Day 11:

Today I was back on the dialysis unit, and it was all about learning more about the process. The doctors usually do this procedure where they join a vein and an artery in order to make dialysis easier. Apparently veins don’t have enough pressure to support dialysis, so by joining the vein and artery, there’s much more pressure. It also forms this little bump (usually on the wrist or near the elbow) called a fistula that’s almost buzzing with such a strong pulse. Because it takes about a month for this fistula to fully form, sometimes the doctors also have to insert a catheter into the patient’s neck while they wait for the fistula to mature. They were doing this procedure right as I arrived, so I got to watch.

It’s interesting because in the US, placing a catheter would probably be an out patient surgery, complete with operating rooms and lots of formality. But here at the hospital, they did the procedure right on the unit with just local anesthetic, and I just watched as I pleased. It’s also interesting because the doctor was telling me that in the US, we have preventative screenings so we know if a patient will need dialysis, at which point we can do the fistula surgery and then usually move onto a kidney transplant. But here in India, it’s all about maintaining quality of life. There’s no preventative screenings, transplants are almost non-existent, and usually patients can’t pay anyways. That’s why catheters have to be placed, because oftentimes patients come to the hospital so much in need of dialysis that they can’t wait even four weeks for a fistula to mature.

The rest of the day I spent wandering around the unit watching the nurses and doctors work, getting a better explanation of the actual dialysis machine itself, helping with rounds, and also taking patients’ blood pressures whenever I got the chance!