Like starting over

By Michael Fraase

Wednesday, 17 June 2009 07:05PM CDT

Section: ESRD

FistulaA 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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What the hell happened to Frontline?

By Michael Fraase

Wednesday, 08 April 2009 06:19PM CDT

Section: ESRD

Single-payer, universal-coverage healthcarePBS’s Frontline historically has produced some of the US’s most outstanding and compelling documentaries. But its March 31, 2009 presentation of Sick Around America was among the most biased pieces of corporate propaganda posing as reporting yet seen. The production considered mandatory, for-profit insurance coverage (aka the “Massachusetts model”) as the only viable alternative to the current US healthcare system.

Not one advocate of a single-payer, universal-coverage healthcare system in the US was interviewed for the documentary. Not one. Never mind that Representative John Conyers‘s (D-Michigan) H.R.676 proposed legislation to provide single-payer, universal-coverage healthcare system in the US has 74 cosponsors. Never mind that the majority of the US populace favors a single-payer, universal-coverage healthcare system. As do more than half of US doctors and two-thirds in Minnesota.

Never mind that Sick Around America was a sequel to Sick Around the World, which aired 15 April 2008. Sick Around the World examined several publicly-funded, single-payer healthcare systems, including Taiwan’s and the UK’s. Not one of the international healthcare systems investigated in the 2008 documentary is based on mandatory, for-profit insurance coverage. In fact, as the Canadian government reports, “the United States is the only OECD country that relies primarily on private insurance for healthcare financing.”

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How I got my biker scar

By Michael Fraase

Saturday, 04 April 2009 04:32PM CDT

Section: ESRD

Worst week everThis is a wholly self-serving article, something I’ve studiously attempted to avoid in the 17 years I’ve been writing online. It’s totally self-indulgent and awfully unprofessional. It’s an email to my sister after I got her weird automated voicemail (like the one we have on our landline) and it freaked me out.

It’s of interest only to my family and friends and those facing permanent kidney failure (end-stage renal disease) and hemodialysis. And I publish it here only so I don’t have to repeat the story (although the biker scar bit might be worth it on good days).

If you’re not a family member or friend, just mosey along. This isn’t what you’re looking for. Here’s the Johnny Cash picture you’re probably looking for. And you know what? That’s pretty damned representative of how I feel right now.

Last Sunday morning (29 March) my fistula failed. I met the surgeon Sunday afternoon who did a quick exam and confirmed it had, indeed, failed.

I was scheduled to go to United Hospital for an outpatient procedure to place the catheter in my chest on Monday morning (30 March). Between Sunday and Monday the surgeon and interventional radiologists decided the success rate with trying to de-clot the existing fistula wasn’t good enough so they weren’t even going to try. I was admitted to the hospital.

When I explained that the ID strap would have to go on my right wrist because of the pending procedures, they got pissy and said they’d just have to do it on the floor, then. One of the first things I remember being told about my first fistula was that my left arm was out of bounds for everything—watches, blood draws, blood pressure checks, everything—including ID straps.

They started off really well by sending me to the wrong place. Well alrighty, then. Every time I go to United Hospital they lose patients. It’s not usually me, but it’s happened before, so at least I knew I was in the right place.

The sonogram ultrasound technician was supposed to do a vein mapping of my left arm so the surgeon could decide where to place the new fistula. She did the sonogram ultrasound, but forgot to draw the lines on my arm. Oops.

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