April 8, 2014

The Whole Sordid Story

My husband was just in the hospital for five days. It was a bit of a roller coaster.

He had to have his fistula (dialysis access) reworked back in February. A vascular surgeon placed a graft and made a sort of hybrid access consisting of graft and fistula. Usually these are two different forms of dialysis access.

Although a bit odd (red flag?), it seemed to be working fine until Mark's body decided to get angry with the graft and it got infected (but wait, we didn't know this was the culprit yet). He developed typical symptoms of infection: fever, chills, muscle pain, and was started on IV antibiotics at dialysis.

Over the next several days we made two trips to the ER because the symptoms weren't going away, which one would expect after only about 24 hours on antibiotics. Mark is especially susceptible to infection (usually staph) and has even had pericarditis, an infection surrounding his heart, so we were very nervous and didn't want to take any chances.
Credit: Janice Haney Carr via PHIL
Isn't it kind of pretty?

His poor mother and niece were in town for a visit -- a visit we hoped would have nothing to do with the hospital since it so often does. At one point while sitting in the ER my MIL says, "My son takes me to the nicest places when I visit." Love her sense of humor.

When we showed up in the ER for the second time, they decided to admit him, to hopefully get to the bottom of things.

(The ER doc was under the impression that I was insisting my husband be admitted. I promise you, I was NOT trying to sway any one's decision in any particular direction. I merely wanted them to HELP HIM - somehow.)

Mark's nephrologist, a vascular surgeon, an infectious diseases specialist and the hospitalist all worked on the issue at hand. There were lab draws, ultrasounds, CT scans, x-rays and a surgery all to come to the conclusion that it was that stupid little piece of plastic in his arm causing all the problems.

Turns out that a plastic graft that is infected won't get any better with antibiotics. Guess you can't treat plastic. Makes me wonder how it can get infected in the first place then....

*scratches head
Regardless, it had to come out. While I was on speaker phone, the vascular surgeon explained to us what he would do. He had three different plans of attack. I liked his confidence. Mark had the surgery the next afternoon and they were able to dialyze him right after. Amazing, right?

He had just had a small surgery, dialyzed until late and there was infection involved, so of course he needed to stay in the hospital another night. I get it. The next day, though, they still didn't want to let him go for the same reasons....I guess? It was a little unclear.

We did know that they wanted to dialyze him again. The plan was to do it the next day, first thing in the morning....

Until the hospital dialysis nurse couldn't get it to work.


So the vascular guru is called back in. He is flummoxed, insisting that it should work. He unwraps Mark's arm, we get a good look at the gaping open wound which needs to heal from the inside out (God damn mother-effing infection!) and he grabs a Doppler thingy to listen for blood flow.

And we hear it. Whoosh, whoosh, whoosh. Move the wand. Whoosh, whoosh, whoosh. Hallelujah and thank you Jesus!

Now Dr. Confident Vascular Surgeon gets to ask some questions: Where did she try to stick you? What happened? Can we get her in here so I can show her what to do?

Mark's fistula is now kind of Jerry-rigged, you could say. "It's not textbook", is how Dr. Confident put it.

My response to that was, "Yeah, Mark makes it a point to thumb his nose at the textbook."

Dialysis is attempted again. After some difficulty, they manage to get him on the machine for a treatment. I breathe a sigh of relief and head back home to the kids.

"Well, I survived", Mark drawls into my ear when he calls me afterwards.

I say, "I kind of figured you were alright when I didn't hear anything sooner. So, can you come home now?"

"Oh no, " he says, "They're gonna do dialysis again in the morning."

"OK then," I concede. Sigh. "Probably for the best." I was pretty bummed, though.

So! Mark is put on the machine fairly easy the next morning and he calls to say they're going to let him go home after. I suddenly feel this urgency about timing and who will bring him home. Turned out that, although Mark had one foot out the hospital door, his nurse was not in any hurry to let go of his other foot.

When Mark finally did arrive home, our daughter greeted him with the good news of where she will be going to high school next fall (!!) and then I rushed out with my dad to grab supplies for our son to play spring soccer. Practices start this week.

And life goes on.

found: here

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