I Hate Dialysis Message Board
Dialysis Discussion => Dialysis: General Discussion => Topic started by: Bajanne on September 22, 2005, 06:23:25 AM
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I had my fistula operation two days ago. The doctor told me as I was leaving not to get it wet and to 'bathe' at the sink. But he didn't say how long I should do that. Can I go under the shower or in the bath now? I will call him later today, but I would like to know what you guys did.
Next, I am living on a tropical island - that means year round and island round beaches. Do you guys on dialysis go to the beach still?
I am not due for dialysis until this heals (they said about 3 months) During this time, can I go to the beach?
thirdly, I read in a post about exercising to make the fistula bigger. Someone tell me about that, please.
Aurora ???
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I had my fistula operation two days ago. The doctor told me as I was leaving not to get it wet and to 'bathe' at the sink. But he didn't say how long I should do that. Can I go under the shower or in the bath now? I will call him later today, but I would like to know what you guys did.
Next, I am living on a tropical island - that means year round and island round beaches. Do you guys on dialysis go to the beach still?
I am not due for dialysis until this heals (they said about 3 months) During this time, can I go to the beach?
thirdly, I read in a post about exercising to make the fistula bigger. Someone tell me about that, please.
Aurora ???
I would stay out of the ocean until the stitches are out at least and if you take a shower try to keep it dry and covered. About exercising your fistula, YES the more you do it the better and bigger it will get and the techs will have a easier time sticking you. Get a soft rubber ball and squeeze it 24/7 seriously, do it while you watch TV, eat, relax, DO NOT stop exercising, squeeze hard and a lot. It will only make your entry into dialysis easier. If you do not get that fistula big the techs may/WILL infiltrate your fistula and cause problems and it will be painful. Trust me I've been there and back.
By the way welcome to the website. Please goto the "Introduce Yourself" section and tell us your story. Please make a new post/topic.
I hope I didn't scare you with my post BUT that is what this site is all about THE TRUTH! :o
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Thank you so much. I was in Office Max the other day and saw one of those goofy squeeze balls. My frined Nick bought it for me, so it is now my Nickey Nick, and I will do as you said. Should be exercising it so much even before the stitches heal?
I am only now responding because the friend's computer I am using (the operation was done in a USVI island and I live in the BVI) that I was using went on the blink after a power surge.
This site is already helping me tremendously and I thank you for it.
Aurora
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Thank you so much. I was in Office Max the other day and saw one of those goofy squeeze balls. My frined Nick bought it for me, so it is now my Nickey Nick, and I will do as you said. Should be exercising it so much even before the stitches heal?
I am only now responding because the friend's computer I am using (the operation was done in a USVI island and I live in the BVI) that I was using went on the blink after a power surge.
This site is already helping me tremendously and I thank you for it.
Aurora
Thank you! it makes me happy that this site is helping you. I wish I had a site like this when I was new to dialysis. And yes you should be exercising now just don't over do it until you feel comfortable. If you start feeling pain at the incision site then take a break. But once the incision heals then you need to squeeze that ball 24/7.
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In my opinion if your fistula is in your lower arm, use the ball. If it is in the upper arm, do either wall push-ups (where you put your hands on the wall and put your feet back a ways and do slow push-ups) or after a month or so do regular push-ups. That will strengthen your upper arm.
My AV fistula is just now 3 months old. I have had the Hickman for a month. I am scared to DEATH of using the fistula. I had them show me the needles. They showed me 17 gauge needles about 1 inch long. GOD! There is no way that I can see me using those 2 needles 3 fricking times a week. I'm going to eat valium prior to going. I don't care if it dialyzes out, I just need to get through the needle stick. I have the Hickman.... I think I will get my money's worth out of it. Isn't it good for a year? I know about the infection risk, but I don't care. When it gets infected, I'll go to the fistula.
Can you EVER shower with the Hickman? I'm sick of baths!
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In my opinion if your fistula is in your lower arm, use the ball. If it is in the upper arm, do either wall push-ups (where you put your hands on the wall and put your feet back a ways and do slow push-ups) or after a month or so do regular push-ups. That will strengthen your upper arm.
My AV fistula is just now 3 months old. I have had the Hickman for a month. I am scared to DEATH of using the fistula. I had them show me the needles. They showed me 17 gauge needles about 1 inch long. GOD! There is no way that I can see me using those 2 needles 3 fricking times a week. I'm going to eat valium prior to going. I don't care if it dialyzes out, I just need to get through the needle stick. I have the Hickman.... I think I will get my money's worth out of it. Isn't it good for a year? I know about the infection risk, but I don't care. When it gets infected, I'll go to the fistula.
