Post 1378: Bloody hell…!

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Dialysis is relatively routine, yet there are moments of drama. Yesterday, when I got back to my car, I noticed I was bleeding from my fistula buttonholes, the two permanent access points where the blood leaves, then returns to the body after cleansing.

I returned to the dialysis unit, of course, applying pressure through my very bloody jacket, and the nurses addressed my emergency: you can lose lots of blood this way, and had it happened at home, the appropriate response is to call an ambulance.

Once the buttonholes sealed and were rebandaged, I drove home, where, of course, I expected to find the kitty boys waiting on the other side of the door. That’s what they do.

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Boy, did I have a surprise for them! Well, so I thought. Dougy was napping in the dining room cat tree and Andy ran away when I opened the door. (I wonder what they’d been doing during me absence…?)

Oh well, I took off my bloody jacket and called Andy over. I thought my little lion would love, love, love to smell that blood! RAWR! Yeah, what a treat for my little predator!

Nope! He did smell it, but he was much more interested in the water off the tuna I fixed for lunch a few minutes later.

Dougy never did come over to smell the blood. My kitty boys apparently are too domesticated to mess with this RAWR stuff!

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I am fine, though the bloody jacket suggests a homicide. I lost a lot of blood, but not so much that I had any issues (fainting, light-headedness being typical for such events). I’ve learned how to soak, wash, and dry bloody clothes to prevent stains. That’s what I’m doing now.

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Bloody hell! Not a naughty English curse, but a potential hazard of dialysis if the buttonholes blow out after dialysis. (Hope I didn’t freak anyone out.)IMG_20170429_111714

It takes a lot of tape, gauze, and bandages to keep pressure on the buttonholes  till the scabs mature. Ugh! If they do blow out, you just do what you have to do. 

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93 thoughts on “Post 1378: Bloody hell…!

    • You know how it goes, truly! You know it can happen, it isn’t uncommon, you just deal with it as fast as you can, and you recognize it’s better to get professional care as fast as possible. I try to make as little a mess as possible, but that’s optional! It helps not to be freaked out by blood, of course, but I am amazed I’m not. (I can’t watch the nurse insert the needles into the buttonholes, for example, and that is unbloody, not particularly, yet I didn’t freak out or panic when I saw the bloody mess you see in the photo!) uncomfortable or painful business.

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    • It’s life! Fortunately for me, I have a positive attitude about things. I saw the happy side of this episode immediately: it happened just outside the hospital emergency door; while I bled profusely, it wasn’t inside my car (whew!); it was a lot of blood loss, but not so much I fainted or felt light-headed; I managed not to bleed on the carpet inside the emergency room lobby (though I’m sure it’s seen some blood in its time!); I was able to get medical care in very little time after I saw the blood seeping through the jacket sleeve; most of the blood was soaked up by my jacket, with very little on anything else I was wearing; and there was no more seepage into the replaced bandages, so the “fix” was a good one!

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  1. Wow ! I hope your system does not make a habit of this. You have a lot to keep on top of. I hope all goes well for you from now on. And i hope the kitty boys each hold a paw for you when necessary.

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    • The kitty boys are very supportive. I am the one who knows how to open their kitty food cans after all, and they haven’t master opening the big bag of dry food yet, either! As for the bloody hell, it happens from time to time, as anyone on dialysis knows. The main thing is to keep your head screwed on tight, apply pressure to the buttonhole area as best you can, try not to drip blood all over the place because some poor person gets stuck cleaning it up, get professional care as absolutely fast as possible, and be very patient! It helps not to freak out when seeing blood in large quantities, to keep one’s sense of humor! It’s a mess, but messes can be cleaned up. As I tell myself, “at least it didn’t happen at night while you slept…!” (That is to say, while sleeping, all my blood seeped out. Whew!)

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      • Not my first rodeo, as they say! I truly was amazed the kitty boys showed no interest in the blood because they are usually very sm=noopy about things when I get home. They sniff me head to toe, rub on me, ask me kitty questions, “meow?”, and don’t let me forget they want their kitty food pretty fast, buster!

