Drainage problem NOT fixed

Spoke too soon.

After 2 really good drains yesterday, this morning the first one took 3 hours to get enough
to drain out...and that was with some walking around, pushing on the stomach, etc. After the
second one started out the same way, we called the dialysis center.

They set up an appointment for an X-ray which was done this afternoon, and
an appointment with the surgeon tomorrow morning.

The thinking is the end of the catheter in the abdomen has gotten turned up so it's above where most of the fluid is.

Assuming this is what is shown on the X-ray, they will put a guide wire in through
the catheter and reposition it.

Certainly hope that is the problem, and that it can be easily fixed.

Because G is pretty swollen, they are setting
up a hemo dialysis run, tomorrow afternoon after the Drs. appointment.

At least tomorrow is the clinic day for the Dr., and they got us in. I guess
it's good that the surgeon's staff knows us quite well by now. We certainly
have spent enough time at their office!

Fingers crossed.

Drainage problem fixed

Long story short, the reason G was having slow drainage was because he has something
called "fibrin" which clogs up the line.

We went to the dialysis place today, and they gave him some heparin and showed him
how to put it into the bag with the fluid. This will break up the fibrin.

It is working.

Good thing, because G was getting way too much fluid build up. Hope in a couple
of days he should be back to normal.

Update on in home dialysis

G and I went back to the dialysis center for a appointment. G will go every week for the next few weeks, so they can draw blood to make sure the dialysis is working. Also, they watch him
do an exchange to make sure he is following procedures.

He did well on his following procedures, so that is good. We did find out that he should
not be using the fluid with the highest dextrose concentration all the time, which he has been using. It takes off more fluid, but we were informed overuse can damage the lining of the peritoneum, causing scaring, and therefore causing problems with the exchange, which happens through the peritoneum membrane.

G is still having some trouble getting enough fluid out. I'll write about that some more later.

The good news is he is looking less swollen, so think we are least pretty much back to where he was after starting hemodialysis.

The calendar is full!

G went to the surgeon yesterday. "They" say the wound is looking good. I saw it looks like a moon crater...but
the Drs. say it looks good, is starting to heal.

They will let it heal from the bottom up, rather than top down, because this incision doesn't like to stay sewn shut.
Not sure why.

Anyway, I am getting better at playing "nurse" (not the fun kind of playing though), as the dressing must
be changed every day.

Have also got the cataract surgery rescheduled, assuming the surgeon will give their release for the surgery.

Also setting up classes for the Peritoneal Dialysis. I guess the class is a week long, from about 9 to 3 each day.
There is some debate when we can go to the class, as the catheter is still "buried", and the site must be
opened and the end of the catheter exposed.

Too much going on.

Gotta run as I just realized the bandage hasn't been changed today.

Great News!

Finally, some good news.

The surgeon was able to place both the catheter in the abdomen for peritoneal dialysis,
and do what he called a "good" fistula in the right arm for hemo dialysis. Both will
probably take about 6 weeks before they can be used.

G will be in the hospital for at least a couple of days, until they get his
blood thinned back to the correct level on coumadin.

At least it appears they are now taking this blood thinning thing as seriously as
they should.

So I feel much better.

And I knew G was feeling better last night, when he called me at 10:00 PM, wanting
me to bring him some food. As I was in the middle of staining some wood in the house,
I declined and suggested he get something from the nurse. They have sandwiches and
fruit cups on the floor.

He phoned back later and said he had.

I am trying to get some projects done inside the house while he was out, as I don't
think the fumes are good for him.

Well, gotta run.

Fingers Crossed re G

OK, back to the trials and tribulations of G.

Yesterday when G was at dialysis he phoned me, wanted me to come see him.
They wanted to take out the dialysis catheter, because they were afraid
it might be infected. He didn't think it was infected, that it just
looked a little bad because he wore a smaller pair of jeans for a few
hours the day before, and it pushed on the catheter.

The concern was if they took it out, he would have to go to the VA,
and they don't move very fast, and if something went wrong and they
wanted him to stay overnight he would miss his Dr. appt the next day,
with the top notch surgeon. This surgeon is the best one in town for
kidneys and does 90% of the transplants. He is double booked, and it
took 2 1/2 weeks to get the appointment.

So, G told them to not take out the catheter. They did a culture, to check
for infection.

Today we saw the surgeon, for about 2 minutes. He had 2 guys and the nurse
do most of the leg work. They changed their minds a couple of times what
they want to do first, but ended up first they will do a test to see if
the Plavix is in fact working (apparently it does not work on 20% of the
population). If it's not working, there is another drug they can
prescribe.

Then they will do some vein mapping to see how bad the veins are in his upper body/arm, because this surgeon thinks he can reconnect to the fistula in G's upper
left arm. It would be great to get a fistula working, as a back up for the PT
dialysis, assuming the surgery for that would be successful.