Can you EVER shower with the Hickman? I'm sick of baths!
wats a hickman?
only 17g needles? i use 14g and with a developed fistular there is no feeling in insertion whatsoever
so get into that fistular s.a.p. the sooner u do the sooner it will develop and u2 wont feel a thing.
oin
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In my opinion if your fistula is in your lower arm, use the ball. If it is in the upper arm, do either wall push-ups (where you put your hands on the wall and put your feet back a ways and do slow push-ups) or after a month or so do regular push-ups. That will strengthen your upper arm.
My AV fistula is just now 3 months old. I have had the Hickman for a month. I am scared to DEATH of using the fistula. I had them show me the needles. They showed me 17 gauge needles about 1 inch long. GOD! There is no way that I can see me using those 2 needles 3 fricking times a week. I'm going to eat valium prior to going. I don't care if it dialyzes out, I just need to get through the needle stick. I have the Hickman.... I think I will get my money's worth out of it. Isn't it good for a year? I know about the infection risk, but I don't care. When it gets infected, I'll go to the fistula.
Can you EVER shower with the Hickman? I'm sick of baths!
Great advice about the upper arm fistula, all I know about is "lower" arm fistulas because when I started dialysis back in the day they ONLY did lower arm fistulas. >:(
As for how long the Hickman can last? It is all up to you and how well you keep it clean. But I have seen people have one for a year or more. I had showered with mine but I used water-proof bandages. It was like a huge patch 6" X 6". The Hickman WILL eventually get infected but of course you want it to last as long as possible to allow your fistula to mature. The bigger the fistula, the easier it will be to stick you.
About the needles, they showed you 17 gauge needles, eventually they will move you to 14 gauge which are even bigger. Not longer but the needle diameter is bigger to allow better blood flow.
I wish I COULD take a bath :'( all I can take is showers. I have not enjoyed or soaked in a bath for 5 years. :-\ oh well at least I can get in the shower and use a shower bench.
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In my opinion if your fistula is in your lower arm, use the ball. If it is in the upper arm, do either wall push-ups (where you put your hands on the wall and put your feet back a ways and do slow push-ups) or after a month or so do regular push-ups. That will strengthen your upper arm.
My AV fistula is just now 3 months old. I have had the Hickman for a month. I am scared to DEATH of using the fistula. I had them show me the needles. They showed me 17 gauge needles about 1 inch long. GOD! There is no way that I can see me using those 2 needles 3 fricking times a week. I'm going to eat valium prior to going. I don't care if it dialyzes out, I just need to get through the needle stick. I have the Hickman.... I think I will get my money's worth out of it. Isn't it good for a year? I know about the infection risk, but I don't care. When it gets infected, I'll go to the fistula.
Can you EVER shower with the Hickman? I'm sick of baths!
wats a hickman?
only 17g needles? i use 14g and with a developed fistular there is no feeling in insertion whatsoever
so get into that fistular s.a.p. the sooner u do the sooner it will develop and u2 wont feel a thing.
oin
If you use the same spot for insertion every time then yes the pain is almost non-existent but if you rotate your insertion sites then it will take longer to deaden the top layer skin. And even then once in a while you will hit a nerve ending, that is not fun. Again I will reiterate if you use the same spot for needle insertions sometimes called a "Buttonhole" technique then the pain is almost non-existent.
A "Hickman" is a temporary chest or neck access.
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Does the hole heal in 48 hours (dialysis to dialysis) or does it matter if it heals?
I get quezy just reading your responses. I'm sure I'll pass out! After 20 years of kidney problems I still hate blood draws. I'm not a good candidate for Kidney Failure. God doesn't make mistakes, but maybe he meant for my sister to get this and not me! ;D
Thanks for your encouragement.
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Does the hole heal in 48 hours (dialysis to dialysis) or does it matter if it heals?
I get quezy just reading your responses. I'm sure I'll pass out! After 20 years of kidney problems I still hate blood draws. I'm not a good candidate for Kidney Failure. God doesn't make mistakes, but maybe he meant for my sister to get this and not me! ;D
Thanks for your encouragement.
The hole should heal in that time however it won't matter if it's not totally healed if you rotate the insertion sites the previous site will have plenty of time to heal. If you use the "Buttonhole" technique:
http://www.esrdnetwork.org/docs/Buttonhole%20Brochure.pdf
Then it really won't matter because you will take off the scab and use the same spot as last dialysis session.
Sorry about making you "quezy" I just tell it like it is so you are prepared. :)
I'm not being >:D I just don't want you to be ??? or :o when you find something out.
