Every day I have my dialysis treatment, a routine is followed. First, I have to get up, leave the house, walk to the station, purchase a ticket, board the train, get out at the terminus, and walk up to the dialysis clinic. Occasionally, I’ll stop for a mug of tea in a coffee shop along the way. Yesterday that was the routine that was followed.

The second routine stage is what happens when I get to the clinic. I ensure I have a face mask on, walk into reception, sign the register, take my temperature, and enter the self-care room. In the room, I put the bloodlines and the dialyser on the dialysis machine. After which I go to the main unit to weigh myself, and on my return to the self-care room, the device has gone through its first preparation stage, and it is now time to prime the machine, which involves putting attaching the lines to the ports where dialysate or waste is given or removed.

Red to blue, blue to red.
Photo Michæl McFarland Campbell 2022.

It was at this second stage that the usual routine was not followed. I was not feeling well, so one of the staff members offered to “prime” the machine, which she did. Unfortunately, she put red onto the blue and blue onto the red on the dialyser. No one noticed this error until the end of dialysis when I was about to put the blue line back onto its port — and then realised that the blue was on the red end of the dialyser. Ah well, I drained the machine and cleared it all in one go. At least this time, it was not my fault.

At the beginning of my dialysis, once I had connected the bloodlines to the needles in my arm, I heard a hissing sound coming from the machine. This worried me as I had never heard such a noise before. I called for assistance from the nurses, and one arrived. They spotted the problem nearly instantly; the arterial blood line and the arterial needle were not fully connected or tightly coupled. They tightened it, and then the machine complained about “microbubbles in the bloodline” for the next half hour. Eventually, this stopped. Disaster averted.

But then, the next problem started. I had difficulty with breathing. Fortunately, two nurses were doing some checks, and they went and sorted out giving me extra oxygen. This happened just as my breakfast arrived, so it was cold by the time I got my tea and toast. But better that I could eat it than have too little oxygen and be unable to breathe.

With the SPO2 monitor connected to my hand, it became apparent that my level was about 88%. That’s not a reasonable level at any time. In time, it picked up and was eventually back to 99%. No one could work out why there was a problem with my breathing.

Dialysis finished, and the third stage of my routine was followed. Basically, the reverse of the first: walk to the station, board the train, get out at my station, walk home, and sit down in the house. Later in the afternoon, I shared a photo of the dialyser with the lines on the wrong way round with a couple of friends. It was then that I remembered that when I had a central line in my chest, the lines always needed to be “reversed”—red to blue and blue to red—otherwise, I could not breathe. I wondered if the simple reversal of the lines on the dialyser had caused my breathing difficulties. I’ll not be repeating it tomorrow just to find out.

Tomorrow, let us hope that the routines are followed more efficiently and accurately.