chapter 4

Once her condition had stabilised, Jane was allowed to go home. She left with the line still in her neck in case they needed it in a hurry, as she had no other vascular access.
One of the reasons she was sent home was to think about what she wanted to do in the future. She could go on the transplant list, but she would need to dialyse until a suitable cadaver donor could be found.
A specialist nurse sat down with her to discuss her treatment options in more depth. She could:
1. Go onto hospital haemodialysis, which could be for approximately 4 hours three times a week. If she was going to do that, she would need to have surgery to have an arterio-venous fistula made in her arm. She could have a permanent line put in near her clavicle bone, but it was not the most ideal solution as they were prone to infection, although the flow was typically better than the temporary line she had in presently.
2. Try peritoneal dialysis. She would have to go to theatre to have a special line put in her abdomen and she would train how to do the procedure herself, at home. She could do four ‘exchanges’ a day, every day, or she could hook herself up to a machine every night and have the machine do all the work while she slept and then disconnect herself in the morning.
3. She could opt not to dialyse at all. Doing so would lead to her eventual death. The doctors would do everything they could to make her life as long and as comfortable as they could, but it was unlikely she would survive longer than a few weeks. Six months at the most.

Jane knew she did not want to take the third option. She was still young. There was still things she wanted to do in her life, places to go, things to see. If she chose the second option, she would have to give up swimming altogether. If the chose the first option with a line, she would not be able to swim. If she chose the first option with a fistula, she would be able to swim, but she would have to be very, very careful. Then again, she would not be able to swim every day, because with waiting times and travelling times added on to her time on the machine, her day would be greatly reduced and she would probably be too tired to swim anyway.
On the other hand, if she chose the second option, she would be in more control. She would have fewer dietary and fluid restrictions, because she was dialysing every day.
The more she talked to her nurse, she realised that the second option would be the most suitable for her.