;)
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Well I was back on the ferry to St.Thomas, US Virgin Islands. I went back to the surgeon about my non-functioning fistula. He said he will now have to do it in my upper arm. So next Tuesday, I will be in the operating room again. More money!!
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Well I was back on the ferry to St.Thomas, US Virgin Islands. I went back to the surgeon about my non-functioning fistula. He said he will now have to do it in my upper arm. So next Tuesday, I will be in the operating room again. More money!!
Damn sorry to hear that, I wish you luck in getting the upper arm working.
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That really sucks. Read that article I sent you about the difference between an AV fistula and a graft. I know fistulas are preferred, but if it doesn't work and you have crappie veins then you may want to explore the graft. Don't let them have the final say. It is your arm and your money. ??? ???
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Well, I found out that what I have is a graft, not a fistula. It is now in my upper arm. But they didn't take out the first one, so I still have those tubes on the inside in my lower arm. My nephrologist, when I told him about that, said that it isn't a problem. I really hope so.
This one seems to be working - I even heard the noise in a stethoscope.
One problem I am having though, apart from the pain, is the my hand on that side gets cold and numb. It goes and comes. Today at dialysis, a nurse wrapped it with a hot wet towel and it felt better.
Has anyone ever had a problem like this. It depends on how I rest my arm, it seems.
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Well, I found out that what I have is a graft, not a fistula. It is now in my upper arm. But they didn't take out the first one, so I still have those tubes on the inside in my lower arm. My nephrologist, when I told him about that, said that it isn't a problem. I really hope so.
This one seems to be working - I even heard the noise in a stethoscope.
One problem I am having though, apart from the pain, is the my hand on that side gets cold and numb. It goes and comes. Today at dialysis, a nurse wrapped it with a hot wet towel and it felt better.
Has anyone ever had a problem like this. It depends on how I rest my arm, it seems.
Yeah my hand gets numb too, It's from leaving your arm in one position for too long OR it could be a thing called "Steel Syndrome" but we won't even talk about that yet, because it may not even be that. Hopefully once your arm gets used to dialysis the numbness will go away, hopefully.
I had the same problem when I first started. And even to this day my hand will get numb sometimes.
As for the non-working graft in your lower arm. Hopefully it will be OK and not have to be removed. I have seen the surgery scars and they are not pretty. They don't just "SLIDE" the graft out they need to cut/dig it out. The graft becomes "one" with your skin. But don't worry I have had mine in for 11 years (it clotted 6 or 7 years ago and has never caused me any problems) It becomes a problem when the graft gets infected and if it does they may need to remove it, to prevent further problems.
I hope this post does not scare you but that's what this site is all about getting the truth.
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I appreciate the truth. I can deal with that. The doctor says that my graft will be ready for use in 2 weeks time, but since I am travelling next weekend - going to a conference in the islands of Antigua - I will not see him until the next week. He didn't want them to use it until my follow-up visit. That works for me. I really want to put off using this means of dialysis for a long time. I am so scared of the thought of being stuck twice every session. And this having to hold the spot afterward until they tape it! Not looking forward to it at all. I so prefer the catheter route. But I am aware it is not the optimum, because of the infection risk.
Tell me about Lidocaine again, please.
By the way, I was allergic to that transparent adhesive that they used as my bandages and got some skin problems. They had to change to the stretchy kind. It never ends, does it!
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I've never been stuck with those harpoons and have the utmost respect for those of you that do get it 6 times a week. Lidocaine injection would require at least 2 or more additional punctures per treatment and there is some debate as to whether it toughens the skin over time. I've also seen lidocaine injected into one place and then an entirely different place is used for cannulation. Lidocaine injection affects only the spot where it was injected so even 1/4 or 1/2" difference is the difference between relief and no-effect. Inquire about EMLA cream. It's a lidocaine cream which is applied to a wide area about 1 hour before cannulation. I think it's covered by insurance. I'm not sure if it works or not, but whether the relief is physical or psychological really doesn't matter, as long as there is relief. Some veteran techs and nurses will scoff over the need for any anesthetic relief and say that by the time they get that stuff applied, you can be on the machine. Screw that, they're not getting stuck. Demand it from your doctor if you want it. However, try to get the first few cannulations out of the way without any pain relief so that you have a baseline. I'm hoping it won't be as bad as you think it will. Do you have a lot of fat tissue over the graft or are your arms lean? There are a lot of variables. 14g needles are unnecessary as well. You can get good flows with 15 and 16. Good luck to you.
