Haemodialysis – Unnecessary Complications

Friday 2014-04-04

Nurse J asked me today why I recently hadn’t taken blood pressure which was routine for patients before, during and after each dialysis. Since she asked, I had to show her. Even after a week my arm was still clearly badly bruised by the injection she give me last Friday, a huge patch of purple and blue which looked real bad as if I took severe belting. I also showed her my photo when it was inflamed and red. She looked uncomfortable. How could any nurse look comfortable after created such an a surrealist piece?

Basically, my entire upper arm was encircled with redness and bruises. I think she asked why I wasn’t taking blood pressure on behalf of her team, after a few days in a row not measuring myself they wanted to know why. I had already put down my reason on my daily record which they should read. Initially I didn’t want to embarrass them about my emergency trip, she must now report back to the manager.

One single injection could make such an impact surprised everybody. By looking at my arm the doctor at the emergency asked me how many injections I had. It is only bruises left now, when I went to the emergency it was in full inflammation. Where did the infection come from while it was done in a hospital and by a nurse?

Actually, today the arm feels not as bad as it looked, though I still feel a slight heaviness when I lifting my arm, I just want to play this thing a bit more.

A few days before she bruised my arm, I already stopped taking blood pressure and forged the numbers. My arm had been hurting for a while now, ever since one day on dialysis the left forearm suddenly started to feel tight and strained and I was hurting so much each time I took blood pressure, outwardly the arm looked normal and fine.

Each time I tell them what’s wrong, they have a remedy, most of the time it would make me felt worse. I can’t possibly even think telling them anything specific these days. Doing blood pressure again may bring the pain back as well. I’m not ready yet, after what they learned today, it would be a while for them to be interested in my blood pressure taking again.

Another thing happened today was nurse S was eager changing the dressing on my right arm on which access nurse M specifically written leave intact till 7^th April which is 3 days away. I mentioned my bleeding event and emergency trip the day after operation 20 days ago. After what had happened to me in this unit since I got here I have qualms in her touching my dressing just yet.

After dialysis she only peeled and changed the outer layer of the dressing leaving the inner layer intact. I was relieved. She is a clever woman and had already made the connection that I tolerate heparin poorly, and peeling one more layer off may lead to unpleasant things.

With a flip of finger today she even stopped my heparin half an hour before finish saying my dialyser always looked clear and white I may not need so much heparin. This reminded me how difficult it was for me to have the heparin reduced in the beginning when I found out I couldn’t tolerate it. It took me more than a month time, and it was the 4^th doctor I raised the issue to who reduced its dose. Albeit only to the level I could survive. I never dreamed to reduce the dose to the level I wanted which was sufficient enough to keep the blood flow without clogging the line.

While working with my drug chart, nurse S wanted to know whether I had my vaccine and I showed her my photo. She was practically gleeful that she wasn’t the one who injected me. By the way, she was the senior nurse who often praised J’s needle work.

Linking both of my incidents, the bleeding wound and the injection infection with heparin, before I left the hospital for the day I overheard nurse S talking to the manager that the super strength power heparin locking for my catheter was to blame for my bleeding and bruise.

Actually she had a bone to pick with the manager. I noticed the strength of heparin lock had recently changed from 5000 unit to 25000; My guess is, S preferred and had been using 5000, the rule in this hospital is 25000; I can’t know all the details, somehow nurse S was ordered to change it to 25000 instead of 5000, she wasn’t happy. Today she threw my bleeding and bruise back at the manager.

I’d been to so many different hospitals and used both neither had trouble locking my catheter. Personally I prefer 5000, when less can do the job why use more, but since when my preference mattered.