Blood burst through my bandages and onto my dialysis chairs' white bedding sheet that I occasionally use during treatments. As I squeamishly avoided sight of this infrequent occurrence, my vigilant son (in his dad's spot for the day) remained near me unafraid, unmoved, unflustered by what he saw.

I was impressed by and admired his apparent fearlessness, his obvious manliness. Since he's been home on summer break he's shown signs of hard earned maturity, signs of astounding growth. Instantly, this day, my boy is no more. He has undoubtedly become a man.

More independent and knowledgeable in the dialysis process, I immediately removed the coagulated blood resting on my sheet at the nearby sink - aggressively and thoroughly rinsing it with cold soapy water. Still demonstrating what I do/why I do things with my son (or my daughter), the physics major knew of this necessity already. "Yes mom, I know", he responded respectfully, as he stood, six feet nearly two inches - gathering the rest of his mother's dialysis belongings on our way towards the exit.

Since he's been home, he's reminded me that he does not need babying, he's an eighteen year old man now. Innocently perplexed, maternally baffled by "where did all the time go", I attempted to reason with him, "you're my firstborn. You'll always be my baby", he grunts, I continue, pleading "just give mommy more time to adjust". No more patience, "mom, you already had eighteen years to prepare".

This day of the "bursting blood", I was remarkably calmer. My pleasantly attentive technician knows I can't stand the sight of blood, so she does her best to clean it right away. Typically, my husband is there with me.

I could feel something oozing down my arm, this is how I knew to look down, other than feeling its warm sensation, there is no extra pain during this gross event.

It's so common, but rare, other dialysis patients nearby just continue to do whatever they were doing, unfazed. Either it has happened to them, or it is going to happen eventually.

When I was becoming aware of what was going on around me at dialysis, I was horrified by the sight of the AV fistulas (research). During the beginning of my disease, a chronic dialysis catheter - CDC (research) was inserted into my chest. This is a temporary assess due to high risk of infection --which I was later hospitalized (for several more weeks) again for - catheter infection.

It takes a while for the AV fistulas to be surgically inserted and several more weeks for them to become functional. They have to "mature", and to help this process along, it is recommended that patients squeeze on a small stress ball several times per day. Slowly, patient will be weened from catheter to fistula starting with smaller needles on to much larger ones. Cannulation (Research this)

Suddenly coming out of my medically induced stupor, and the aftermath of a stroke (frontal lobe), I began to notice where I was (even though I had been transported from the Urgent Care facility I was hospitalized in via ambulance/gurney three times per week, for three hours each time), someplace foreign. Before my kidneys completely failed (was functioning at 5% by the time I became fully aware and had to be rushed to ER from a scheduled eye doctor appointment {blood pressure  230's/100's} - *I plan to blog more about how everything started later) room, I had no idea what dialysis was. Never even heard of it. And certainly wasn't prepared for it.

So when I'd go to get my treatments, I'd notice lots of elderly people around me, similar to my medical appointments. I noticed other patients and their visitors noticing me (I guess since I was considered so young and new). Along with minimal to slow consciousness of everything else around me, eventually, far far down the line, I became aware of other patients fistulas - and this awareness nearly caused me to have a public nervous breakdown/panic attack (well, actually I think I did) there in the unit. Began sobbing uncontrollably, as I observed the humongous needles inserted into the arm, two of them each visit. AV fistula cannulation - needle in artery, needle in vein (research process).

Seeing the huge, hideous lumps or knots permanently developing on some of the patients arms. Seeing large quantities of blood bursting from the bandages - soiling chair, clothing and onto the light colored floor. Watching the techs work to stop the blood by re-bandaging the area and using a clamp device to hold it until the pulsating from the fistula calms. *Research for more accurate information on why this oftentimes happens. Seeing the patient sit there calmly with all this blood squirting from their arm was terrifying to me. I'd ask the nurses, the technicians, "is THAT going to happen to me?"

Most avoided the question as I quickly saw. After getting my temporary catheter removed and the AV fistula surgically inserted, I became aware of my fate. Regardless of my countless fears (before this disease, I had a very high pain tolerance) and positive thinking for a miraculous healing, if I wanted to live, this was going to have to be my reality ~ regardless of any belief or my  personality.

The AV fistula is permanent. Even after I get a kidney, it needs to remain on/in my arm just in case the kidney fails. *Ironically, I have a half sister (paternal) with the same disease. Her mother donated her kidney. She still has her fistula.

For daily maintenance: I can never ever sleep or carry things in or lift anything heavy with the fistula arm. Never ever wear jewelry or anything tight on fistula arm. Never ever get blood pressure or blood drawn from fistula arm. Never ever anything tight or restrictive on fistula arm. Never ever compete in contact sports due to the risk of injury. Life changes in so many unfortunate ways with this disease.

There is always a pulsating sensation coming from area in the fistula arm, which is called the "thrill". The best I can describe it, it's like a throbbing heartbeat - which will remain in my arm forever.

I've had my fistula now for a little over a year. Already there is the huge disfiguring knot and permanent scaring formed from the needles being reinserted three days a week - which will also remain a part of me for life, even after I get a kidney donation. *I "think", I hope at some point lumps/knots can be surgically removed if they get too grotesque or too cumbersome.

I don't look at my arm anymore, especially not when the needles are being inserted (I notice some patients do watch the entire ordeal). I just remind myself, while taking myself tranquil and beautiful in my head, I have to bravely endure this, do whatever is necessary to keep myself mentally/physically healthy; follow the renal diet (research), avoid drinking too much liquid, get plenty of rest when needed (have no energy without proper kidney function), continuously & consciously surround myself with quality people, places and things. Importantly keep a genuinely positive attitude for not only my sake - because honestly, if were only "me", I'd chosen death long time ago, but mainly for the love and devotion to my husband and kids. For if it not for them, there would be no Sage.