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Bajanne2000 - I'm with you. I am still on the Hickman and am dreading the fistula. I am going to use the Hickman until it does get infected. It cost $13,000 and I'm going to get every penny out of it. I just cannot imagine getting stabbed twice three times a week. I hate blood draws once every 6 months! Can't they come up with something better? ??? ???
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I can't even use your argument - my Hickman was free! None of the other patients complain about the sticking. I am hoping that it is something you get accustomed to. I am not at all looking forward to November 7. I think you guys will hear my scream!
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I appreciate the truth. I can deal with that. The doctor says that my graft will be ready for use in 2 weeks time, but since I am travelling next weekend - going to a conference in the islands of Antigua - I will not see him until the next week. He didn't want them to use it until my follow-up visit. That works for me. I really want to put off using this means of dialysis for a long time. I am so scared of the thought of being stuck twice every session. And this having to hold the spot afterward until they tape it! Not looking forward to it at all. I so prefer the catheter route. But I am aware it is not the optimum, because of the infection risk.
Tell me about Lidocaine again, please.
By the way, I was allergic to that transparent adhesive that they used as my bandages and got some skin problems. They had to change to the stretchy kind. It never ends, does it!
Ask them to use "Paper tape" to hold your gauge. I can't stand that transparent tape, it rips my hairs out. It actually hurts when it's pulled off. It's a good tape if your hairless and have leather for skin, plus it tears into pieces really well. I only let them us "Paper Tape" it's not as sticky so it comes off easily and causes no irritation to my skin.
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You are so right! They can't use the transparent tape with me. I got some bad skin problems with it. They were using it with my catheter as well as the graft. It itched me badly and when they took it off, in some places my skin came off (little spots). They said I was allergic to it, so they use a stretchy white bandage with tiny holes now and that is better. I will insist on the paper tape.
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I'm using my arm for one needle and the line in my chest for the other access.
I'm scared to move my arm! By the end of 3 hours my fingers are cold and stiff! :( They told me NOT to move my arm! I think LifeOnHold said she use to knit! One of our posts said the needle fell out and blood squirted everywhere.
How much can I move my arm?? ???
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I have two lines in my neck, last Thursday one of them clotted off. So now I have no choice but to use one needle and one line. I lost the bottom 6+inches of the fistula when I got too dry. the nurses can only get one needle in now. One nurse does try to get two in( Rachel >:D). But up to now she as not got the second needle in.
Kevno
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It was interesting, spotting this topic, seeing how far back it started & how recent the
obtaining of a fistual is/was for some of you, who I assumed were "old hands" :)
Living somewhere as warm & beachie as you do Baj' I can tell you I am in my pool all the
time & fully intend to hit the surf soon....but like everyone I had to wait thru the healing
process. I will probably wear a neoprene sleeve to protect it in the sea (& from knocks on the
surfboard)
The thought of sticking myself on a regular basis was...well not appealing. But after a year on
a non-working P.D. - my creatinin was always sky-high, along with everything else & I had about
enough energy to crush a grape! - I thought O.K.I guess we have to this route :-\ ::)
But since I went to Home Haemo, they were keen to get you doing it a.s.a.p. Actually I found
this was a good thing - you get a better feel for your fistula then nurses who are stabbing a dozen
patients a day, all with varying access....I had several 'blows' when the nurses did it, a couple times
ending up in a non-dialysis session/come back tomorrow scenario :o
Since doing it myself I have only had one 'blow'. Unfortunately, my fistula (upperarm btw, as a sonar
scan of my arms revealed most of my veins were pretty useless :( ) has moved & I've had to go back
to using sharps about 2/3 of the time, so the chances are higher of getting a blow. I use 14g btw.
Yes it does stress me out a bit when I am setting up, wondering if I'm gonna get blunts in the
buttonhole sites, or whether the sharps will puncture the side if I have to use them.
BUt overall things are improving, he says optimistically :)
I know a lot of patients on in-unit dialysis are encouraged to self-stick. I think if you do, you'll feel
a lot more confident if you travel & have to go to another center for dx.
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...Oh! and now I know where the expression "Hickey" comes from ;D ;D
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Am I nuts?? I had surgery last Aug. for a fistula... it never developed.. despite exercising...
Surgeon wants to try again.. March 20.. eeeek... I'm chicken.. especially since I know what it will be like... I'm also kinda needle phobic... so that doesn't help... aaaahhhhh!!! :o :'(
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I know how you feel sussie q, I have seen 2 Doctors and a professor over my needle phobia. But unlike other phobias we have no chance of advoiding the needles. I hate haemo, was on CAPD for over 12years and felt great. But can not go back to CAPD, so for the last 5years been on haemo. Not to bad when my lines were used. But now that one of the lines is not working as well as it should be. I have to have One needle. Then one Nurse tries to get two in, but up to now she has not been able to. But I have been advoiding her on the unit ;D getting some other nurse to put me on who I know will only use one needle.
