Fistula

Yesterday I travelled to Oxfordshire to the town of Banbury. The purpose of the journey was to undergo an operation on my arm to create a Fistula. The first stage of a process which will lead to Dialysis.

The past couple of weeks have been challenging as I have come to terms with the magnitude of this change. It’s been a bit like the long run up to a big rollercoaster- a slow climb with to the crest of the ride. On a rollercoaster you have the anticipation and excitement of what is to come, as well as a nervousness about what is about to happen.

Take away the excitement and you have my feelings of the two weeks. This has lead to many sleepless nights and the odd panic attack. My faith has helped me but it has been difficult not to dwell on the negative in the early hours of the morning.

These thoughts have often focused on constraint- both in the actual operation and looking forward to the dialysis process to come, which will involve thrice weekly dialysis for four hours each time. Initially this will take place in Oxford – a further two hours to be added to the process. The potential impact on work and subsequent income.

Last week was half term and a week off work. This gave me much needed rest (especially post-Covid) but also plenty of thinking time. I made a decision to speak to my Renal nurse. On Monday I met for a pre-op assessment and used the time to talk through my feelings. I left the meeting a good deal more reassured on many fronts. In the short term I arranged to have the fistula operation under General Anaesthetic, rather than simply having Local Anaesthetic.

I awoke on Tuesday morning and was driven to the Foscote Hospital in Banbury. The operation was to be carried out in this Private Hospital but hired by the NHS.

I arrived at 8am and was admitted to my room. Private hospitals certainly give you an upgraded service (not that I was paying!) My en-suite room resembled a hotel room

I was shown to my room by two orderlies who carried out basic tests (temperature, blood pressure and lateral flow covid test). I was provided with an overall and disposable underwear.

It had been originally suggested that the operation would take place in the morning, but because I had changed to a General Anaesthetic I was pushed back to the end of the day. So lots of waiting.

After half an hour a nurse came to get me to fill in some more forms, but it was many hours before I saw anyone else. I settled down to watch TV.

It wasn’t until 12 noon I met my surgeon who talked me through the operation to come and marked up my wrist. The fistula is made by joining a vein in the wrist to an artery in the wrist. The purpose is to grow a blood vessel which will be strong enough and robust enough to allow for regular dialysis. The will take about eight weeks from the operation.

I was informed that the operation would take place at 2pm. Two more hours of waiting! During this time I met with the Anaesthetist answered a tranche of new questions and lots of repeat questions. I had an ECG to check my heart.

At 2pm I walked down to the theatre. Here I was given a cannulae and a face mask. The mask was pumping pure oxygen so that I was removing the nitrogen (78% of Air) in my lungs to maximise the effects of the anaesthetic.

As I breathed in the Anaesthetist asked me to imagine sitting on the beach in The Maldives, watching the sun set. I remade thinking that lovely as this was I had seen on the news how The Maldives would soon be under water due to Global Warming. The anaesthetic did not seem to be worki……………………..

……………….. The nurse was speaking to me – asking how I was. I was back in my room. I looked at my wrist and saw that the operation had been done.Image of Scar

It was 4pm. Two hours has passed in an instant. The sky was darkening and they brought me food and drink – my first meal of the day. I tucked into my sandwiches and yoghurt and enjoyed some fruit juice and a lemon & ginger tea.

I needed to be observed for two hours or so before I could look leave. I phoned my wife and arranged for pick up at 6:40pm.

I have taken today off work to recover and to allow the anaesthetic to recede. Ordeal over and it’s been fine.

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