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      • I carry in lots of smells they find interesting, so I always give them a few moments to sort through them. I’m sure they learn a lot this way, and, while they never will see the dialysis unit, this way they would feel comfortable if they did because the smells would be familiar.

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      • I’m having some technical problems today with comments. I wrote a reply to another comment by someone else, and it showed up on your comment. For the sake of those wondering what your response was to my missing comment, I’ll try to recreate it here: I am doing fine, though you’d think I survived a murder attempt from the appearance of my jacket! I don’t recall exactly now what I had to say about the British expression “bloody hell” other than I know it is a vulgarity. However, it’s a Galgenhumor response to the occasional blow out of fistula buttonholes, so the joke is I can say “bloody hell” outright in front of everyone, knowing it is vulgar, yet soooo appropriate when you see the blood hell on my jacket! Of course, I admonished you not to mention the expression in front of you sweet little guy, four-year-old Maximus! I mean, he is a Brit !

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    • I’m fine now. I’m not suffering any ill effects, amazingly enough, though my jacket suffered some broken buttons in the wash despite my efforts to protect them by inverting it first. I think they must be wooden buttons, but I’ve ordered proper plastic ones to replace them all. How tedious!

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      • That’s good to know. There was a lot of blood. Tedious, indeed. I would offer to sew the buttons on for you, but 1) I’m too far away, and most importantly of all, 2) I can’t sew! 😂

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      • Well, I give you a big thank you for good intentions, Persia! I’m somewhat closer to the jacket and adequately skilled to sew buttons, though I confess to doing a pretty sloppy job of it! The buttons I found on like are for military uniforms, so I know they should be more durable than what came attached to a very expensive jacket for the poor quality of the buttons! And, if the turn out to be poor quality, too, I have the consolation of having 94 extras after I replace the six on the jacket.

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    • Actually, the scab is picked off each time I go in for dialysis. In a real sense, it never heals, but the buttonholes seal up sufficiently when I apply pressure on them for 15 minutes (sometimes longer) that a special bandage with a pad that helps coagulate the blood, a redoubled gauze pad on top of that, and a special blue tape that holds it all down under pressure keep me safe from blow out (most days!) until I remove it all the next day. Then the scabling (as I have nicknamed the barely cured scab) air cures till it’s picked off by the nurse before she can insert the needles that have a special tube attached that further attaches to tubing connected to the dialysis machine. It is relatively painless, with more of a sensation of pressure than anything. Once the scabling is picked off with tweezers, oddly, the buttonhole doesn’t bleed or spurt blood as you might expect it to. The nurses have some druthers about picking scabs since it goes against everything they stand for as nurses, but they do get special training to handle this medical procedure!

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      • It’s amazing what bodies and minds can handle. The kitties must be used to blood smell by now. The doggies here would definitely have been interested in the coat.

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    • Me, too! So far, it hasn’t happened away from the hospital. I do know what to do if it does – takes that almost $300 one way ambulance ride to the hospital and let the professional determine what needs to be done, from replacing the bandaging after determining the bleeding has stopped to a blood transfusion first if enough blood was lost. Since I don’t panic (and the amount of blood lost is less because my blood pressure doesn’t rise, pumping out proportionately more blood!), I do OK.

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      • Not in this town! The only traffic jams are around the schools at the beginning, middle, and end of the day, and a three o’clock shift change of a factory on the east side of town. None of these is on my rout home. However, that stated, having it happen while driving the short ride home would be a mess. I’d still be able to make it d=back to the hospital without bleeding too much more.

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      • That’s good to know! Here, in Florida, our population swells during the winter – my guesstimate is at least 1/3 more and possibly double…. it is most obvious on the roads and in the parking lots. During the warmer months, we don’t have many traffic issues.

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      • I suppose the time around the Sturgis Motorcycle Rally could present some travel problems. I live 185 miles (298 kilometers) away, but this entire area, from Western Nebraska, to Wyoming, to North Dakota, and, of course, the Black Hills of South Dakota is awash in motorcycle traffic from the end of July through the middle of August because roughly 500,000 participants pass through those points into Sturgis.

