Chronic Kidney Disease Is Not A Laughing Matter...Usually

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By: Bob Northam

Bob Northam is the author of The ABC's of the Big D: My Life on Dialysis, a humorous look at the lifestyle, personal, and work issues faced by dialysis patients.  Bob is a longtime dialysis patient who recently retired from a Fortune 500 company, where he was VP, Finance.  He and his wife Donna have two adult children and one grandson.

Anyone who enjoys The Marx Brothers, The Keystone Cops, or, for that matter, even The Three Stooges, would probably have enjoyed watching me train to do home hemodialysis. Before proceeding with the story, it would help to point out that I'm one of those people who you might politely call "technically inept." 

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Of course, if you weren't being so polite, you might say that when it comes to any type of machinery, electronics, appliances, household items, or any type of building projects, I'm just a disaster waiting in the wings to happen. The simplest of tasks can go bad in my hands.  One time, I tried to change out a fuse in my basement and almost burned my house down.

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And I can cause a computer to malfunction just by going near it. In my defense, I pointed all these factors out to my nephrologist who was overseeing my in-center treatments, but he still insisted that I was an outstanding candidate for switching to home. My wife, who was destined to be my training partner, asked if there was any kind of interaction with machinery, or anything remotely technical involved.

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"Well, yes," said the doctor.  "You have to setup the machine, prime the lines, and be responsible for putting your own needles in."

She looked like she was going to faint.

"You don't understand," she said in a hushed voice.  "The handyman who works on our house has a cottage in the Bahamas because of him.  Every time he starts working in the yard, the neighbors pull their children off the street.  I had to hide his tools from him so we wouldn't have to take out a second mortgage..."

"Okay," I broke in.  "I think he gets the point."

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The doctor just laughed and assured us that he had patients worse off than us who thrived doing home treatments. My wife just snorted in derision. So, for our first home hemo training session, we were told to "wear comfortable clothing." Turns out, we would have been better off wearing bathing suits.

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We were heading back to the training area, and as soon as we walked in, alarms on a couple of the machines started going off. There was nobody else in the room, and the nurse/instructor said, "Hmm, that's unusual.  These usually don't just go off on their own."

My wife was eyeing me suspiciously, but I just smiled weakly and we started with the lesson.

The nurse showed us how to hook up the saline lines, but I forgot to close one of the clamps and saline poured out all over me.

"Here we go," said the wife.

But, I dried myself off and said I was ready to proceed.

"We'll have to use a new saline bag.  This one's three quarters empty," said the nurse, trying to suppress a smile.

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The rest of the setup was going okay, then it was time to "snap and tap," which home patients will recognize as the process to get excess air out of the system. The nurse showed us what to do and said she wanted the wife to clear the air out of the arterial line, which she did.

"Now, why don't you do the venous line," she said to me.

"But..." my wife started to protest.

"No, it's ok.  I got this," I said confidently.

"You'd better stand back," my wife said to the nurse.

I ignored that and started snapping and tapping the line.

It was all going swimmingly, but then I ended up almost going for a swim.

When I got to the end of the line, I said, "Ok, all done.  See?  Nothing to worry about."  The wife looked relieved that it was over.

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Then a bubble near the top of the tubing caught my eye.  "Oops let me just get that last one," I said and went over, twisted the tube slightly to tap out the bubble, and the line came undone and, once again, saline started pouring out all over the place. The machine alarm started going off.

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The nurse looked like she was going to herniate herself from laughing, but she just said," The alarm is from the pressure change."

Saline was continuing to pour out.  Then we heard a shrill beeping sound that just about cracked the window glass.

"What is that??" I yelled

"It's the fluid detector," said the nurse, still laughing heartily.  "You can just skip the step where you test the battery in the detector."

"Well, how do I stop it from going off??" I asked, figuring that my initial thought of smashing it against the wall probably wasn't correct.

"First, close the clamp on the saline line."

"Right," I said, but I closed the wrong clamp and Niagara Falls continued to flow.

Finally I closed the correct clamp and stopped the flood.

"Now, dry the detector off with a paper towel," said the nurse.

"Right.  Got it," I said running over to stop the infernal alarm from squealing.

Then I walked through the puddles back to the machine.  When I looked over, my wife and the nurse were just looking at me.

"So," I said sheepishly.  "How do you think it's going so far?"

Then all three of us cracked up.

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Believe it or not, I completed the training without any fatalities and have been doing home hemo now for a few months, showing, I suppose, that's there's hope even for the most helpless among us.

Thanks for reading.

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