Dialysis and the First Stick

I was on a forum posting about my fourth Anniversary and I realized I never wrote anything about my “first stick”.  So, here it is…

I had advanced knowledge that I was going into dialysis for kidney failure.  I was lucky. Most people don’t have that experience. Most end up in an Emergency Room and that’s not a pleasant way to enter the dialysis world! But, I knew and so I had my fistula in the previous March and entered the hospital on August 21, 2008, four years ago.

The doctor likes to have new patients first stick in a hospital setting because the trauma of dialysis for the first few times is pretty hard on the body.  Anything can happen. I’ve read some real horror stories of people who had their first dialysis in-center rather than the hospital and passing out, falling down stairs, severe nausea, heart failure, stroke, you name it.  Due to the increase chances  of catastrophe, it’s good advice to have the first sessions in the hospital.  I wasn’t given a choice and I appreciate that.  I didn’t know enough to make it anyway.

I was very lucky. I got a private room just outside the nurse’s station in a very nice hospital near Fort Worth, Texas.  Several people came in and listened to my virgin fistula with their stethoscope and pronounced it “good”.  I learned a new meaning for the word “Thrill” and a new word, “Bruit”.  Later in the first day, a technician rolled in a dialysis machine about the size of an arcade video game station and proceeded to set it up.  She carefully walked her fingers around my fistula and I jokingly pleaded with her to “Be gentle, it’s my first time!”  She barely broke a grin as she pulled out two HUGE needles, swabbed my forearm, and explored some more with her gloved hands.

She used Lidocaine to numb the areas where she was going to stick.  I’m not sure which hurt worse between the tiny needle for the Lidocaine suspended in alcohol (I know you understand the pain of alcohol applied to an open wound.  It’s the same when injected under the skin.)  After waiting a few minutes for the Lidocaine to deaden the area, she stuck me with the dialysis needle.  It was the “smallest” needle at 17 gauge but it’s still the largest needle ever inserted into my body.  If I can relate it to a woman’s first experience with sexual intercourse, this was my first time being penetrated and DAMN it hurts!

The first needle was much easier than the second.  Unfortunately my fistula is pretty deep as it moves up my arm about a half-inch deep.  She had a really hard time finding and poking it properly.  We were like a young couple trying to make love for the first time and it was just as sloppy and troublesome. I was not enjoying it though.  After a half hour or so, she gave up.  My arm was beginning to turn yellow and brown from the bruising and infiltration.  Later a nurse brought in a bag of ice to put in it.  That was it for the first day.  Not a very good beginning for my first time as I’m sure many can say!

The next day, a new tech came in and seemed much more confident. He found both locations (the vein and the artery)  and stuck me with little hesitation or relative pain.  (As I wrote in “Dialysis Pain and Lidocaine“, the pain of the Lidocaine stick is worse than the dialysis needle stick.)  I sat quietly for the next four hours as the machine chugged and burped.  He came in, removed the needles and taped me up.  That was the end of the second day and the first dialysis session.

I gotta say the food at the hospital was pretty dang good!  It made the really boring periods of time go by.  Because I was there for dialysis, there wasn’t much going on other than the treatment.  The food made the time go by.  I didn’t expect good food in an institutional setting.  I’m so thankful for cooks who can pull off tasteful food in large quantities!

I went into the hospital on Thursday expecting to be discharged on Saturday but, because of the failed “first time”, I had my third session on Sunday morning and was discharged later that day.  In retrospect, it was not too unpleasant.  My arm was still bruised from the infiltration and that was the beginning of many similar events to come.  I would learn to get used to it.  The food was good and the staff attention to my needs were excellent.  It was quiet and peaceful between sessions.  I had time to read and relax until the anxious moments of the treatments.  It’s been said that dialysis is ten minutes of horror followed by four hours of boredom.  That sorta says it all.  I was glad to have three sessions under my belt before I would do in-center dialysis for the next several years.

Anyway, that’s how I lost my dialysis “virginity”.  It was four years ago and it seems ages ago but just yesterday.  See my posting about “Dialysis and Anniversary” if you haven’t already.

