Skip to main content

A pointed issue

For someone who has had quite a lot of experience in and around hospitals, I am not a very good patient. In fact I am incredibly impatient. I get bored and grouchy and I start to wriggle. I have mild OCD tendencies and hate being surrounded by dirt, or ill people, or ill people coughing up dirty things. I like my own space and privacy and to sleep in my own bed with my Bear. I don't like being woken up at 6:30 am after having already been disturbed two hours earlier by Ethel falling out of bed for the third time. I despise the food and the constant noise, and the relentless boredom drives me crazy. There is something that makes me dislike hospital more than all these incessant niggles combined, however, and unfortunately the two are symbiotic: I am afraid of needles. And, yes, to a lesser (and weirder extent) tea, but mostly needles. And hospital means needles.

It must have come as something of a surprise, therefore, when two years I decided what I really, really wanted most in the world, more than a new laptop or less bushy hair, was to swap from peritoneal dialysis (PD) to haemodialysis. PD involves having dialysis through a catheter which remains permanently in your stomach and having already experienced the joys of one 12 years earlier, I felt I was ready for bigger and better things. I knew that having haemo was going to involve needles eventually, but to start off with I sported what is surely going to become one of the key trends for A/W 2010: a tube flapping around just under my right collarbone. Ahh, the neckline. The itchy, irritating, ugly, infection-prone, shower-prohibiting neckline. Memories...it was a massive relief when, finally, my fistula was fully formed and ready to use as it meant the neckline was removed (they hacked it out whilst I was still awake, an enjoyable 25 minutes). Horraay! No more fucking neckline! But booo... needles in my arm. Swings and roundabouts.

A fistula is formed by re-routing an artery through a vein so that it is expanded by the increased blood flow. This creates a conduit near enough to the surface of the skin that it can be permeated by a needle but also large enough that it can cope with the high volume of blood that pumps through it during dialysis. For most people, the fistula is visible as a bump or ridge on their arm. I'm obviously special, because my fistula is a giant, throbbing, hideous deformity that makes me look like a python still trying to digest the mouse he ate whole last week. "It's very strong, isn't it..." say some of the kindly Phillipino nurses, or, less tactfully, "Oh my God, it's massive..." When it comes to fistulas, bigger isn't always better...its just one hell of a lot more disgusting.

Initially, the thought of needling the fistula made me break out in a cold sweat. Aching, cramping, throbbing: these are all pains I can deal with. I even take a perverse enjoyment in toothache. The sharp sting of needles is something that I have always dreaded; yet I found myself watching as two (not small) needles travelled rapidly towards my left arm.

Thank God for Emla cream. It is numbing cream and it is miraculous. At first I used it religiously but then my old familiar foe rose his ugly head: his name is Chronic Laziness (grr *shakes fist*). The cream has to be applied at least half an hour before getting needled; too soon, and it doesn't work, not long enough and it wears off....and it was slimy, and it got on my clothes....uggh, even just thinking about it makes me tired. So I gave up on the cream and started... er...going commando.

Bizarrely, it didn't hurt as I thought it would. The more you push a needle through the same patch of skin, the weaker the skin becomes; the needle slips through more easily and the pain subsides. I also found the amount of pain to be relative to the nurse putting the needle in: some have a magic touch and can push that sucker in without you feeling a thing. Others are so cack-handed I worry for their husbands. Which is not to say it doesn't hurt, it usually does, but you become so used to it, it stops being an issue.

Until recently, that is. Inexplicably, the site for the lower needle in particular has become really pretty sore. We've tried inserting the needle in varying locations, but nothing helps, it hurts like a bitch. Yesterday - I cried. I actually cried because I am a little, pussy, five year-old girl. The poor nurse couldn't stop apologising for...er....doing her job. "S'okay," I snuffled, wiping my eyes as best I could with my remaining free hand, whilst she loaded me up with as much Emla as she could get her hands on (which turned out to be two boxes, because this is the NHS). Because the needles had hurt so much going in, my arm continued to burn throughout the whole session (suddenly the Gilmore Girls quick-fire witty repartee didn't seem very funny) and man - those puppies hurt when they came out.

But that's dialysis for you: sometimes good, sometimes bad and nothing that an M&S sandwich can't usually cure. The needles go in, but they also come out again. Some day, maybe, they won't even have to come near me at all.

Comments

Popular posts from this blog

Postscript

You wouldn't believe where I am. You could guess, if you've seen the gratuitous images of my self-satisfied gurning face in front of an infinity pool on Facebook...otherwise you might find it hard to imagine the paradise in which I currently find myself. I am in Dubai. Bar Abby Clancey and the cast of TOWIE, is is not everyone's idea of paradise - it actually wasn't mine. It is exciting, exotic and fucking hot, but the skyscrapers and traffic, the desert and cultural  deficiency (not to mention the chavs that clutter up the Ritz Carlton these days, I mean honestly...) suggest you'd be hard-pushed to call it paradise. It is vaulted to utopian heights simply because, four-months after the transplant, I am here. My nearest and dearest suffered for seven years as I dreamily aired my wanderlust. Yet the reward of a post-transplant holiday seemed too extravagant a prize for which to yearn - wasn't a life free from dialysis enough? Wasn't having a drink when t

The nights are closing in

The final step of my home dialysis journey (bleugh, journey...sounds like I'm on The X Factor) begins on the 22nd July when Nurse Carla will arrive with a sleeping bag and, presumably, some strong coffee, and sit on my sofa all night whilst I perform my first nocturnal session. It is the dialysis equivalent of hiring a wet nurse. During a regular daytime session, nothing should go wrong unless I have lined the machine carelessly with one eye on Only Connect and consequently forgotten to connect/un-clamp/tighten something pivotal. Dermot should behave, stay quiet and not do any of his ghastly alarm-yelping. At night, however, the chances of rolling over onto the tubes and occluding the blood flow, or the needles falling out and slowly bleeding to death, are much higher, what with all the concurrent sleeping I'll be doing; when this happens Dermot senses DANGER and screams at me. Undoubtedly, my first session with Carla will be seamless; I know from experience that it is only

The phone rings Part III: The Final Chapter

Two weeks ago today, I was in surgery receiving my new kidney. The hospital kicked me out in less than a week and over the last seven days I have divided my time between the transplant clinic and my sofa, with the occasional shuffle up to Sainsbury's to ensure the muscles in my legs don't atrophy. I've had the pleasure of a steady stream of visitors, all of whom have bought me yet more wonderful and totally unnecessary gifts – I have been royally spoilt and I am stupidly grateful to all of you. The kidney itself appears to be going great guns. I was initially attending clinic on Monday, Wednesday and Friday and was committed to doing so, but the hospital are so pleased with me they are happy to start seeing me just twice a week. The pivotal result they test for is my level of creatinine, a substance that occurs naturally in the body as a result of muscle break down. The kidney filters out creatinine through the urine, therefore if there is lots present in the blood it is