About six weeks after I started dialysis, my veins started “popping” or becoming visible just under my skin. It started with my forearms. One night I woke up to find my left arm asleep; when I looked at it, a vein was zigzagging its way from my wrist to the elbow and all the way back to the wrist (at least it looked that way). This started a complete and total fascination with my blood vessels – veins in particular – that continues to this day.
Veins are actually very weak muscles that transport oxygen-depleted blood back to the heart. They vary in size, thickness, length, angle of vector or curve, elasticity, and in far too many other ways to mention here – and that’s just taken from the few veins that are visible. At a couple of places (wrist, crook of elbow, neck) you can actually see movement of the vein as blood is pumped . My calves have really intricate vein layouts, and they look to be completely different on each leg.
When my fistula was built in my left arm, I was completely freaked out by the entire idea. A fistula is the result of a grafting procedure in which a vein in the patient’s arm is grafted to an artery, increasing the blood flow in a specific area to make the dialysis procedure faster and more effective. It’s quite visible on the arm, in my case as a intricate vein/artery structure on the upper inside of the lower arm and a huge artery/vein that runs along the top outside of my left bicep. Fistulas look different on some people; some are relatively unobtrusive; some appear as odd bulges; some look really bad. Dr. Nakki, the person who performed the surgery, says that this is mainly because people keep using the same spot on the arm vein to insert the two needles that are inserted at the beginning of each dialysis; this causes keloids, scarring and sometimes infection. Knock wood, I think Dr. Nakki did an excellent job on my fistula. It’s my understanding that a well-tended fistula can last for decades; here’s to mine doing just that.
At first I was alternately fascinated and horrified by this half-natural, half-manmade grouping of veins and arteries. The blood flow is extremely strong; it feels like one of those “joy buzzers” if you touch it in the right spot. And just like the rest of the body, the fistula veins don’t all become visible at the same time; it’s a gradual process that takes month to complete as the fistula matures. So every once in a while, I would look down on my arm and say “holy crap what is that?” Now things have calmed down down there, and so have I. I’m as used to this thing as I’m going to get, I guess.
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