It's Probably Your Medication, It's Something You Did, It's Nothing We've Done
Last Tuesday, I went in to dialysis, but it had been one extra day past when I probably should have had dialysis. During treatment, my blood pressure dropped and I started to feel nauseous. I asked the Tech to stop the fluid withdrawal, even though we had a lot of fluid to take off, I soon asked the nurse to add some fluid from the IV bag. My blood pressure started to spike. A couple hours later I had driven my self to the hospital and I was getting meds to lower my blood pressure, it took them most of Wednesday to get the job done.
They kept me overnight Wednesday so they could dialyze me Thursday mornning. Dialysis at the hospital went fine and they discharged me later that day with a whole bunch o' blood pressure meds.
Saturday I went in for dialysis and after about 2 hours, I started feeling nauseous again. I knew it wasn't the fluid issue, but I'm not a Nephrologist, so I had no clue what it could be. NEITHER did anyone else at the dialysis clinic. I had been dialyzing fine for 2 months and now suddenly I have a problem. I had been told I could get an antiemetic to keep from vomiting, but the nurse was reluctant to give it to me until I started dry heaving. I passed out soon after I received the drug and woke almost an hour later. The nurse told me because of the drug, I couldn't drive home and she asked me whether I wanted an ambulance, cab, or if I wanted to call my wife. I called my wife and she dragged the 3 kids out to pick me up.
I spent Sunday on the couch popping antiemetics and trying to keep from vomiting. I had asked to come in on Monday to take some excess fluid off, but the Nurse told me I had to come in for a full treatment (she was mistaken).
Spending the weekend thinking about the problem, I think it may be the Dialysis solution got changed. I seemed to remember the doctor making some off-hand comment about changing my solution recently (but with my memory, I couldn't recall when). I also seemed to recall that the hospital used a "1k solution" (the solution is refered to by it's concentration - 1K, 2K, 3K). So, Monday morning, I had a discussion with the Tech about my dialysis "bath" or solution.
According to my records, as far as Davita was concerned I was on a 2K bath. The tech couldn't tell me when it was switched. I asked if they kept records of when switches were made and she said "no", the nurse just makes a switch depending on the results from lab tests. I asked to see my chart and then I had issues with my fistula and the next 40 minutes were spent with two Techs and a Nurse trying to get it to work. Luckily, they failed and I was scheduled for an angioplasty Tuesday morning.
I say luckily, because they had me on a 2K solution and the Tech wouldn't change it without the Nurse's say so and the Nurse said he'd "look into it". When I got home, I knew I'd need help, so I called in reinforcements and my parents showed up a couple hours later.
The angioplasty went well and I went in to dialysis later that day. My Tech for the evening, who we'll call Sam, had set me up with the usual, a 1K bath. She hadn't looked at my chart, so she didn't know I was supposed to be on a 2K bath. Normally, that would be a bad thing, but I convinced her to leave it. The Nurse on duty told me she'd order a weekly potassium to confirm the problem. I asked for and was given my chart. Once I flipped past all the insurance info and got to the medical stuff, there, on the first page, at the top of the first page was this " ↑ Δ 2K" This was dated 3/17/09. According to the Tech, my dialysis on 3/17/09 would have been set up as a 2K bath because of that note. AHAAAAA. SO that's what sent me to the hospital. I looked further back and found that I had been switched to the 1K bath back on 1/15/09. I finished dialysis Tuesday night feeling normal again. Hallelujah.
The moral of the story is that some of the healthcare professionals around you don't care why you are becoming sick. They have no motivation to figure out what's wrong. They'll treat the symptoms and go their merry way. You have to learn everything you can about your treatment and be involved. They would have happily kept ripping me apart with each dialysis session until my monthly lab results came back. I am angry.
Tomorrow I will write about something scary I learned from reading my records.