Well, much has happened and I thought about taking the blog down completely. Everything seemed too personal, too painful, too difficult to put into words. Sonshine was being monitored each week after he left the hospital and after a few test results that showed that creatinin and BUN levels might be heading back where we were hoping, everything started to slide off the cliff. Lab levels of everything started to go up and the doctors at one time had Sonshine on 3 different blood pressure medications just trying to get it down. Finally, Dr. Cheam, Sonshine's Pediatric Nephrologist said it was time to prepare for hemodialysis. We left the office in shock. I don't think there is any way to prepare yourself or someone else for news like that. I do know that Dr. Cheam could not have done a better job. We left the office that day with a referral to a vascular surgeon and the promise that the office staff would work with us to get some radiographic films of the veins in Sonshine's right arm and hand. The next day, we were at the radiology lab for the films. Torture to watch since Sonshine didn't have any place that hadn't been poked with a needle in the past few weeks. Once they placed an I.V. in his hand, they were injecting dye and taking pictures. The radiologist was an ass. He didn't come in until Sonshine was prepped, on the table and ready to have the dye pushed. The dye made Sonshine violently ill and although he had not eaten, was dry heaving and feeling awful. The doctor was visibly annoyed. Sonshine was sobbing. My 16 year old man cub broke down and I could do nothing to help. They got the films that they needed, packaged them up and sent us out the door, films in hand to visit the vascular surgeon.
The vascular surgeon saw us on Wednesday and wanted to do the surgery to make the fistula on Friday since he was leaving for vacation after that. We were the last surgery on what was a very long day of procedures for the surgeon. Never, never, ever be the last patient for surgery. In addition to the fistula, the doctor would be inserting something called a PermaCath. A catheter that has two lines (one arterial and one venous). The dialysis nurses would be using the catheter until the fistula was mature and could be used for dialysis. A fistula is the joining of a vein and an artery. When that happens, the vein has to grow and get bigger to accommodate the increase in blood flowing through it. The patient has to exercise the hand and arm to get the vein to increase in size. Once the dialysis nurses feel that it has matured and the vascular doctor has examined the patient and given the clearance, the nurses will begin to "train" the fistula.