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      • Oh gad! I can only imagine what that’s like! Probably safer to be off the roads because of alcohol consumption among the visitors as well. I think people who ride motorcycles know better, mostly, to stay off their machines after drinking, though that oisd a big part of the rally activities. They bring in auxiliary police and patrolmen from all the surrounding states and South Dakota, so things are kept down to a low roar pretty much.

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      • There is generally at least one biker group in the area (along with loads of sun-burned tipsy students) during Spring Break…. add that to all the elderly, who are here for the winter and traveling is super stressful… I would take icy roads over that mix any day!
        So, I hibernate.

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      • You described it perfectly. That said, a friend who visited Cairo, Egypt said traffic there on any day was worse than Spring Break … Since hearing that, I haven’t had a desire to visit Cairo.

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      • I agree! I don’t even like driving in American city traffic. Denver is about the biggest place I will even try it, but not with any enthusiasm or without a person familiar with the streets.

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      • Fortunately, my husband doesn’t mind driving, though the heavy traffic and inattentive drivers put him on the defensive… For me, inattentive covers those who aren’t paying attention to where they’re going, oncoming traffic, etc. This can be due to lack of familiarity with the area, or paying attention to something else (usually their phone). Of course, here in Florida, we also have a big share of elderly drivers whose eyesight isn’t tiptop. A couple months ago, an elderly widow (87) got a ticket for going 20 in a 45…. We don’t know why, since she was in the right lane & frequently see that in the left lane. That said, we suspect the officer ticketed her because her cataracts are obvious and she really shouldn’t be behind the wheel….

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      • I suspect I could add some to your list, but I doubt I could top it by any means! Any time you have people from many places and of many ages and driving abilities in a crowded situation, you are bound to have a clash.

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      • My husband loves to work on projects, so he has a big ole Chevy truck, which is very handy for hauling plants, cats and all sorts of other things, but not so much fun to find a parking slot for.

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  2. Sorry to hear you are having to go through dialysis. My younger brother was on it for over 4 years, 3 times a week. He was a severe Type 1 diabetic, with many other complications. He also had a fistula like you described, with a few bleeding incidents, although not as severe as yours. I will keep you in my prayers as you cope with this treatment.

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    • I am fortunate that I don’t have diabetes like many in the unit, though Wegener’s granulomatosis is potentially fatal in short time when it flares if not treated. One can survive for many years on dialysis, with some people opting for trying for kidney transplants and a life on anti-rejection medication that is pretty grim stuff and the possibility of tissue rejection anyway. (The actor Gary Coleman is an example of someone who had more than one kidney transplant that failed, and he ultimately died at age 42.) Fortunately, I have a positive attitude that gets me through incidents like this one. I decided to share the experience, not to shock so much as to inform. Many people reading this blog suffer far grimmer circumstances than I and I get to have Andy and Dougy in my life for humor and a reason to get out of bed (“Feed the kitties time” = 1:00 AM by kitty boy tummy time…!) Life is good!

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  3. Sending prayers your way and you are so calm with all of this. Look slick the boys find the blood boring and have bigger adventures to go on.

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    • It is one of those things people on dialysis periodically experience. Part of it is because they have to administer anti-coagulants to prevent the formation of blood clots, so if there is a delay in starting the procedure (for example, the blood in the tubes attached to your arm my start to coagulate if they don’t. Getting the right amount is critical or this sort of bleeding can occur. Most people can get away with applying pressure to the buttonholes for 10 minutes. I had frequent blow outs holding only ten minutes, so, though I want to be done with it and leave, I make myself wait at least 15 minutes applying pressure. If the nurses have other patients they’re working on after those 15 minutes, I always tell them to go ahead and finish up because every minute more than 15 I apply pressure decreases the chance of a blow out. Anyway, I am comfortable with the vicissitudes of dialysis, mostly because Medicare and my supplemental pay for it (unless the Republicans screw health care up the way they seem destined to do – sorry for going political, but this is life or death for me), though time consuming, there is little pain associated with it, I like the people (both nurses and patients) I associate with in this process, and I am retired so I have the time to do it, unlike people who have to quit jobs or are fired because they are tied up three times a week with dialysis for half their day. Compared with many, I have it good!

