Just when everything was going smoothly, last night I had a terrible incident.
Around 3:30 in the morning, the machine, a Fresenius 4008S gave an alarm. I instinctively pressed the reset button. The alarm persisted. I then noticed blood dripping out of my arterial site. The needle was more than half way out of the site and blood was dripping out. I alerted the technician who is with me and to cut a long story short, he handled the situation. Not before the needle came out completely though. He reinserted the needle and the dialysis continued.
However about half of my t shirt was wet with blood. I have no idea how much blood I lost but it was a lot.
This kind of a thing has happened for the first time. I used to use a dri sleeper but stopped after there was no blood leak after I started tying my hand with a piece of string to the bed.
I am still clueless about why the needle slid out in the first place.
This kind of thing really sets me thinking. I have been having a tech come and stay with me during the session but this is not going to last too long as he is getting married soon and will not be available. Nobody in my house is trained to handle this. There is also no training in India, where I live on how to handle these kinds of situations.
I value the freedom nocturnal gives me and wouldn’t like to trade this for anything in the world. But then, I feel scared when things like this happen.
Do you use tape to secure your sites? I use Tegaderms with some supporting tape and feel the Tegaderms are much more secure. When I was in-ceneter, tape had a way of unraveling simply by catching on my blanket etc. So, I have never trusted tape alone. I’m pretty sure I heard about the Tegaderm method at this board and that made more sense to me for a nocturnal tx. I have never had a problem- they stick tight as glue, but come off easily at take-off. And when I sleep at night, I sleep in every direction.
Yes Jane I do use tape but not tegaderm. I use transpore. I tape it in a manner that the tape should never come off and it has worked all these years. But I will need to find a better way. The problem with my fistula is the needles are always in at a huge angle, almost vertical for the arterial. Will tegaderms work in that case?
Just got the results of a blood test I got done this morning to see the extent of damage caused. My haemoglobin has fallen from 11.8 last time to 10.6. So, I must have lost quite a lot of blood.
Kamal, would there possibly be any point to revising your fistula so it is closer to the surface and the arterial needle doesn’t have to be at such a steep angle?
Okay, adding on to this post. I’m REALLY sorry you went through this, Kamal. It had to be terrifying for you. We do strongly urge folks to use a bedwetting alarm under the access AND under the dialzyer (another place leaks can occur). Now that you’ve had a needle dislodge, you might find that you feel more secure with an alarm.
I’m also wondering how long your arterial needle is. Would a shorter needle allow you to come in at a more acute angle that would be easier to tape? It might seem like a shorter needle would pull out more easily, but you can’t tape the needle part anyway–only the hub and tubing outside of your fistula. So, if you can level the needle out by using a shorter one, it might allow for more secure taping, and less apprehension for you.
Wow, it’s hard to picture the needle standing up in almost a vertical position. In a case like that, a Tegaderm probably wouldn’t work. I use gauze pillows to prop my needles up a little bit, but that’s all, and the Tegaderm holds it securely in place. I can only tell you if you can surgically or otherwise get the angle more level, to try Tegaderms and you will see how much more secure they are then tape. Glad you are ok : )
Actually I didn’t even know that the needles came in a shorter version! I use a 1" x 16 gauge for both arterial and venous. I have no idea about the shorter one and if it might help. Worth trying, I think.
About the fistula, Dori, the vascular surgeon had a tough time creating the fistula itself. There was a block somewhere and they had to do it in a different way. They do not want to touch it now because I am losing out on options for locations. So I dont think that is an option right now.
I had a good session today and i am hoping more secure taping and an alarm will help ensure this does not repeat.
Is the bedwetting alarm available easily in the US? Where can I ask someone to go buy it? How much does it cost?
On May 18, 2010 - the FDA cleared this BLOOD LEAK ALARM / DETECTOR device for HOME USE. It senses blood leakage at the fistula or needle site to immediately detect needle dislodgement at the first drop of blood. Now Home/Self Use Hemodialysis patients, who may not have a caregiver on stand-by, can rest at ease, and no longer fear significant blood loss overnight. Details at www.bloodleakalarm.com.
Not sure if RedSense is available in India yet. Luckily, with the Internet, many things are possible! Not sure what the electrical situation is where you are, but here is a site that compares bedwetting (enuresis) alarms and links to many types: http://bedwettingstore.com/Buyers_Guides/buyers_guide_alarms.htm.
Medisystems, I believe, makes 3/5" needles, which can be useful if you need a shorter than 1". Something to check into, anyway, especially if the surgeon is reluctant to alter your fistula.
Actually I have a friend who is coming to India from the US next week. Where can I ask her to buy this? Will this be available in Walgreens or Walmart? And which brand do folks on nocturnal generally use?