A little more than two months ago, my fistula used for dialysis failed. A fistula is an arterialized vein; a vein and an artery that are surgically attached, allowing blood to flow in both directions. Two large needles—in my case 14-gauge—are inserted in the blood vessel, one to pull blood out and pass it to the filter; the other to return it from the filter to the body.
When my fistula failed, I had no way to dialyze—and without dialysis I would eventually die. The only choice available was to have a tunnel catheter surgically placed in my chest with two lines directly to my heart. I was not looking forward to this because the first tunnel catheter I had—when I was first diagnosed with permanent kidney failure—got infected and I almost died from the resulting sepsis. But the choice was to take the risk with the catheter or eventually die.
What I didn’t know was that I was going to have to basically restart the dialysis process from scratch. First the catheter, then one small needle, then two small needles, then two larger needles, then two largest needles.
On June 1, 2009, I had a single 16-gauge venous needle placed with the arterial flow relegated to the catheter. On June 5, 2009, the same; and again on June 8 and 12, 2009.
On June 15, 2009, I had two 16-gauge needles—one venous; one arterial—successfully placed for the first time. That will continue until I gradually work my way back up through 15-gauge needles to 14-gauge needles. Each needle size hurts an order of magnitude more than the next smaller size. The one thing that’s different than when I began dialysis is that each and every needle placement has been successful (knock wood). When I started using my first fistula there were days when I was stuck with eight needles, none of which were successful and I was sent home without dialysis. That was no fun at all, but I have to tell you:
Starting over sucks rocks.
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