Infiltration — Not the Spy Kind

Our dialysis story — chapter 35

On Monday, one week before Christmas, I dropped Ben off at dialysis as usual. On my way home, I stopped at the grocery. Thirty minutes later, I was walking Syau when my phone rang. It was a local call but not a number I recognized. I answered, and a voice with a strong Spanish accent started speaking rapidly. I couldn’t follow what the woman was saying.

I’m very experienced at listening to and understanding accents from many Spanish-speaking countries, but I couldn’t make sense of what the woman was saying.

Did she say “infilration”? As in, the spy infiltrated the enemy’s army? Huh?

I asked the caller to speak slower. She took a breath and spoke a little slower. Finally, I realized she was one of the nurses at the dialysis center. Something went wrong with Ben’s dialysis. Again, that word infiltration.

I’m sorry. I don’t understand what happened. What do you mean by infiltration?

She said something about the needle going into his arm, but I still didn’t comprehend the problem. I did get that I needed to return to the center to pick him up.

I was scheduled to work for a client — in 20 minutes. I was also walking our dog.

Still unsure what happened, Syau and I turned around and headed home while I called my client to cancel. Not a good time to be canceling on her. She works from home. Her house is for sale. On Wednesday, she will close on her new home and move on Thursday. I really need to work for her before she boxes up her home office — before she moves. She said I could work on Tuesday. I have another client on Tuesdays, but we agreed on a time that worked around my other client.

Thirty minutes later, I arrived at the center. Ben was waiting for me in the lobby. The clerk at the front desk buzzed the dialysis room, and an unfamiliar nurse came through the lobby door. As soon as she spoke, I knew she was the one who had called me. She spoke just as quickly, and still, I couldn’t understand her. I asked her to speak Spanish to Ben so he could translate for me. She ignored me and rattled on in her Spanglish.

The clerk came from her office to help, explaining that when the nurse inserted the needle, it went through Ben’s fistula (connected vein and artery) and out the other side — a definition of infiltration that I didn’t know.

The nurse blamed Ben, saying:

He moved his arm. Not my fault.

That pissed me off. This wasn’t Ben’s first time having dialysis, and I doubted that he moved his arm. I also know he has a tricky curve in his fistula. There was no need to place blame on anyone, but as the new nurse, she was doing just that — deflecting the blame to him. I get it — she’s new and doesn’t want to look bad. I felt certain the nurse was not told about his tricky curve, or she forgot. But it didn’t matter.

The clerk explained that blood seeps into the arm when infiltration occurs, causing swelling, bruising, and pain. Ben held out his arm for me to see; it was already badly bruised and swollen.

The nurse thrust three small boxes into my hand. They were cold packs. I tried to return them:

I don’t need these. We have medical ice packs in our freezer.

The nurse refused to take them, saying:

Twenty minutes cold. Rest twenty minutes. Twenty minutes heat. Today, tomorrow. Dialysis on Wednesday.

I said:

We have appointments Wednesday morning.

The clerk said:

Come whenever you can. We’re open until 9 pm.

I replied that we could get there between noon and 12:30 on Wednesday.

We kept Ben’s arm elevated and did the ice/rest/heat dance for the rest of Monday and most of Tuesday. The swelling and pain decreased, and the bruising worsened, as expected.

I worked for my clients on Tuesday, and Ben returned to dialysis on Wednesday. He was assigned a different nurse — one he had many times before. Dialysis went well, but Ben’s distressed that he has to return Friday and Sunday. Because the center is closing for Christmas, all Monday patients were moved to Sunday.

Three dialysis sessions in five days. I reminded him that’s what he used to do before they decreased his sessions from three to two per week. I also reminded him that, after his Sunday session, he won’t have to go again until Friday. That will be a nice long break.

Now, I have one more thing to worry about — infiltration. I didn’t know such a thing could happen. Of course, I can do nothing about it, so worry is fruitless. Just like the blockages he’s had. I can’t prevent those, either. Still, I worry. That’s been my default emotion for almost 18 months, which might explain all the digestive issues I’m having with flare-ups of IBS and colitis and the new kid on the block, acid reflux. OTC drugs haven’t helped the reflux or have only helped minimally. I have a doctor’s appointment in January, and I know he’ll recommend a lifetime prescription for some medication I don’t want to take.

Meanwhile, I’m doing my research. My bedtime reading is online articles and videos about acid reflux and its connection to stress, IBS, and colitis. Hell, that type of light pre-sleep reading may be making it all worse, but it’s the only quiet time I have to delve into everything that can go wrong with digestion. Who knew our digestive systems were so wimpy? Or maybe they don’t age well. Either way, mine is not doing its job well.

My doctor will be thrilled when I tell him that I’ve self-diagnosed my acid reflux as “laryngopharyngeal reflux” — aka silent reflux — a type of reflux that occurs in the throat or sinuses rather than the chest. I don’t have traditional heartburn, but I have a bubbly irritation in my throat that results in coughing, burping, and the persistent need to clear my throat. I’ve become a teenage boy who can belch on command. Charming.

Honestly, my doctor is used to me showing up and saying:

So, I’ve been researching, and this is what I believe is wrong with me.

He’s also used to me being correct and has a begrudging respect for my ability to do deep research. We don’t, however, always agree on treatment, and he will annoy me with tests to prove my self-diagnosis. As if my research isn’t proof enough 😉

Since I don’t want another medication — I already take one for IBS — I’m trying to find time for yoga. I found several online videos of yoga and breathing practices that help with digestive problems. It's worth a try, though my doctor will likely disagree. Or maybe not. He’s more open-minded than most MDs. That’s why I go to him.

Meanwhile, I’m turning our spare bedroom/office into a yoga room.

Wish me luck!