A September medical adventure on dialysis

For the last couple of years, I’ve been unusually healthy: no major dramas or hospital admissions; not many infections, colds or the like. And I was pretty healthy for our Lisbon trip.

This kind of peace and quiet can lull you into a false sense of security, where you start to think that health might just be the norm. But sadly, all of us BigD-ers need some pretty fancy footwork and a good dose of luck to stay healthy.  Or at the very least, we need to keep thinking and not make dumb decisions.

I stopped thinking and fell into my unexpected medical adventure on the 13th, around an hour into my dialysis run. I went into AF (irregular heartbeat) and my pulse got faster and faster. I was short of breath and had waves of chest pain; I thought my chest was going to explode. I persisted with dialysis for a while, hoping to get to the end of the run, but that was not to be. The staff called an ambulance, took me off the machine and I called Julie.

Julie arrived first (and I was really pleased to see her), followed by the ambulance. The paramedics were cool and calm and started work immediately. They took a range of measurements (pulse, ECG, temp, bloods, etc), asked me how I felt and I said I had chest pain like an ache in waves. The senior paramedic thought it was heart rate pain – because my heart rate was too rapid, it couldn’t effectively pump blood to the rest of my body, depriving my organs and tissues of oxygen and causing the pain, shortness of breath, etc.

They gave me a GTN (Glyceryl trinitrate) patch (to widen my blood vessels and let more blood and oxygen reach my heart) and some chewable aspirin (to slow blood clotting). Then a small injection of Morphine, to reduce the pain. I felt a lot calmer after this, but my heart was still playing helicopters in my chest.

1-af-amb-3-001Then they packed me up and we went for my first ever ambulance ride. Julie followed in the car.

We went to the closest hospital, The Austin, which is also my ‘Home” hospital, where I have had two transplants, three kidney removals, and many, many stays for infections unknown and known (like pneumonia) and the odd heart disease problem. It is quite disorienting, scooting along in the back of an ambulance. I know the way there quite well, but each time I looked out the window, I really had no idea where I was.

In the past, I have always been admitted via the Emergency Department, often after a lengthy wait. This time, I arrived at the Ambulance entrance with flashing lights; the doors opened and I was wheeled in on a trolley. There was still a wait; it was super-busy so I just laid there and watched the drama, of which there was plenty.

For some reason, this was a night for Ice overdoses and aggressive, crazy people. The ED staff are not only skilled, they are brave. In the glimpses I saw, one patient was clearly out of her mind; fighting, swinging, grabbing, punching, screaming, swearing and staring with blank, hate-filled eyes. She was gradually strapped in place in a bed but continued to thrash and struggle and stare. It was as scarily close to a real-world zombie movie as I ever wish to experience. Asking myself why anyone would do this to themselves was as horrifying as it was pointless.

Every few minutes, I texted my progress to Julie and Mark, our eldest, who were in the ED waiting room, about my progress.

Eventually, I was taken to a cubicle for more tests and heart drugs. By this time, it was about midnight. Julie and Mark were shown in. Mark left around 1:30am. In the past, I have spent the night on a trolley in ED waiting for a bed in the kidney ward. But no one mentioned being admitted this time. Julie was all for waiting around, but I thought I would be hours yet, and eventually convinced her to go home around 2am.

Around 2:30am the heart drugs started to kick in and my heart beat gradually returned to normal. Around 3am, the cardiac specialist came by and said I could go home! I called Julie, who had just fallen asleep. She drove back and picked me up. We arrived home around 3:30am and flopped straight into bed. I slept like nothing had happened

I slept like a log and woke feeling like nothing had happened. Luckily, there were no after-effects, and heart-wise all is well. Julie and I are still recovering from the drama.

Lesson. Later, discussing the whole thing with my doctor, I remembered that sometimes when I try to take off more fluid that I need to, my heart reacts to the reduced fluid volume by going into AF, usually for a few hours. This time, I had tried to take off much more than I needed to.  Stupidly, I persisted and my heart reacted accordingly. What I should have done was to stop dialysis immediately, have a drink, and recalculate my dry weight. What I did was panic and keep dialysing.

Like I said, sometimes  good health simply involved thinking straight and not making dumb decisions.

7 thoughts on “A September medical adventure on dialysis

  1. So glad you are okay now. There is a good lesson in what happened to you for the rest if us on dialysis. Thanks for sharing your experience. I hope things go smoothly for you from now on.

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  2. I have been a dialysis patient for nearly 5 years and one thing I have learned is the problem that dialysis patients have is taking too much fluid off in too short of time. If you have to take off a large amount of fluid you have to stay on for a longer time, my calculation for this is no more than 500mls per hour. This can be very hard for someone who has to take off say 3kg would mean 6 hours treatment. I am very fortunate I always take off the same amount, that is 350mls during my 4-hour treatment as I have full kidney function. I run at the same pump speed 280, this I have been doing for nearly 5 years. I use the button hole method to cannulate.

    On Friday next My wife and myself travel to Sydney to board a cruise ship where they will provide dialysis on board, this is our 3rd trip travelling with Dialysis at Sea and so far all has gone well. I have posted comments in regard to travelling in the past but these have never been posted on your site, I wonder why? I certainly could inform patients about travelling by ship. The best company I have been with is a German company ‘Trans Ocean” they operate out of Frankfurt and Budapest. We took a trip all the way to the Black Sea and back to Frankfurt last year. This company is no way as expensive as Dialysis at Sea. and provided a great service, there were 8 dialysis patients aboard and although not all could speak english we all had a great laugh and got on just so well. Living with a small number of dialysis patients on a small ship was quite informing and I learned a great deal and realise what some have to put up with having other problems to deal with.

    Hope this post is of some interest to other dialysis patients.

    Greg Francis. New Zealand.

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    • Hi Greg. Thanks for the comment. I don’t know why your previous comments haven’t appeared, but this one and all future ones will from now on!

      I would also like to put your thoughts and comments about your dialysis cruises in a separate guest post so they can be easily linked under Dialysis Travel. Please let me know if that’s OK with you. Also, if you have more to add, including your previous comments, please sent them to my email address (see About) and I will add it as a larger post.

      Best regards, Greg

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  3. Hi Greg
    I have been on dialysis for just over a year. During the last three months I have experienced a migraine like headache and AF starting in the third hour of dialysis. My nephrologist altered my dry weight but the problem persisted. I am now trying HD instead of HDF. Any thoughts?

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