Kevno
There is no such thing as being chicken, when you are a renal patient >:(
maybe a bit unsure ;)
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Seriously kevno, I think you'd be a lot better if you learnt to self-cannulate.
Most of us hate being stuck like pigs, but it's a lot better when you're doing
it yourself, as you know where it is, when it hurts, etc.
When I went in for my first 2 nocturnals last week, I was having trouble
cannulating (no blood showing) so I let the senior nurse do it (& she IS good)
- but she had no better luck. I did tell her that if she left nursing, perhaps coal
mining might be a good next job ;D
- anyway, we wasted 5 cannulas before giving up & going for a sharp (normally
a big NO-no on nocturnal, 'cause of the risk of a blow) & we got away with it
on night#1. I took my own blunts in on night#2 & was fine.
- I had a bit of bother again doing my first at-home one on Sat night, but I got
there in the end...& without a seriously sore arm like the night she dug about
in there!!! ::) :)
...feeling pretty stuffed now tho - poor sleep plus change of medication.
Hopefully it'll all settle down :-\
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Hi Bear,
It's nothing to do with the pain. It's the Flash Back from when I was a Child on the Machine Being Held down, my arm strapped to a board. Then the last thing they did for me, before I went on the machine was give me Valium!
I was only Ten. It even goes back further than that when I was six years old on the ward I aways knew when it was my turn for blood taking. TWO NURSES TO HOLD ME DOWN and ONE Doctor to try to get the blood. My fistula is so bad now the nurses have trouble getting one needle in. If the nurse misses with the first attempted I drop my BP. But I have had a vein taken out of me leftarm for a Venus loop fistula. In my right arm I had a normal fistula. Which I lost the bottom six inches of, about 5 years ago.
I have had all the scans done to see if the doctors can form a new fistula. But my veins are so thin now there is nothing they can do. Not even one in my Leg.
So it looks like one needle in my arm done by the Nurses and one line in my neck, for now. But the line does not last forever. I have had this one in since October 2003 so it as lasted longer than lines are expected to.
Bloody Needles the bug of nearly all my life! >:(
Kevno
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Be brave Girl! Buck up! ;D ;D ;D After all it is only 1 inch needles going into your skin three times a week two spots a day. You can do it! ::) ::) Yes you can!!!
Now that the sarcasm has been spent, let me tell you about it. Yes it hurts and it is gonna hurt for awhile. Your skin is going to toughen up, but the nerves under the skin still get in the way sometimes! Ouchie. You let them know when it hurts more than two minutes and have them adjust the needles for you. The first few times it is gonna hurt like a mother F***.
I have never used lidocaine. I have to much fear of more needles. Why take four when two is just fine for me? They thought I was brave, no I just did not want more needle sticks. Some patients use lidocaine all the time. It is up to what you want.
I am going to yell here. Pardon me.
iT IS UP TO YOU HOW YOU WANT TO BE STUCK WITH THE DAMNED NEEDLES. YOU TELL THEM WHAT YOU WANT AND DON'T EVER LET THEM BULLSHIT YOU AROUND!
I would also advise finding out who the best stick in the house/unit is and have them stick you the first few times when you are so scared and worried. Take your drugs before hand and go in and scream about it all you want!!! Good luck.
Katherine
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Had my fistula surgery today... can barely type.. hurts like hell.... whine whine .. Lol..
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Well, I use lidocaine with all except one of the nurses and now my skin in the area is so tough. That particular nurse is the one who speaks creole with me and she tells me I have 'lapeau bef' - cowhide! It would be 'la peau d'un boeuf', for those who speak French.
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actually i think it would be "la peau d'une vache"... ;D
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'vache' would be even a bit more tender. 'Boeuf' says it all - oxhide!! ;D
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Had my fistula surgery today... can barely type.. hurts like hell.... whine whine .. Lol..
So sorry about the pain :( Where did they put it? How long before stitches out?
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My fistula was made in my left wrist area... stitches will be about a week to 10 days.. Hurts like hell.. oh.. i already said that.. ;D .. This is the second attempt so it better fricken well work this time... ::)
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I sure hope it works well for you , SusieQ! Hope the pain is lessening daily also. ~Anja
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My fistula was made in my left wrist area... stitches will be about a week to 10 days.. Hurts like hell.. oh.. i already said that.. ;D .. This is the second attempt so it better fricken well work this time... ::)
Hope so too!! Sorry about the pain, hope it's better today.
