March 11, 2025
Spoke with the vascular surgeon this morning about the vein mapping and fistula placement. My veins are suitable for a fistula, so I'm going ahead with getting one and doing hemodialysis permanently (at least until an eventual new kidney transplant). The fistula is basically a greatly enlarged vein created by joining a vein in an arm with an artery to increase the flow of blood through it, making it stand up in the arm and make it possible to run all the blood in the body out and back in within the four hours hemodialysis takes.
Next up is speaking with his scheduler in the next day or two to set a date for the procedure. It's an outpatient procedure, so I'll be out and home the same day. He'll also remove the useless peritoneal catheter so I won't have to keep maintaining it when it does absolutely nothing for me.
Another reason to be done with peritoneal dialysis altogether is I'm resuming immunotherapy treatments for my cancer tomorrow. I have no idea what the new drug will do as far as side effects, but if it is even a fraction as bad as the previous treatments, I won't feel well enough to do all the work peritoneal dialysis requires. I don't think any of the doctors aside from the vascular surgeon even considered that aspect of my situation. He seemed relieved when I told him I wanted to go ahead with fistula placement, like that was what he thought was the best choice all along, but didn't want to push a decision onto me (which is what happened with the nephrologists and peritoneal dialysis – they were so adamant about it that I just went with it not knowing what I was getting into). When I said it was what I wanted, he immediately started telling me how much he agrees and with everything else going on, it's the option that puts the least responsibility on me.
As I already said, I resume immunotherapy treatments tomorrow and I am not looking forward to it. In fact, the idea scares the hell out of me after what already happened. I lost my transplanted kidney, went to the emergency room and then the hospital four times in two months, had damage to my left lung that took months to heal, and permanent damage to my thyroid that caused me to lose 30 pounds in a month, and I'll have to be on thyroid medication for the rest of my life. I didn't quite grasp it as it was happening, but later on I realized those immunotherapy treatments literally almost killed me. I'm doing a totally different drug, and only one instead of a pair this time, and it has a greatly reduced chance of negative side effects on paper, but the oncologist can't promise anything. But there is no other option for treatment, so I have to go for it and hope for the best.
