Needling

There are two techniques for doing needling: rope and ladder or buttonhole. Rope and ladder means you use different sites progressing up and down a "ladder" on your limb. A buttonhole is a permanently used hole that you open up every time you dialyse. You scratch the scab off and put the needle in. That sounds revolting.

I do buttonholing. At first, like most people, I thought it was disgusting but then I relaxed. Here's why. It reminded me of when I was a kid and had a graze or cut. A few days afterwards the idea of picking at the scab was irresistible. It was strange how picking at the scab never hurt and how satisfying it felt. By tapping into this "scabby knee" recollection I easily overcame whatever revulsion I felt and buttonholed easily. I recommend this little mental trick to you.

A Checkered Life

If there is a maxim that I use for HD it is this:

I know I just checked my setup. NOW CHECK AGAIN.I don't remember if I checked my setup. NOW CHECK AGAIN.

Checking HD lines is what saves you from causing real problems for yourself if you're doing HD. Setting up the machine and the bloodlines takes about an hour and is very complex. My hunch that you perform about a thousand separate physical actions in this setting up. I can't remember a thousands things, can you? That's why you need to take every opportunity to check what you've done. It's funny how you can get a sense of knowing something is wrong but you can't put your finger on it. Checking will help you identify what it is that's causing that nagging feeling and allow you to fix it.

Last night I set up my machine and had some spare moments. I just sat staring at it in general. It was then, after gazing at it for about a minute I realised I hadn't placed a hypo full of anticoagulant in the place where I grab it after an hour of treatment. Seems minor but if it wasn't in the right place I would be squirming all over my bed praying that the cap doesn't come off and the hypo stab me. I put things right and last night's session went smoothly.

If you're doing HD then you've been trained in the process in a group of people that are skilled in training HD patients. It's the habits you have to learn and checking is one of them. Check you later.

The First Time

Despite all the preparation, all the support, there is no way to be really ready for the first time you receive HD. It's a bit like travelling on a plane for the first time: you know what to expect, you've spoken to others but none of that prepares you for the feeling when the big jet starts hurtling down the runway then tilts toward the sky. At that moment of take off there is one thought - I have no control over this.

No Control

That is the overwhelming feeling at the time of my first HD. I felt like a bag of meat and blood in a seat with a swarm of nurses prepping me. They told me things but my level of anxiety was too high to take things in. It was just a case of go with the flow. And there was flow. The blood.

Blood

My fistula was virgin. A tender little tube of thrilling blood waiting to be taken advantage of. They say the first time is painful. Well it wasn't. The first local anaesthetic was painful. Why are locals so bloody painful? It was more painful because of the stressed state I was in. And then all that stuff about a virgin bleeds came true. The nurses didn't know my veins. No-one did at that stage. The needling was an educated hit and miss. A lot of blood. More than I had ever seen from a cut in my life. Then it settled. Nurses watched me and the machine and checked constantly.

The Session

It was a short session. I can't remember if it was one, two or three hours but I recall that the nurses told me they always kept the first few sessions short so that people get used to HD. A nurse sat beside me the whole time the first time and tried to keep me relaxed.

Have you ever found yourself in a serious, life-threatening situation where you cope by using gallows humour? That's how I got through that first session. I can't remember any conversation just the feeling that I thought this was my life and it was being determined by a thin tube leading out of me and thin tube leading back to me and all that was in between was a box of stuff made by bored factory workers on the other side of the world.

What can I say?

When you start dialysis it's a personal milestone that no-one else can pass for you. No amount of description, preparation or support will make it completely knowable for you. It's a trip we each have to do alone, but in company, if you know what I mean.

Once you pass that milestone you really are on a new and special journey. And I want to talk about that another time.

Hello

This is just a simple intro to what I hope will be a series of occasional posts about my experience of nocturnal home haemodialysis. I have been receiving haemodialysis (HD) for nine years now and started on home HD four years ago. I live in a suburb of the north west of the city of Brisbane, Australia and am supported by the HIDS unit of the Royal Brisbane and Women's Hospital.

As intros go this is decidedly boring. It's the weather. After a week of glorious sunshine cold, heavy squally showers have come belting across my house and my mood. The only people not upset by this miserable and unwelcome weather are the scrub turkeys, one of which is browsing in the garden outside my window as I type.The purpose of these birds is a mystery. They are less use than a wi-fi sausage. Then again, I suppose humans are pretty pointless too.

Before I go I will tell you this: I do not have a name for my HD machine. In all the HD centres I've been to each machine is named. The names are witty or meaningful or deliberately cryptic. Mine's just "the machine" or after a bad run "that bloody machine". I would not want to share a bedroom with a device called "Miss Muffet" or "Mephistopheles". There's only room for one named thing in my room, that's me.

And that's all for now. Til next time. Bye.