When a patient needs hemodialysis, they need a reliable connection between the dialysis machine and their blood circulation, known as their “vascular access”. It can be in the form of a natural internal connection of their blood vessels (“fistula”), a synthetic tube that connects blood vessels (“AV Graft”) or a plastic tube in their neck to their blood circulation (“catheter”). Blood is drawn from the vascular access, brought to the dialysis machine, cleaned, and then returned to the patient. This vascular access is their “Life-Line”. Please read Derek’s story of self advocacy and his Life-Line.
“I Look, Listen, and feel my access and also have learned to love it, after all it is my life line.” Derek Forfang
The Story of my Vascular Accesses, yes I said Accesses, is a long and winding story, like the few good veins I have left. OK probably a bad joke, but I had to start somewhere. I started with a catheter in the neck after a rough start in the Emergency Room. A few months later I found out during a venogram, that due to my Peripheral Vascular Disease from Type 1 Diabetes, I was not a candidate for a Fistula.
So I started with an AV Graft. A few months after using the AV Graft I started having clotting problems. My Nurse and Techs kept asking me what I was doing at home. “Did you sleep on your arm?” they would ask and I would tell them no, but they would say “Well you must be.” It got to the point I was afraid to fall asleep. I kept thinking about it and I asked if they might be taping the bandage on my AV Graft too tight. The Nurse explained to me the tape was not tight enough to cause this problem, but no one seemed to be able to tell me exactly what the problem was.
The AV Graft never had a strong thrill I could feel (which would indicate the blood flow through the AV Graft is good), so I bought myself a stethoscope and listened before every dialysis treatment and after dialysis, as well as at home. A few days went by and I listened with the stethoscope every morning and my access was working fine. After a treatment at the Clinic one day I listened with my stethoscope after it was bandaged and I heard nothing. I yelled for the Nurse, she listened then pulled the bandage off and the flow in the AV Graft restarted. They apologized stating they had never seen that before.
After that, instead of using tight tape on my AV Graft to stop the bleeding, I stayed longer at the Clinic to hold it and place pressure to stop the bleeding, leaving with just a band aid on my access. To figure out that problem it took the person that is with me all the time. That person was me.