Hubby's vascular surgeon said he didn't think exercise makes any difference in fistula development. >:D ??? >:( My husband waited one week after stitches were out and started squeezing the rubber ball again and it appears to be developing nicely. :) Has anyone mentioned exercise to you?
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Thanks for the well wishes.. the pain is less today, but it bled thru the nite.. I saw it when I got up... The stitches will come out in about a week or so then I can use the ball to exersize.... The dr. also mentioned a cuff around the upper arm may help also.. we'll see. ;)
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...The dr. also mentioned a cuff around the upper arm may help also.. we'll see. ;)
If you use the cuff be very, very careful. Listen carefully to the instruction you are given. Trauma and scarring the veins in the upper arm may make dialysis difficult. Don't want to make you paranoid but I know that we can't depend on the "medical professionals" for the information we need.
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Thanks for the advice... I didn't know that.. :o
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Have had two graphs in three years. First one crashed after a surgical procedure. If you rotate sites, should work well. And yes hitting a nerve no fun. doesn't happen often. I use 15 gauge 1inch needles and doing home hemo so I do the needling myself. My wife does one i do the other.1st set of needles were nerve wrecking , dreamt all night of being chased by giant needle.Wife was even worst when she first did it but thats another story. Have not had many problems since. Miss the odd one but no big deal.
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Have had two graphs in three years. First one crashed after a surgical procedure. If you rotate sites, should work well. And yes hitting a nerve no fun. doesn't happen often. I use 15 gauge 1inch needles and doing home hemo so I do the needling myself. My wife does one i do the other.1st set of needles were nerve wrecking , dreamt all night of beening chased by giant needle.Wife was even worst when she first did it but thats another story. Have not had many problems since. Miss the odd one but no big deal.
Two in three years :o doesn't sound like fun. Have you ever had vein mapping done in your arms or legs to try to find a vein to do a short fistula so you could "buttonhole"?
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Have had arms checked. Have a PTFE graph due to fact that veins are to small for fistula.Graph works very well, lost first one due to low blood pressure during surgery, it clotted and could not be saved.
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Well.. it has been almost 2 weeks since my fistula revision ... my wrist is still sore.. stitches still in... coming out on Monday.. how soon should I expect to see the vein getting bigger??
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Well.. it has been almost 2 weeks since my fistula revision ... my wrist is still sore.. stitches still in... coming out on Monday.. how soon should I expect to see the vein getting bigger??
Well that all depends on how much you are exercising your fistula. If I were you I would be squeezing a ball as hard as you can several times a day. It literally can take months for the vein to get bigger, And even then it may not get bigger until it is being used.
- Epoman
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Epoman, do you still squeeze the ball? I quit after they started using my fistula and I've been wondering if I should still be doing that. I had problems with my fistula yesterday. I will NOT put up with access problems. :(
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Epoman, do you still squeeze the ball? I quit after they started using my fistula and I've been wondering if I should still be doing that. I had problems with my fistula yesterday. I will NOT put up with access problems. :(
Oh HELL no, my fistula already looks like a huge snake crawled under my skin. :o But you know what I wonder if their are studies out there that show that continued exercise even after a fistula is matured is beneficial, hmm I need to research that.
- Epoman
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Two weeks ago, when the first needle was inserted, it puffed up. They left it in and just put another one down further. When I got done there were two lumps. One went down and now the other one looks like a bullet sticking out of my skin.
Yesterday, before I went on, the Nurse told me "not to touch it, because it is big and the skin is shinny." he told me to see my Vascular Surgeon ASAP. Well, they aren't going to have an opening for probably a month!! I called and left a message because of course they are closed on the weekends. Tonight my fistula (around it) is swollen. It may be an infection??
I HATE access problems. If they can't find a way to give us ALL kidneys, the least they could do is find a FREAKING access that WORKS! :P >:D
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Don't get me onto access problems again. We not let the Nurses use my fistula just now. So they have to use my lines. Which I am having problems with again. Can only get pump speeds of 220. Just now do not really care. Will deal with access problems after I get the other problem sorted out. :-\ My fistula is only 26years old.
Kevno
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I saw the Vascular Surgeon today. They "fit" me in. Told me to be there at 4:15. I finally saw him at 5:30. Damn! I fell for it again! Call me Charlie Brown! :P
Anyway, I get to have a fistula-gram next week. He thinks I've got a narrowing going on. Oh JOY! :-*
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Oh nuts! I hate for anyone to have access problems.
