On Tuesday, dialysis ended normally. Around 10:30 in the morning however, I felt pain in the venous puncture site. There was a slight swelling around the puncture site. I was wearing a formal shirt which had full sleeves and the cloth kept touching my puncture site and made the discomfort worse. One more reason for me to hate formal clothes at work!
By afternoon, I developed a slight fever as well and I decided to go back home. I called Dr. P. C. Gupta, the vascular surgeon who made my fistula back in 2005 and who is a wizard when it comes to matters of the vascular system in the human body and asked to see him right away. This had to be treated quickly. Luckily I was asked to come over immediately.
Dr. Gupta said it was infected and I would need to be put on antibiotics. Augmentin 625 mg twice daily. I thanked him and went back home and started the antibiotic. Being Tuesday, I did not have dialysis that day. The next morning the fever had gone up to 101 degrees F. I was feeling quite bad as well. I had some breakfast and took the antibiotic apart from some paracetamol. The whole day was quite bad. The fever touched 103 and wasn't coming down.
I had already skipped dialysis the previous night. So, I absolutely had to get dialysis on Wednesday night. However, dialysis cannot be started at temperatures above 100 degrees. Despite taking paracetamol, the temperature was just not falling!
I called Dr. Gupta in the evening and he advised to add Cifran 250 mg twice daily and also send the puss for a culture. Within two hours of taking the Cifran, the temperature started reducing. By about 10:30 in the night, the temperature was at 99.8 and we started dialysis.
The next morning, I felt even better. Though there was a lot of weakness (I was taking two very strong antibiotics at the same time!) and a horrible taste in my mouth, at least the fever had become normal and the infection was healing.
As I was leaving Dr. Gupta's room on Tuesday, he remarked that the repeated infection could be due to the buttonhole technique I was using. It was true that the buttonhole method was prone to more infections than the regular cannulation techniques. He added however that it was a small price to pay for the convenience and the long life of my fistula. That quite settled things!