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  4. Thank God, you are okay there sir. I am also a HemoDialysis patient. Sometimes it happens to me and whenever it happens, I get panic. You know how blood important to us, right? How long have you been to Dialysis sir, if you don’t mind my asking.

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    • I started dialysis a year ago the first Monday in April. I didn’t have a dialysis fistula mature enough for use until about the first week of last July I think it was. I don’t like it when I bleed this way, mostly because it means the first thing I have to do when I get home is soak the bloody clothes out of the garment or garments soaked in blood. As you probably are, too, after dialysis you mostly want to lie down or stretch out on a recliner and relax. It can be very draining. It isn’t necessary to panic if you have a good sense of what you need to do when it happens. Of course, everyone reacts differently because blood IS life! I have experienced low blood pressure most of my life, with fainting. When I was in rehabilitation, the therapists often caught up with me the moment I returned from dialysis and had me exercise or do other therapies. As you can imagine, I started to white out oftentimes, just short of fainting! One time, I actually did faint, but the upside of that was the therapist never asked me to do that particular exercise again! Ha! (It didn’t help that I referred to her from that point as the therapist who tried to kill me. I was joking, but she took it personally. I eventually let her know I didn’t hold it against her because I did tell them my goal was to get well so I could get back to my kitties, so not to pamper me. And they didn’t!

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      • I’m in my fourth years now. I am sometimes faint too. You know the feeling after four hours of the session.
        I used to bleed very hard during my first year, but now I’m not anymore. After my session, I rest first and make sure that my fistula is well pressed so that it won’t bleed anymore. I didn’t undergo therapy though just like what you did. Do you have plans for a transplant?

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      • I forgot to include the actual start of dialysis, which was January 20, 2016. The April start was when I got back home. The therapy was necessitated by the state I was in after I had end term kidney failure and ended up in the hospital in January. After they stabilized me, they sent me to a care s=center for therapy, and I continued dialysis while there and in a second care center closer to home.

        Yeah, I know that feeling well! Fortunately, a light headache followed by vision going snowy and black and white pretty much warn me of what’s coming if i don’t stop what I’m doing, lower my head till the feeling passes….

        No, I don’t plan on a transplant. There are so many people who are much younger and not retirement age who can become productive working citizens again with a transplant. I am retired, have a vascular disease, and am a poor candidate for a transplant. I also am creeped out at the idea of a foreign kidney inside me. The idea of taking medications fro life (or till it fails) to try to prevent rejection of that kidney also doesn’t appeal. My attitude toward transplants, too, I feel would make success a problem.

        I am encouraged to hear your fistula hardened up after this first year and bleeding became something of the past! I know part of my problem may be related to anti-coagulants used for clot control. Little by little, as the nurses become familiar with my particulars as a patient, they take much less time to hook me up because the internal fistula buttonhole locations are more quickly accessed than before, through practice, I’m sure the need and amounts for/of anti-coagulants will diminish to a point where the anti-coagulant doesn’t contribute to the bleeding. I mean, I held the access points for five minutes longer than most people anyway (15 instead of 10), and for a further 10 minutes after the bloody hell episode before the mess was in control. I suspect I could hold it for 20-25 minutes and never have this problem. Whatever! The nurses and I will have to work it out.

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      • I see, in my case I have someone hold it for me. Do you have a watcher when having your HD? I’m 34 this year and I still need someone to look after me when I’m having my session. I agree with you about transplant, I too don’t want to. I’m scared though Doctors kept telling me I will survive. But I heard a lot of stories in the center about patient having transplant, it’s like 30% survived and most of them rejected by the organ and instead of prolonging their lives they end up somewhere. If you know what I mean. My fistula is getting bigger, I mean my veins and if you see mine, you’ll not gonna like it. Would you like to see my fistula? I am new here, actually I blog and it’s my first time here. I searched for tags associated with Dialysis I found yours. I wanna know people like me.

