Post surgery

I was totally knocked out after having my dinner upon reaching home. Had a good 7 hours sleep.

Yesterday my surgery was much longer than others (they only need 1-1.5 hours) because my AV fistula vein inside is so small that after putting 6 balloons in it, it burst like a fountain and I can feel the blood spurting and making my whole arm wet. Plus the surgical team went into a really busy panic like mode trying to stem the bleeding.

Sorry, I did laughed on the surgical table under the covering, thinking how comical the whole scene was... coz this is not the first time my other surgeons found out how easily I bled. I have been informed by different surgeons I always lost a lot of blood in my past surgeries due to how different my body seems to be from the norm. Other normal people's veins are usually with main vessels & a few slight branch out. But mine is full of branching tiny veins that any slight mis-step, it can just ruptured and leaked into the surrounding tiny veins too.

I can hear the surgeon yelling 'Oh shit!' as he called out for his more senior consultant to come over. He immediately said he has lost access and then I can feel him pulling out the wires or ballooning devices while the rest of the operating trying to clean up the messy blood everywhere.
Then they studied the veins map on the ultra scan to decide on another alternate route, finally settle for another tunneling through the fats & branching veins to reach a more suitable vein to use. That also mean more pain as the other vein has never been enlarged before.

So enduring through the seething pain as they re-tunneled... I just clenched the side of the bed plastic padding with my left hand in beats while singing Christian songs in my mind. Yes, I always sing in all my surgeries till I lost consciousness from the sedation.

I awake to the ever more seething pain again and the surgeon immediately injected more anesthesia into my arm as the surgery proceed longer than expected. I just continued to clench the bed padding and divert my attention away from my arm with more singing in my mind. Each time the pain intensified, I tell myself this is necessary for my survival so must endure!!!

After the surgery was finally done and the surgeon mentioned before leaving... he initially thought my AV fistula should have matured 70-80% after 2 years and he thought I'm back due to slight blockage. But it was NEVER even maturing at all! I then joked I am a pre-matured baby mah, so everything not matured. The surgeon laughed and said not like that lah!

I then told them I did exercise with a hand ball as told, but till the ball had turned into a pulp and I gotten triggered fingers symptoms for really exercising to my max, I also cannot feel the AV fistula vein maturing. I cheekily joked should I try lifting weight next time to build up the vein? Then I lift my surgery arm in jest.

The surgical team burst out laughing. We all know the AV fistula arm is not allowed to carry more than 1kg stuff to prevent rupture. The nurses were also amazed that usually other patients will be screaming or crying out in pain with their maturing veins. Yet I didn't make a single sound with them tunneling my NEVER matured vein and other new vein which will be even more painful. They asked me if I felt any pain?

Well, I told them I was trained by my Dad to endure pain without making sounds. And I admitted it was damn painful till I felt like toothache like pain hitting again and again against the top inside of my brain as they ballooned but I choose to just clench the bed padding. They were amazed but also told me I can tell them if very painful. Nah, it's okay as it was over in the end. The surgeon said I did a good job too!

I think due to growing up watching my Dad who don't show his fears or tears, I also learn not to cry at personal physical pains in front of people. That seems weak. I think my Dad has inspired the G.I. Jane in me. Lolol...

Beside, with so much surgeries in the past 12 years for survival, I will be an emotional wreck if I always cry, right? LIFE got to go on... well, adding another battle scar to my survival list again. Just gotten rest well in these 2 weeks, let my NKF nurses removed the stitches in a few days time and try to exercise the arm again.

Then the NKF will decide when to start the new buttonhole cannulation, a more expensive method using less sharper needles to make 2 open wounds tunnels for permanent usage. This method is suitable for tiny veins patient like me but the initial tunneling will be more painful than other normal patients due to creating the tunnels. I also have to be even more careful with skin care due to the open wounds as it can get infected easily.

But once the tunnels are formed (after 12 successful trials), then it will be less painful to poke through for arm dialysis. I might be able to poke it myself one day! And yes, I am also the only patient in my current centre to do buttonhole cannulation and only 2 nurses are trained in that to do for me. So it will be good if I eventually get a hang of it.

Very grateful to my SGH teams... they really took very good care of me to survive so far.