Day 2 was much better than Day 1. We had to use the pre-pump bloodlines because the post-pump ones were still not available. Thiagarajan had a totally different style of priming the dialyser and the bloodlines. I do not think there is anything wrong with my style however and plan not to change. Learning this new style may take a long time and especially since there is nothing wrong with what I am doing, it probably does not matter.
I was on dialysis by around 10:20 in the night.
Next, Thiagarajan explained that Blood Leak alarms and Air Bubble Detector alarms are the two most common alarms that dialysis machines give out.
Blood Leak alarms occur when blood leaks out of the fibres within the dialyser into the adjoining compartment for the dialysate. Should this happen, you need to change the dialyser. I was told orally how to change the dialyser.
Air in the blood can be very dangerous. Even a small amount of air in blood can be fatal. The design of dialysis machines and procedures makes sure that the chance of air entering into the blood stream is close to zero. Should air enter into the blood stream despite this, machines are designed to detect this at the point where blood returns to the body through the venous line and clamp the line to prevent the air from going into the body. I was taught orally how to handle situations where air enters the blood lines.
I was quite sleepy by then! We decided we would simulate these two situations the next morning and practise how to handle them.
The night was uneventful apart from a couple of small alarms that required a simple press of the reset button. I had a reasonably good sleep without any sedative.
In the morning, around 5:00, the machine alarmed to signal that dialysis had completed. I returned the blood back through the venous line and disconnected the bloodlines and removed the needles. I did everything pretty much myself including removing both the needles and tying the tourniquets using the trick Thiagarajan had taught me the previous day.
Then I had to practice the handling of the Blood Leak alarm and the Air Bubble Detector alarm. This was a little tough as it was the first time and my left upper arm was sore from the needles that had just been removed after a gruelling seven hours of hard work!
We first did the Air Bubble Detector alarm which meant that air had entered the blood lines. This involved disconnecting the bloodlines from the needles, going into recirculation mode and then ensuring that the air is removed by forcing all the air out by aspirating it from the chambers and hitting the dialyser to force it out from within. Piece of cake? Not exactly! But then, Chennai wasn't built in a day!
Then I practised handling the Blood Leak alarm which involved changing the dialyser. This was an equally dangerous problem albeit with an easier solution. You basically clamped the lines going into the dialyser and then took a new dialyser, primed it with saline and then replaced the old, defective one.
We quickly did this and then did one more round of air bubble handling just for kicks. Practice, they say, makes a man perfect. Whoever coined that probably had home hemo training in mind!
I was done for the day by then. With a promise to meet at five this evening, we wound up Day 2.
I did my swimming soon after, followed by a sumptuous breakfast at Murugan Idli Shop. Gosh, that place can be addictive! I take it as a reward for the hard work I am putting in through the night!