tell you - it's tougher than it looks.
Until Wednesday, this minor ailment had never been anything a gentle foot rub couldn't relieve, but during my mid-week session this week I had a cramping experience the likes of which I am not likely to repress any time soon. The session had started well: I managed to get some work done so treated myself to the latest episode of The Great British Bake-off (and as I said to Siobhan, no I don't think Brendan was hard done by; the task was to construct a magnificent, complex gingerbread structure, not the shell of a basic house, finished off with exuberant icing. It was fondant over substance, I'm afraid, and as for the Shredded Wheat on the roof...) As I approached the final hour, however, I felt a bit of cramp in my left foot. It was of little concern...until it started creeping up my calf. I rubbed myself vigorously for a while (make of that what you will) but it didn't help; the cramp was actually getting worse. It eventually became too much for me to deal with on my own and I resorted to calling over to Maud.
Maud is one of my favourite nurses, and I am confident that I am one of her favourite patients; it is she who has trained me in the art of needling we have a good relationship. I was very glad, then, that it was she who came to my aid. The cramp in my left calf had progressed from uncomfortable to outright painful. Maud straightened my leg and rested it in her hand, rubbing and beating it like a Persian rug. The pain would ease for a moment or so before even a minute movement sent the muscle back into spasm. The pain was by now barely tolerable. I was still attached to the machine but Maud was able to stop the fluid from being removed and in theory this should have helped; it didn't, and neither did the 100mls of fluid she infused into me. The pain was now getting so strong that I couldn't remain still any longer: I have a visceral reaction to pain, I try to physically distance myself from it by moving away from it, but this is tricky to do when you are connected to a dialysis machine that is in possession of a lot of your blood. Maud counselled that my cramp would ease if I put my leg on the cold floor, so I sat up and swung my legs over the side of the chair. This was a mistake.
I have never experienced cramp like it. The pain was unbearable. I was crying but was so overwhelmed by shock and agony that I was unable to release any sound, so I sobbed furiously on Maud's shoulder in between some very undignified episodes of flailing and saying "fuck fuck fuck fuck mother-fucker fuck". It was intensely embarrassing - there were five other patients watching me have my little melt-down. But Jesus Mother of Christ - it would have been less traumatic to simply chop my leg off. I couldn't think, I couldn't speak, I couldn't urinate because the surgeons took my kidneys some time ago, but boy if I could I would have pissed myself for sure. By now my blood pressure had dropped because of the excess fluid removal so in addition to the searing pain in my calf I was now so dizzy that if I was about to end up on the floor whether I wanted to or not. Except, of course, the cramp - have I mentioned the cramp? - impeded me from any movement beyond the flapping of my arms, so Maud had to lift me back into the seat of the chair and manoeuvre me to horizontal. The whole thing was about as humiliating as it gets without the added elements of a blow job and/or your parents. Maud infused me with yet more fluid - a dialysis no-no in most cases, but desperate times....and with a little more rubbing, the cramp very, very gradually dissipated.
Maud stayed with me as a I rubbed mascara from my cheeks and apologised for having the resilience of a walnut. She was exceptionally compassionate and only once she was sure I was alright did she leave me to attend to the other patients as I watched the remnants of a West Wing episode and trembled with PTSD. The moral of this story? There isn't one, I'm afraid: this sorry tale should highlight the importance of setting the correct amount of fluid to remove of a session - and yet I had. It was simply a quirk of dialysis, because even after a extra 300 mls of fluid I still managed to end my session 0.1kg under my dry weight. There are many, many things I hate about dialysis, and it's unpredictable, often inexplicable nature is one of them. I can't do anything to negate the risk of cramp at hospital, but I might have to shelve my dream of running the 1500m in Rio. I have now lived the life of an Olympic athlete and I tell you - it's tougher than it looks.
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