Katherine
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I saw the Vascular Surgeon today. They "fit" me in. Told me to be there at 4:15. I finally saw him at 5:30. Damn! I fell for it again! Call me Charlie Brown! :P
Anyway, I get to have a fistula-gram next week. He thinks I've got a narrowing going on. Oh JOY! :-*
;D Charlie Brown ;D yep, we've all been there.
IF the narrowing is above or below the fistula or buttonhole, can they put in a stent like they do for cardiac patients? Or do that "roto-rooter" type thingy?
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My sympathies to any of you who have had access problems. I have seen lots of them in my unit but I myself have been very fortunate as to not have had any problems with mine.
I hope to have nxstage soon though and was worried about getting stuck every day and what it would do to my fistula so I decided to try the button hole again. I think it's actually going pretty good. I do still use lidocaine though. I know a lot of patients that say why get 4 sticks when you can get only two but for some reason I don't feel the lidocaine. Those 15g needles sure don't do any thing for me though I feel it the whole time if I don't use the lidocaine.
The tech says it's all in my head :P but you know what I say, doesn't make any dif. if it's all in my head it still hurts.
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Ah...interesting. I can be O.K. for a full week (4-sessions) or even 2.
By then I have stopped the 'caine (it stings, I find) and just gone to putting the
blunts straight in. Great ;)
BUT...then I'll have trouble cannulating and a couple of attempted digs will make
my arm sore & I'll be reaching for the little 'caine syringe (it's part of my 'going on' kit,
so I always load it up ready). I find I'll then need to use it (psychosomatically or otherwise)
for the next few sessions. But _it_ can swell the entry area & cause cannulation
problems itself! So then I'll stop it again. ::)
Repeat cycle ::) ;D
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Just got back from a fistula gram. Had some narrowing, they ballooned it three times,ouch,thank god for happy drugs. It helped some, flows back to normal but will have to keep a close eye on pressures for a while. I Had roto rotor back in Dec for a clotting.Not bad, ballooning worst.
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Fireguy...... any suggestions for me? I do NOT like the sounds of your experience. Happy drugs? Did you take your own, or did they provide them.
Did you drive yourself? Do I need someone with me?
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My "routine procedure" went BAD. When they put in the balloon and inflated it, my vein split and blood poured into my arm and breast tissue. All I know is it felt like the JAWS of LIFE gripped my arm and was trying to squeeze blood out of it. DAMN it hurt. The guy was trying to stay calm........"GET ME A STINT, GET ME A STINT!!"
I just got home from the hospital. They kept me overnight and then dialyzed me with the same fistula. OUCH! But it still works thank GOD. Anyway, I've got to go lay down.
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My "routine procedure" went BAD. When they put in the balloon and inflated it, my vein split and blood poured into my arm and breast tissue. All I know is it felt like the JAWS of LIFE gripped my arm and was trying to squeeze blood out of it. DAMN it hurt. The guy was trying to stay calm........"GET ME A STINT, GET ME A STINT!!"
I just got home from the hospital. They kept me overnight and then dialyzed me with the same fistula. OUCH! But it still works thank GOD. Anyway, I've got to go lay down.
OMG!!! :o I am so sorry. That sounds awful, but I am so glad it still works!! :) I hope they sent you home w/ something for pain and you get a good night's sleep.
Lorelle
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My "routine procedure" went BAD. When they put in the balloon and inflated it, my vein split and blood poured into my arm and breast tissue. All I know is it felt like the JAWS of LIFE gripped my arm and was trying to squeeze blood out of it. DAMN it hurt. The guy was trying to stay calm........"GET ME A STINT, GET ME A STINT!!"
I just got home from the hospital. They kept me overnight and then dialyzed me with the same fistula. OUCH! But it still works thank GOD. Anyway, I've got to go lay down.
Oh man I'm sorry that happened to you Rerun, I hope you feel better soon. I live in constant fear about something happening to my fistula. I even have nightmares sometimes.
- Epoman
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OMG.. Rerun, I am so sorry this happened to you.. scary stuff.. :o
They are hoping to start using my new fistula in a couple of weeks.. it's not visible but an ultrasound measured the vein at almost .5mm.. I'm scared.. :o
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Sorry to hear about fistula again. You have not had much luck with it up to now. But it will get better I am sure. I see they have still used the fistula for dialysis. At least you are using your fistula, I have not let the nurses use mine in over a month now.