G may have too much scar tissue in his abdomen for it to work. They will
have to do some sort of invasive test to check it out, before they would
consider surgery.

This is so much more reassuring than what the stupid VA Dr. was going to
do. He just said "oh, I can do that surgery", and set up a date, without
doing any thinking, checking, etc. What a cowboy. And now I realize he
probably would have done that surgery, and screwed it up so there would
be scar tissue which would prevent Peritoneal Dialysis. Like I said,
the surgeon said there could be too much scar tissue to prevent the
fluids from flowing properly do to dialysis. But, this is why
they want to check it out before trying to even do the surgery.


So, at least we feel better.

Oh, and we asked the surgeon to look at the catheter and he said "that's
not infected", so G certainly made the correct decision yesterday.

Planning for the future

Well, another wake up call for me, to live life to the fullest.

I guess I must be a slow learner. My husband died 21 years ago,
my dad 10, my mom almost 2, G's mom 1 year ago, and now my brother,
2 weeks ago. Of course add to that friends and co-workers over the
years.

I always remember a guy I use to work with. He was literally counting
the days to retirement...crossing the days off his calendar and keeping
a countdown. I think he had about 1 1/2 years to go. I can't remember
when he was going to retire, maybe at 55, or maybe a bit older.
He had lots of money saved up, and he hated his job.

Well, spring comes, he goes out to mow the grass, and dies of a heart
attack. His family gets all the money, and he never enjoyed life.

I was able to work on my "bucket list" after I quit working, 9 years
ago. Actually managed to get all the things done I wanted to, and then started thinking of more.

Then, it was time to start care giving. That has been my life for the last 4
years or so.

But even though G still has some health issues, we are planning on what we
want to do. The weather has been awful here this last summer, and last winter.
G lived in San Francisco before, so we are thinking about trying to live there
for a year. I realize now the reason I have been reluctant to move from
here was because of my brother M. I knew he really needed someone around
to help him out. And I was right. But now he is no longer a reason to stay
here.

Hopefully G will get the surgery he needs to be able to do peritoneal dialysis,
which means he can do it himself. He will do it every day, and it mimics
the kidney function better than taking out the blood. He sees the surgeon
Sept. 1, for the first consult.

Of course, there is always the risk the surgery won't be a success, or something will
go wrong later, but that is possible with anything in life. We could also
be in a car accident, or be in an Amtrak train which gets hit by a truck.


I always function better with a deadline. So, this will force me to get the
houses fixed up and hopefully rented. We can put all our stuff in storage
in the attic of the house I just bought.

We will get on a wait list for a handicap accessible apartment in San Francisco.
That will take some time, but I don't think I will be ready to move before
6 months from now, probably more like a year.

Lots to do. This will give me a reason to get rid of "stuff". I have
way too much stuff, and I really don't know how that happened considering
8 years ago my belongings were what I could fit in my car.

I've got guys here today putting in a new window in the bathroom. The old
one extended over the bathtub, so I could not do a proper handicap shower.
M had been nagging me to get it fixed. I thought he would be able to use it,
but obviously not. At least his nagging has forced me to get off the dime
and do something about the bathroom. I guess M is looking down from
above and saying "it's about time".

Update on G

For all of you going "enough already, what's up with G?"

Oh, too much to even tell.

Here's the short version. I have made an appointment with the
best surgeon in town to do the special surgery G needs. He will have surgery to allow for peritoneal dialysis, which is done by yourself, at home. But, you need a catheter placed in your stomach area, and then you put in fluids, leave them for some time, and take them out.

They say it mimics the kidneys the best.

But G tried to have the surgery done for this in March 2010, but he had too
much scar tissue in his abdomen from previous exploratory surgery.
However, apparently one can go in from the side, around the organs, to
insert the catheter. It is much more complicated, and a real surgery, not
just outpatient.

The horrible VA surgeon claimed he could do this surgery, so
we couldn't get a referral from the VA, so G will have to pay for the
surgery himself. But, hopefully the surgery will be successful,
and G has Medicare part A, so he will just have to pay for the
surgeon and the anesthesiologist.

But, the first consult appointment I could get is Sept. 1.

That's OK. G really needs to have a sleep study done first, which I just
got scheduled for this Sat. G says he can't sleep on his back, and when he
is in ICU he must, so it's a big problem. G went for 3 days without really sleeping after that last botched surgery, and he was in bad shape. Of course that was
when he lost all that blood and they didn't give him a transfusion.

G's dialysis catheter is running OK, so I think it will work for another month, fingers crossed. He was also told by the dialysis center that another catheter
could be placed in that same site, if this one fails....but as G said "they probably are just saying that to keep me happy"....

Now that my brother is no longer here (may he rest in peace), the house is quiet, G and I can enjoy time together, and needless to say, the stress level is much lower.

Stress is a horrible thing.

Sleep is good.

Think I will take a nap.