A couple nephrologist appointments ago, I finally agreed to have an appointment to see a surgeon and have "vein mapping" done. When you start hemodialysis, you need to have a big ole vein system set up to accommodate the needles associated with dialysis. One needle draws blood out of your body, which then sends the blood through a machine that cleans it, and another needle delivers it back into your arm. (I'm not a doctor, nor do I play one on t.v....)So, I had an appointment made with a surgeon to find the best sight for this fistula, or access sight.
I was sitting in the exam room, in my lovely johnny, when he came in, introduced himself, and then told the technician to fire up the ultrasound machine. He was barking at the poor woman from the first moment she started, and I really felt bad for her. She wasn't doing this right..and hold that there better.."NO NO, that's not it..that vein over there!" I was cringing as she tried to do her best to please him. I was busy thinking, jeez..lighten up you ole geezer, and then he started in on me.
He said this is where the incision will be..and drew an imaginary line down my arm, from my armpit to my elbow. He said, "This is going to be a very intricate, delicate three hour surgery, and do you know why?" When I shook my head no, he grabbed my upper arm flab, shook it vigorously, and said " Because of this!! THIS is why it will take so long, this arm fat."
I was flabbergasted, as I had never had my arm flapped by a doctor before. I was thinking two things..First, someone feed this skinny old buzzard something..Can I fry you a donut, or make you a pie or something?? Good grief! Then I thought..Hey! That WAS muscle, until a couple years ago. Cut me some slack, I'm almost 50! OK, I actually thought three things..Number three was that there was NO WAY this crotchity old bear was going to be in charge of merging my veins into one mega vein.
So, I said "I will think about it", and left. As I ate my TAKE THAT! burger on the way home, I decided that there was likely to be another doctor out there someplace that had a better "bedside manner" then that guy, and I would insist on a second opinion.
At my next nephrologist appointment, he was all chatty, and asked how I liked my surgeon visit. I said I was pretty sure a mother grizzly had more charm, and told him that guy wasn't going to cut me open come hell or high water. I said I need a second opinion, and we set up appointment number two at a different office.
It was all together different. I had a good feeling as I found the building, with no problem. There was a parking garage attached to the office, yay! I drove in and found a parking spot right in front of the door. Good sign, I thought. The elevator was located right inside said door, and the ladies room as right in front of the elevator door when it opened on my floor. I could almost hear the birds singing and smell the flowers, it was going so well. As I washed my hands, after using the ladies room, I thought to myself "I'm getting a really good vibe here at this place, maybe this doctor will be a good one." I opened the door to walk out, and realized I had just used the men's room...(which might explain the damp toilet seat).
I was glad no one saw me moseying out of the men's room, laughing out loud, and really thankful no one came in to USE the men's room while I was inside. I just could tell it was MY LUCKY DAY! I sat in the exam room, and waited for the ultrasound technician, hoping it would go easier then last time, and it did. The guy was very professional, it was quick, and over in no time. The doc wasn't there with us, but would come meet with me after the report was done. So I sat in the office and waited. And waited. And waited some more. Finally, in he came, introduced himself and shook my hand ( NOT my arm flab, a very good sign I thought.)
He said " Let's take a look at your chart.." and opened it up, reading a few pages.
"So, you didn't like your last surgeon, and you don't even want to have this done, huh?" I just laughed and said "Boy, they don't mince words do they?"
He then gave me his version of what they would do and how. The incision would be below my elbow, but a lot smaller. The surgery would only take 45 minutes or so, and I would go home the same day. He said it takes 2 months for the fistula to "mature" and be ready for use, which is why they need to get it in before I need to use it. I've heard that moment described in many ways.."when the wheels come off the bus..", or when "my kidneys crash", or when "it's go time!"
He did say I do need to lose more weight, and then I can meet with a transplant team to see if a kidney transplant is something that will work for me. I don't look forward to a life on dialysis, so that is very good incentive to eat better. I have been trying to do so, as I have known for a while that that was the case, and have alreadylost 25 pounds. How you ask? I have been eating more whole grains, fruit and veggies. ( I feel like I should be shoving clothes that are too big into a Goodwill receptacle as I say that..) It isn't easy though..one symptom your kidneys are getting ready to go into complete failure is a loss of appetite. Leave it to me to still be starving as they gasp their last breath...when I was first told I had kidney disease, my diagnosis on my lab work was "chronic kidney disease", then it progressed to "chronic kidney disease, severe", and I think now it is "chronic kidney disease, how the heck are you still alive??"
So, now I have my latest lab work, and the "magic number" of 5.4. I guess it really is "go time!"
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