One of the crazy things about the daily routine with working with this disease is that it often turns non-routine when you can really least afford it.
Aida and Christian returned from last weeks clinic visit Friday afternoon. They had skipped dialysis on Wednesday in order to drive to Houston, dialyzed at the hospital during Thursday clinic (which lasted from 7:30am till 7:30pm that day) and drove home Friday morning - arriving about 3pm.
Christian REALLY wanted to be home because there was a friend's birthday party Friday evening on a big party bus - pizza, music, etc while driving around town. They made it in time, yay!
We picked him up after the party at 7 and prepped, accessed and placed him on dialysis about 8pm. The treatment should have been finished about midnight.
Unfortunately, we ran into a series of alarms which required stops, adjustments and restarts to the treatment. These typically are pressure related access alarms that are generated when the pressures required to pull the blood from the artery port into the machine and subsequently return it back into his body through the venous port get out of range for safe treatment.
It's a critical issue - if the pressure is too great in either direction, you run the risk of hemolysis - ie, breaking apart the red blood cells as they enter or exit the access needles. There are several potential causes - usually positioning of his arm where the access needles are, positioning of the access needles themselves within the vein (fistula), clotting in the needles, clotting in the filter mechanism on the machine, etc.
It doesn't take alot of time to adjust for these events - and most of them Friday night were body positioning. As he slept, he would move some during treatment and partially kink the tubes or fold his arm in such a way that it would restrict flow out of / in to the vein from the access needles.
So the machine stops itself, you adjust, restart treatment, the machine recalibrates it's pressure balances and then spins up and resumes running the therapy.
All told it takes about 5 minutes to get back on track. Well Friday was a real bear as we ran into the alarms 4 - 5 times an hour. It was just after 1 am Saturday morning when we finally finished and turned in. 6 hours (7:15p - 1:15a), yuck!
Part 2 coming later today.