arm surgery

Okay, so I asked the man, how much cutting is involved? And when will I be able to return to work? And how will this limit my use of that arm and for how long?

He responded with a shrug and said, "Well, it's outpatient surgery, you should be able to go back to work at what you do, immediately." But, hey, we'll schedule it for Friday, that way you'll have the whole weekend to recoup. The "you idiot!" was implied. Of course, he says, there's always the chance he won't be able to do the fistula, in which case, he'll put in a graft. You know, instead of connecting the vein to the artery, he'll have to insert an artifial vein. But not to worry.

I asked him about sleeping, because I had read that it might be a problem if I was side sleeper. He waved his hand at that and said, "Oh, don't worry about that. It's not even an issue."

This was the extent of my preparation for this life-changing surgery. And that is why I hate surgeons. No matter how you ask, they will not tell you what you need to know. And you will be surprised at what they have done to you, when you wake up. (Having said this, I warn anyone who writes to me and says anything about having to be your own advocate - you give me this advice at your own risk. I did research on the internet and I did ask the questions.)

He did not tell me that I would lose all the strength in my arm (I hope that's temporary). Or that it would be four incisions, three of which have 9 or 10 staples. Or that my skin would be pulled so tight, my arm kind of sticks out away from my body at a strange angle. It almost feels like he detached my arm and sewed on someone else's.(Someone asked me if I had hurt my back, because of the way I was walking.) I usually carry a pillow under my arm in order to prop my arm at the right angle so it isn't pulling the skin too hard.I cannot sit or stand comfortably.

As for sleeping, which I asked him about specifically - I have been unable to sleep in a bed. I have to sleep propped up in a recliner. I don't know when I'll be able to lie down again.

After the surgery, as you'd expect, my arm was swollen huge and all black and blue, but it's been a week so most of the discoloration is gone. I still have swelling and constant pain in my arm, though. I cannot lift my arm easily.

My poor skin reacted to the bandaids and so I can't cover the incisions. When I took one of the bandaids off, it pulled some skin with it, leaving an open sore in the elbow bend.

While my arm feels hot to the touch, my fingers are cold. This is a circulation problem, and cold fingers in this hand may be something I'll have to live with forever.

It feels like I have giant tubes under my skin and it itches just below the surface of the skin (you read right) where the graft is.

I'm posting a couple of picture so you can see my Frankenstein arm. Yes, I know it's red around the staples of two of these incisions and that may be sign of infection. But the redness started yesterday, and being a holiday, I was advised by the doc's answering machine to wait until Monday or call 911. I am taking levaquin, which I just happened to have on hand, and I will call on Monday.

Thanks for letting me vent. Now it's time for more pain meds. I hate to take too many of these, so I go as long as I can without taking them, and then I cave, pop the pills, and turn on the TV.

Time marches on

I guess it's high time for an update. I've been back to the nephrologist a couple of times since my last entry. I go every two to three months. I'm driving to Shreveport for each appointment now, because they rotate the doctors that come to Natchitoches. I want to see the same doctor each time now. She's been my nephrologist for ten or twelve years. I like her, because she's very straight forward and confident. Unlike some doctors, she talks to me like an equal - like I'm perfectly capable of understanding what she's telling me. She's never been patronizing like so many other doctors I've been to over the yeas. And I really don't have as much confidence in some of the other doctors in the group. I'm sure they're capable, but they don't know me from any other patient.

My phosphorus is okay, so either the pills or the diet is working okay. But my creatinine was 2.8 this last time. My function is steadily getting worse. The next step is to go have my veins mapped and then have surgery to put in a fistula. This is where they attach an artery to a vein to increase the blood flow to the vein. This causes the vein to grow and get stronger and better able to withstand the needle sticks and for use during the dialysis. Sounds awful, right? They do this before you need dialysis so that it has 8 to 12 weeks to heal before you need it. Otherwise you need a catheter inserted to use while the fistula heals.

Dr. N wanted me to have the vein mapping as soon as I get back from our trip, - the same week. But they wouldn't schedule it that far in advance. Her nurse then scheduled it for April 27th and left me a message letting me know the day. I've tried to reach her about that as I don't know if it makes a difference how much time passes between the mapping and the surgery. The nurse may not have been aware that I was leaving for two and a half weeks in May, when she made the appointment. There's no way I'm having the surgery before my trip. But we played phone tag for two days and then they were off for Good Friday. I'll try again on Monday. I read that once they do the mapping they don't want you to have any needle sticks, like blood drawn, until after the procedure is done. Considering I have blood drawn every two months or so, I'd think they'd want to schedule the mapping and the procedure pretty close together.

Our trip to Greece is only 4 weeks away! It has changed a bit from the original plan. Our original trip was canceled as it didn't fill up, but another company had a similar trip starting a day later. It was a day longer on land and an additional day on the cruise, but they were offering a special rate on the airfare, saving $800. This means we ended up with two extra days for almost $300 less then we originally planned. Of course, we'll need spending money for the extra days, so we really aren't saving money, but how could we pass it up? Our other option would have been to reschedule the original trip to three weeks later. I'm glad we decided not to do that, as time is getting to be a real issue with my health and three weeks could make a difference in when they do the fistula surgery and healing times, etc.

Now it's time for me to go walk. We're trying to walk and/or exercise every day before the trip so we can keep up. I've not been doing this as faithfully as I should have been, so we really need to be sure to get it in every day. I'm worried, because it does seem to take something out of me and I'm sure we'll be doing a lot more on the trip. Especially, up and down stairs and uneven terrain.

In any case, it's going to be great and I can't wait. I just hope I'm prepared. I'm trying to figure out what I'll need to have with me and how to pack when you can't take too much, but you can't wash clothes (except by hand) either.