© 2012 DevonTexas

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About DevonTexas

I am a person with ESRD (End Stage Renal Disease) which means my kidneys don't work. Forty or so years ago that would have been a death sentence but today there is Dialysis which means I can be hooked up to a machine that will clean my blood as the kidneys should. Three days a week, I go to a center and have too very large needles stuck in my arm to remove and replace my blood as it passes through a process where it's cleaned and the fluid is removed, a process taking a little over four hours each time. I want to advance knowledge about dialysis so that other patients can learn from my experience and mistakes. We shouldn't have to reinvent the wheel, eh? There is so much to be learned and experienced about our predicament. There are vast resources available to support us and enrich our lives but many patients don't know about them. There are also many issues that we have to deal with whether we want to or not. So I blog about them. All comments are confidential until I approve them. If you don't want your comment public, let me know and I will respect that. So, feel free to leave a comment. Enjoy.
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6 Responses to Dialysis and the First Stick

  1. ovaldaze says:

    Oh my gosh, that is why I refused to use my fistula! I saw what the other patients went through and I dug my heels in. I also saw what happened to their arms after time, some people’s arms swell up to double the other arm. I just didn’t want that to happen. Dialysis is so hard on a body. I really feel for you Devon, geez.

    • DevonTexas says:

      I understand to hesitation about a fistula but it’s the best access for dialysis at this time over chest catheter and graph. The choice of the location is a medical one generally and we have little control of that. I asked that it be in my right arm because I’m left-handed. Other than that, I had little choice but to trust the surgeon’s discretion. It’s not pretty and I wear my access cover from http://www.dialysisarmbands.com to hide it. Perhaps today, I’ll shoot a pic of my access! LOL

      There are great chances of infection with the PD access. PLEASE be absolutely sterile with your access. I’ve read so much about infection problems. (I’m on a CDC Infections Control Panel) Like you don’t want the fistula, I don’t want to chance infection. I can’t maintain a sterile environment with two dogs and a cat that can’t be away from me for 10 minutes. I’m the pack leader to them all. I could never maintain a sterile place to use PD.

  2. I have been on dialysis for thirteen years, and sticks NOW are almost as bad as my FIRST sticks!! My arm never got toughened up. Lucky me, I have only had two accesses in all that time! I have had several catheters, but only two fistulas!

    • DevonTexas says:

      Geeze! I’m sorry your needle sites haven’t deadened. Mine still hurt some but in areas where I’ve been stuck a lot, I barely feel it… until they punch through the blood vessel and into the muscle. Then it hurts like all hell. Fortunately the doesn’t happen too often. Thank you so much for sharing your experience and for reading my blog. I hope you found it helpful.

  3. Tutu O'Brien says:

    Right on!!! Finally I hear the truth behind the sticks……I was one of those people who received limited info about dialysis, and when I went to the center for the first time, I expected an introduction to the process, maybe a short tour around the clinical setting, to familiarize myself with the noise, the machines, and the process. What actually happened was that I was welcomed by the receptionist and told to have a seat, that someone would be with me in a minute. After a short time, the big door swung open and my name was called. I entered the clinical setting for the first time, blinking at the bright lights and loud noises. I was escorted to the scale, weighed, taken to a chair, b/p cuff put on, arm examined, then came the needle sticks. OMG. I don’t consider myself a weak woman; in fact, just the opposite. However, the pain of those sticks (4 that day-first tech couldn’t get it) came as a brutal surprise. I had had no preparation for the pain. Nobody wears a nametag, so I did not know who were the RNs, the techs, the MDs, the staff-who are all these people and what the hell are you doing to my arm????? I went home in a state of shock and almost didn’t go back 2 days later. How could I have not known how brutal dialysis is? In spite of the rising fear, I took my now blue and black arm, and heavy heart back for another torture session. The second time was worse than the first. The person sticking me cause huge hematomas, and took 5 sticks to get me plugged in. I knew there had to be a better way, so I took myself to the social worker’s office, even though I had not yet been introduced to her, and told her I was not able to tolerate the process, due to the pain. She went and got the clinical coordinator, who I had not yet me. He told me about lidocaine cream, which applied as an ointment, was effective in reducing pain. He also suggested that staff use a smaller gauge needle, not the 15g that tore up my arm. He asked if I had been exercising my arm, something I knew nothing about. He did some education with me, explaining the rudiments of dialysis. EVERYTHING changed once I bought the lidocane ointment ($28. for 30 Grams). I apply it to the access site 30 minutes before venipuncture, and the difference is amazing. I am now a much happier client. MUCH.

    • DevonTexas says:

      Thank you so very much for sharing that! I can certainly relate to that experience and with some effort, perhaps we can change the experience for others. I know what it’s like to be so uninformed and to suffer so. Again, thank you. If you don’t mind, I’d like to post this as a blog post. You described it so perfectly and I really appreciate the point about going to the Social Worker for aide and support. Also, the fact that no one wears a name tag so how do you know who to call if you need help? It’s a desperate situation indeed.

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