chapter 7

Jane managed to get herself into a bit of a routine when she was on haemodialysis. However, she could not say she was living her life, she was existing. She was either tired and full of fluid because she needed dialysis, or she was tired because she’d been dialysed and been up so early.
Her weight had stabilised after she’d come off peritoneal dialysis. She now hovered around the eighteen stone mark. It was heavier than she would have liked, but there was not much she could do about it.
She’d started on EPO, an injectable kind of a hormone called erythropoietin soon after starting on haemo. The hormone would help her become less anaemic and hopefully give her a bit more energy. Sometimes she needed an iron infusion to give her iron stores a boost as well.
She was on a whole host of medications - antihypertensives for her blood pressure, vitamin D, a blood thinner, phosphate binders and calcium supplements, water tablets, something to prevent indigestion, laxatives. She was now on a 1 litre fluid restriction in 24 hours - that included all her drinks, sauces and gravy. The poor diet and lack of fluid made her quite constipated.

She was sure that other people thought she was just being lazy when she complained of feeling tired all the time. The poisons that we’re not removed by dialysis gave her skin a ‘uraemic’ colour. Some would say she had a ‘muddy complexion’, others would say she looked like she’d just come back from a relaxing holiday on the beach in Spain.
It was not like she had a visible illness. She could still walk, she could still speak. She could actually still do most everyday chores, except, it may take her a bit longer to complete.
There was one shining pinprick of light in her future. That was the chance of having a transplant. If she got a new kidney, her life would be completely free of dialysis. She looked forward to getting away from the humdrum routine that had been imposed upon her. She was sick of the grumbling of the other patients, sick of arguments about transport, sick of her food tasting bad, sick of the constant tiredness. She was sick of hearing alarms going off, sick of watching the elderly on her shift getting poorly on dialysis and having to be admitted. Some of them came back onto their shift when they recovered. Some she never saw again.
Out of the fourteen patients on her shift when she had started over six months earlier, seven had died, two had moved to other shifts. One person had been called in for transplant in that time, but had been unsuccessful. Apparently he had been a back up for the first choice.

Then one night she got a call From the transplant coordinator at two o’clock in the morning. A kidney had become available. On paper it looked like it might be suitable for her. They needed her to come into hospital now, so that they could do the appropriate tests.
Jane was all a frazzle. This could be it! Her life might change tomorrow! Her husband drove her to the hospital. They were both as nervous as each other.
When she got there, she was shown into the day room, out of the way of the other patients on the ward. She was given an information booklet, but she was so nervous she could not concentrate to read it. A nurse gave her a brief rundown of what to expect. They were going to prepare her as if she was going to theatre. She was going to have to undergo a series of tests. She would probably need an extra spin of dialysis as well. The important test was the cross match, which was where they tested her blood directly with a small piece of donor tissue. It could take four or five hours to complete. If the match was positive, she would not receive the kidney on this occasion, but it would not jeopardise her chances of being called in again. The waiting list was long, but there was not too and no bottom. Priority went to the person who was the most suitable on the day.
Jane hoped today was her day! She had competition though. There was another two patients who had been called in at the same time as her for two kidneys. One of them was going to be disappointed! She had her blood pressure, pulse, temperature and oxygen saturations taken. She was weighed, she was examined and questioned by the doctor and then questioned by the nurse. She had an ECG, she had a chest X-ray. Her rivals underwent the same tests and there was only one available bed on the ward. They all took turns to lie down on it for their examinations. Would any of them actually get to sleep in it?
When all the tests were completed, she went to the kidney ward, where she had come for her first ever dialysis. It had not changed much in these last few years. The curtains had changed. The staff had changed, but the layout hadn’t. The anatomy posters on the wall had not changed.
She settled into the familiar routine of dialysis. Would this be the last time she had needles like this inserted into her fistula?