Well crap.

I'm having a more difficult time than usual collecting my thoughts, so this is going to be even more disjointed than normal.  I apologize in advance.

When I ended my post yesterday, the plan was that I had to be at the hospital at 9:00 this morning for a Fistulagram.  Later I got a call from the Vascular Surgeon's office saying that instead, I needed to be at their office at 12:30 for the procedure which they would do there at the office.  Huh?  I was told I would receive a phone call in the morning with more details.  Great.

I spent last night powerleveling my Husband's Warrior from level 23 or so all the way up to level 38 (Yay for EQ Hot Zones!) and during all that time I thought long and hard about having another Fistulagram done since it had only been 3 weeks since the previous one.

This morning my phone rang and it was the Surgeon's office calling to give me the final details.  I didn't mean to, but before I knew what was happening I become this weeping, sobbing, hysterical person who was begging not to have another procedure done on my poor fistula.

The nurse didn't understand why I was so hesitant until I asked her why I needed another one when I had literally just had one done a few weeks before this.  She had no clue what I was talking about.  Yep, that's right.  This Doctor did not have any record of my having the Fistulagram a few weeks ago, yet the Doctor who preformed that one is in the SAME OFFICE.

I pleaded with her to just do an ultrasound or something instead.  My arm is aching like you would not believe and it has just been unsuccessfully stuck 3 days in a row.  I did not want to have it stuck again today and then have to stick it again tomorrow for dialysis.  Finally she told me to just be at the office by 12:30 and we'd talk about it then.  In the meantime, she would gather all of my records so they would have the entire story instead of bits and pieces.

I called down to Alabama to the Doctor who put the fistula in and had them send my records to this Doctor as well so that finally, all of my records would be in the same place at the same time.

When we got to the office, I had to wait until after 1:00 for the ultrasound (keep in mind I had had basically no food or drink since dinner the night before because we still didn't know at this point if I would have to have anything else done or not).  The ultrasound showed that my fistula is, as we already knew, awesome.  The flow is perfect, it's actually not deep at all (contrary to popular belief) and everything with it actually looks really good with one exception.  There is some sort of crazy bend in it, which everyone has known about since my first time getting dialysis at the hospital.  Apparently though, that wacky bend is causing a lot of grief because the nurses just can't figure out how to get a good stick because they don't know exactly where it is.  As for the fistulagram, thankfully the Doctor agreed with me that there was no reason to have it done.

He asked me a few questions like, "Do you still make urine?" and "What is your Potassium?"  I told him that I still make (in my opinion) quite a bit of urine and my Potassium, rather than being high, is actually low even with a Potassium supplement and eating a banana each day along with potatoes whenever I felt like it.  He then asked me, "So why are you on dialysis?"

Uh?  Because my Nephrologist told me to?  It's not like I woke up one day a month ago and said, "You know what would be fun?  Having needles repeatedly jammed into my arm over and over and over again in a futile attempt to cause me cramping and dizzy spells!"  Uh no.   That's not how it happened.  Trust me.

He told me that my arm definitely needs a rest.  It is so swollen and inflamed from all the infiltrating and bruising that it's no wonder nobody can get a good stick.  He wants me to rest the arm for 2 weeks and then see me again to evaluate it.  At that time he will either decide to open up the arm and physically move the fistula and straighten out the stupid bend in it or, if he determines it necessary, he will build a whole new fistula in the upper part of my arm.  I'm really hoping he decides to go with the first choice.

In the meantime though, I needed to figure out if I still needed to be getting my dialysis treatments.  If I did, then I would absolutely have to have a PermCath installed.  It would only be temporary of course, just until my fistula was truly ready to be used, but it was my only option other than not getting treatments at all.  I left the office with the understanding that I would go straight to my Clinic and talk to them about my options.

I got there and we did talk about it.  As far as I was concerned, I was going to forgo the PermCath and just not get treated for the next month or so and in the meantime, the Surgeon could go in and move the fistula around and make it easier to stick.  (I had misunderstood some of what they had told me while I was in the office... for example, I didn't catch the whole 'or build a new fistula in your upper arm' bit.)

The Clinic would have to get with the Nephrologist to decide if that course of action was appropriate and they would let me know but ultimately it was up to me to make the final call.  I left out of there feeling happier than I've felt in awhile, because in my mind, I would be able to stop getting poked with needles long enough for my arm to heal and then they would reposition my fistula and then, like magic, I would never have another bad day again.

Reality is a bitch however...

The clinic phoned me shortly afterwards to tell me that the Neph had said that I definitely needed to continue with dialysis and that I should definitely NOT take a break of several weeks up to a month.  I needed a PermCath ASAP and I needed to keep on my schedule.

Soooo...

The way things stand now, I'm going in tomorrow morning to have the PermCath installed.  I'm terrified.  I just keep reminding myself that it's a temporary thing and that as soon as my fistula is 'fixed', they can yank that son of a bitch out of me and we can get back to poking my arm.

Doesn't matter.  Still terrified.

I'll post again as soon as I'm up for it.  Until then, let's just hope they can pipe "Moves like Batman" into the OR while they install the damn thing in my chest...  I'll need all the smile help I can get.  :-/