Access Issues

The theme of my day at work was "Difficult Access." In order to get dialysis, each patient has to have a means of getting physically hooked up ("access") to the dialysis machine. This can take the form of either a fistula (somebody's artery and vein, usually in the arm, are surgically ligated together, and then needles are inserted into the vessel), a graft (a synthetic piece of material inserted between an artery and a vein), or a catheter (basically a large iv inserted into one of the large veins of the neck or groin). For patients who need dialysis to stay alive, having a functioning access is imperative for survival. Today, there was an endless stream of clotted fistulas, clotted grafts, and poorly functioning catheters. It's not a very intellectual problem to deal with on a day-to-day basis, but nonetheless an important one.

Enough shop talk: Here's a nice series of Sophie pictures playing with the remote control on our couch.