"My Haemodialysis journey"

I started PD at home in Jan/2022 with the support of Dr Gorry, Joan and her team at Queen Elizabeth Hospital Glasgow.

All went well until June/2022 when I developed peritonitis. I was admitted to Queen Elizabeth Hospital to have strong antibiotics and be kept under observation. Unfortunately, due to the nature of the peritonitis this was the end of my PD journey. Any future dialysis would have to be via haemodialysis.

Initially my haemodialysis was administered through a central line in my neck but during my stay in hospital, I had a fistula created in my left arm. This would be used for haemodialysis going forward.

It was a very nervous and challenging time for both myself and my wife, mainly because we had lost control over doing dialysis at home by ourselves. We were now fully dependent on trips to and from hospital and on nursing staff to carry out my dialysis.

In September/2022 I began attending Glasgow Victoria Hospital’s evening sessions for haemodialysis. My fistula needed to heal and develop more so haemodialysis was initially administered through the central line in my neck. These early days of attending the Victoria Hospital were very challenging and depressing as I found it very hard to adapt to the haemodialysis process and procedures and this new routine that my life had become. In some ways I fought against it.

At the start of Jan/2023 I was offered the chance to train for home haemodialysis and was transferred to Stobhill Hospital.

I am not going to hide the fact that I was somewhat concerned about doing this as there seemed to be so much involved and it was very daunting. I questioned whether we would have the ability/skill to mirror the actions of the nursing staff when it came to setting up the machine, canulating needles, connecting, disconnecting and understanding how the machine worked and what the many warning messages meant.

All of the above was alien to us both and with that came a level of stress, anxiety and fear that we would make mistakes and not know how to handle them in the same way that a professional renal nurse with experience would.

Over the first few weeks I learned to line and prime the dialysis machine. I gained an understanding of the main components of the machine, what their functions were and best practices to setting it up. This all took time and yes, I made mistakes, but the support and patience given to me by the nursing team was excellent and focused. Over the next few weeks, I made steady progress and gained confidence in setting the machine up.

The next milestone in my training was to self-canulate my dialysis needles into my new fistula. It is one thing watching skilled professionals do this, who have bags of experience. Now it was my turn. With my heart rate up and stress levels through the roof I pierced my skin and placed the needles into my fistula, always being guided and watched over by the nursing staff. My confidence in self-canulation grew each time I performed this procedure.

Then the inevitable happened, the dreaded case of me not placing the needles correctly into the fistula. I had somehow damaged my fistula requiring us to do single line dialysis. My confidence took a dent that day knowing that I had damaged what is my lifeline. Anne-Marie helped me understand what went wrong, and also helped resolve the issue, giving me continued support and reassurance that I was doing okay and that this was just a blip. For a short time, I dreaded canulation in case I had a repeat episode, but all the nursing staff kept a keen eye on what I was doing and this gave me back my confidence.

During March and April my wife became more involved in the process. Dalene and her team spent considerable time showing her how to setup and connect me to the dialysis machine to commence the process. It's fair to say this was a daunting process and she did inevitably make mistakes. Once again, the nursing team were on hand to give her all the support and guidance she needed. I could see she was becoming more confident over time.

Lastly, the nursing staff trained my wife on disconnecting me from the machine and removing my needles. They also spent considerable time showing both of us how to deal with unexpected situations arising during treatment and how to understand and resolve these and any warning messages displayed on the machine.

What boosted my confidence with the dialysis process was down to a time when another patient on our ward took unwell whilst we were all on dialysis. I watched Dr McManus and the nursing team come together as a very effective team who were able to quickly understand the patient's issues and provide clear concise instructions, actions and a clinical solution which addressed and fixed the issue. To see them working as a team in what was a difficult emergency situation was very impressive and this gave me a lot of confidence, confirming that I was definitely in the right hands here.

I would also like to mention that the staff are all very friendly and understand that the softer skills of the job are also very important. They have these skills in abundance, and it does make life so much easier on the dialysis ward.

I would like to thank Dr McManus for giving me this opportunity to do home haemodialysis training. A special thanks to Dalene, Anne Marie and all the nursing staff for helping to get us home again.

Never in my wildest dreams did I think I would be writing this feedback whilst doing dialysis from a converted bedroom in my house. I am home now and have more control back in my life. The nursing staff should all be very proud of their achievements.