For a dialysis patient, access to the bloodstream is like the golden ticket to Amul’s chocolate factory – it’s where all the magic happens. Blood is pumped from this access through the artificial kidney, or dialyzer and back to the body.
Enter the AV fistula, the superhero of dialysis accesses. Mine was created in 2006, and since then, we’ve been inseparable. But, like many long-term relationships, this one has also had its share of challenges, like aneurysms in my veins. Who knew veins could be so high-maintenance?
In my quest for vein peace, I switched to buttonhole needles (the gentler cousin of sharp needles) when I started home dialysis in 2006. They’re supposed to prevent aneurysms, but unfortunately, mine had already RSVP’d before I made the switch.
My fistula and I have been through thick and thin. A few years back, a stenosis, or narrowing of the vein, decided to crash the party, and I had to undergo angioplasty to open it up. I’ve had the procedure thrice now, the last one being around a year and eight months ago. Recently, high venous pressure alarms started going off like the horns of Mumbai’s traffic, prompting me to visit my vascular surgeon.
A few days ago, we embarked on yet another adventure: an angiogram to take a closer look at the inner workings of my fistula. Turns out, there was a clot! The surgeons came to the rescue like expert kabaddi players, clearing the blockage with two balloons – one small and one large – bringing my dialysis flow back to normal.
After 27 years on dialysis, I’ve learned that life will throw a googly now and then. It’s frustrating dealing with these unexpected issues, but I’m thankful for home hemodialysis, especially the nocturnal sessions, which have made a big difference to my quality of life. Still, problems can crop up, like unsolicited WhatsApp forwards.
This angiogram-and-angioplasty routine is something many long-term dialysis patients are familiar with. The vascular access team recommends a check-up every six months to avoid surprise blockages during dialysis. But sometimes I wonder if it’s necessary if everything seems to be flowing just fine.
Thankfully, my nephrologist shares my doubts and advises against unnecessary interventions unless there’s a clear issue. So, for now, I’m just keeping an eye on things during dialysis and will visit the vascular surgeon only if needed. Otherwise, I’m just going to enjoy the journey and take things as they come!
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Usha balu.