A Perfect Storm

This evening I got so caught up with writing that I missed my hook-up time. I should have started dialysis at 8, but didn't even begin the set-up process until after 9.

Timing is crucial, as the dialysis solution should not dwell in my peritoneal cavity for more than eight hours. During the nighttime therapy, I pass through five cycles, each dwell time of a little more than an hour. After eight hours of dwell time--which can be easily reached between the mid-day and the night hook-up--the solution and all the toxins it contains are absorbed into the body, thereby defeating the whole purpose.

Once I realized how late it was, I started to scramble. I went to the kitchen and took my blood sugar. It was a dangerously low 60. In the confused mental state that accompanies low blood sugar, I thought I shouldn't have anything to eat or any juice to drink because I would be hooking up soon, and the dialysis solution has dextrose in it. Definitely not thinking clearly.

I took my blood pressure, as this is a crucial factor in determining what strength of dialysis solution to use. Yellow, which is the weakest solution, for low blood pressure, a loss of five or more pounds in a 24-hour period and/or a dehydrated state. Green is for blood pressure around 120/80 and stable weight. Red is for fluid overload with blood pressure around 150/100 and a weight gain of five or more pounds in a 24-hour period. My BP was 170/84, but my weight gain over the day had been less than five pounds, so I decided on two green bags.

I returned to the bedroom to pull the correct quantities of solution from the boxes under my bed. In my low-blood-sugar daze, I was sloppy with the aseptic technique I am to use to prevent infection. I didn't wash my hands before connecting the drain and the tubing. When connecting the bags, I neglected to wear a surgical mask.

Then the alarm sounded, and I had to call a technical rep. He walked me through correcting the tubing problem. By this time, my jaw was going slack. My blood sugar must have dropped further. I finally got some juice to raise my glucose level and so my consciousness, a part of me still deliberating which was more important--hooking up as soon as possible or correcting my dipping blood sugar.

I am very fortunate that a part of me demanded that I get some juice. I was in the midst of a perfect storm--low blood sugar, past my hook-up time, sloppy technique due to muddled thinking, technical problems with the dialysis machine. Any one of those factors is problematic, but all four might have ended in disaster. But as it is, I am hooked up, and my blood sugar is now a perfect 129. I passed through the storm once again.