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      • While on HD, nurses supervise but don’t sit with us. We have automatic warning signals on the machines that activate for different conditions requiring nurse intervention, and can call nurses if we notice problems or have muscle spasms. It’s a small unit (only six chairs in a small room that used to be the nursery in the old part of the hospital, which has been and continues to be remodelled and expanded on. Until we move back to the remodelled six-chair unit, we are in a two room, four chair set up, which means the nurses are assigned one or the other room. Regardless, it’s a small unit and there is at least one nurse per patient or more, something that wasn’t the case at a commercial HD unit in Denver or Scottsbluff, Nebraska: I am very, very lucky to be where I am! Yes, my fistula is getting bigger, too. I’ve seen one on another person that was huge. I don’t know how long he’d been on HD. I can appreciate your interest in knowing others with end term kidney doisease. it help to lower anxiety or to inform decisions we all make to know someone who has dealt with specific issues. While we get handouts at dialysis that explain the options for dialysis, benefits and problems associated with them; nutritional issues; fistula and catheter care issues; etc., personal experiences are more helpful.

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      • Indeed, personal experiences are more helpful other than reading about it.

        In our center, we are many. Sometimes 5 is to one nurse if there is no nurses available. We the main center who has 30 Dialysis machines and in the Annex who has 50 Dialysis machines. I think this case is very serious because percentage of patients having dialysis is getting higher every day.

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    • People with chronic diseases (I have Wegener’s granulomatosis and end term kidney disease) tend to think in terms of “the new normal”. The new normal for me returns after dialysis each time. It is a tenable state that means I am less vigorous than I used to be, yet in a tolerable state because I can safely drive my car after it, for example. Vigorous activity isn’t a good idea, though, mostly because I tend to have low blood pressure, something I’ve had all my life. My blood pressure after dialysis can be in the “normal” range for most people or something like 92/58, which wouldn’t seem uncomfortable to me, but is lower than most people experience. When it get really low, I feel a light headache and can start to feel like I’m going to faint. Reasonably enough, I know to stop what I’m doing and lower my head to my knees to increase blood flow to my head!

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    • Believe it or not, soaking that jacket in cold water, rinsing out the blood till the water was more or less “clearish”, then letting it soak further over night before washing it in the soak + cold water regular cycle with a good detergent has never failed me. People say you should soak it in soda water to get the stain out, but I guess that means after it’s set. I always begin the process as soon as I get home. That means the blood doesn’t have time to set up that much.

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  5. I am sorry you had the blowout and the washing chores afterwards. The post and comments are educational regarding what someone on dialysis goes through. You have amazing fortitude! All the best from cats and crew here. 🙂

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    • Once you acknowledge the “new normal”, you just do what that requires, and don’t really give it much thought. As noted in the post, I took time to show the bloody mess to my kitties first before taking care of soaking and washing it! Ha! I was disappointed they didn’t get excited about the blood.

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  6. I’m oddly relieved the kitty boys didn’t get excited at the smell of your blood. (“Hello, we are Count Andy and Count Dougie and we have come to suck your blood.”)

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    • I guess Andy and Dougy are just too domesticated to get excited about the smell of blood. I do try to expose them to interesting smells one way or another to keep them stimulated.

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    • Thank you! I was just outside the entrance to the emergency ward, so couldn’t have been better placed for “rescue”! Yes, I am fine. The photos make it look pretty grim, but people who have this occasionally happen to them know the routine, what to do before you lose too much blood.

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  7. “I’ve learned how to soak, wash, and dry bloody clothes to prevent stains”

    Was this before they relocated you to Nebraska and changed your name? [evil smirk]

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    • LOL! Yes, I suppose that makes me a dangerous fellow in some respects, though I know they have a way to highlight cleansed blood stains that means I can’t commit the perfect crime after all! (I can’t comment on the relocation…, LOL!)

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  8. Fortunately you kept your self control -( sang froid in French, without word game).
    It was a serious hemorragia. with risk of faint or infection . Afterwards you courageously drove your car .
    What a courage !
    In friendship
    Michel

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    • I wairted a few minutes before I drove, however, just to make sure I felt safe and the bleeding was done. There is a waiting room for the emergency area, so I talked with some of my fellow patients till I knew I could safely leave.

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