Keep chin up ;)
Kevno
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Ok it's been a couple of days since I last posted, I went last week to my neph and this Wednesday I finally get my vein mapping done. The following Thursday I go for a renalgran, whatever the heck that is and then on June 1st I finally talk to the surgeon about my kidney removal and subsequent dialysis. My kidneys are both large 27-28 cm each and am now about 15%GFR. Any feedback would be appreciated
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Hi I just had my first appointment with a vascular surgeon now i am off for a mapping ultsound of my arm. After reading some posts iam getting abit nervous about it all as i have a needle phobia but i guess that is something i will have to try and get over not much choice is there ? Well thanks again for all the great info
Cheers
Charee
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Hi I just had my first appointment with a vascular surgeon now i am off for a mapping ultsound of my arm. After reading some posts I am getting a bit nervous about it all as i have a needle phobia but i guess that is something i will have to try and get over not much choice is there ? Well thanks again for all the great info
Cheers
Charee
Be sure to have a good talk w/ your surgeon BEFORE the surgery about using your non-dominant arm. Having to learn to do everything w/ your other hand, because your dominant arm has the fistula and needles, is an aggravation you can do w/o. After hearing about some surgeons using the dominant arm, because the veins were larger and easier to use, my husband refused to let the tech map his dominant arm. :o That was probably a little extreme but he was VERY nervous. ;D His fistula appears to be fine. The scar from where the surgeon went in is already gone. BTW, he had so little pain that he didn't need the pain med the Doc prescribed -- only took two Tylenol. Hope yours goes as well.
Lorelle
PS: Be sure you are exercising your arm (Hubby squeezes a small rubber ball) so the veins will get larger and get better blood flow.
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I have never had a choice of which arm one big (well in the 70's we called them shunts, now fistula) Vein taken out of leg put in left arm. Called a Venus loop fistula. 1980 the nice wrist fistula in the right arm only 5 stitches. 2000 that fistula stopped. 2001 the surgeon had a go at restarting it. He had to unblock the vein from my wrist to the top of my forearm. 44 Staples. After all that all I have is a two inch stretch which one needle can be put in. That is if I am in the mood to let a nurse have a go. Most of the time the lines in my neck are used.
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How does one learn to stick themselves? I have such a bad phobia with needles that I can't look
at them before and after dialysis. Having very small veins and not having my fistula developing it
might be better if I could possibly learn to do it myself. I'd appreciate any tips.
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How does one learn to stick themselves? I have such a bad phobia with needles that I can't look
at them before and after dialysis. Having very small veins and not having my fistula developing it
might be better if I could possibly learn to do it myself. I'd appreciate any tips.
Give it time, once your vein is a little biggrer, I mean it's clearly visable above the skin. Give it a try, I promise you won't let anyone else EVER stick you again. Then maybe try the buttonhole technique, and I promise you will feel no pain what so ever. You need to get over your fear, just hold the needle and get used to it. I promise it is very easy.
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How does one learn to stick themselves? I have such a bad phobia with needles that I can't look
at them before and after dialysis. Having very small veins and not having my fistula developing it
might be better if I could possibly learn to do it myself. I'd appreciate any tips.
The unit should be able to teach you. Also there are videos the unit should have on buttonholes and one that teaches how to stick yourself.
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My unit says they can't teach me unless I go to another shift .. but it took them over a week just to leave the note for the head nurse so she knows I want to do this. But it looks like it will be awhile since my fistula blew this week. I was like "umm.. is that bad? My arm is getting really big really fast!" and the nurse had to take the 15 gauge needle back out and use my catheter again :(
Man ... problem after problem after problem with me :( And the surgeon said I would have no problems and don't even have to use the ball... good thing I listened to D&T City and now IHD (here)!!! I have learned the hard way .. do what other patients do ... not with the nurses or surgeons and doctors say you don't NEED to do! If it will help then WHY NOT DO IT!!?!?!? I don't know why all the medical staff are so laidback about things ...
Get all the advice you can from other patients!! They know experience and the doctors and nurses don't live your life every day where as all patients live their lives every day!!
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My unit says they can't teach me unless I go to another shift .. but it took them over a week just to leave the note for the head nurse so she knows I want to do this. But it looks like it will be awhile since my fistula blew this week. I was like "umm.. is that bad? My arm is getting really big really fast!" and the nurse had to take the 15 gauge needle back out and use my catheter again :(
Personally there isnt much to know about it. I was ready to do it by watching the nurses do it. However the nurses had other plans. ;D They had me watch a 5-10 minute video on it and one on buttonholes. They then wanted me to have a buttonhole but I nixed that because I told them I would have no problem doing it.
If you dont like needles a buttonhole is probably the way to go. Myself I kinda like being stuck.
This is not advice on how to do it, only your unit should teach you, but from the video it told me to stick the needle in at a 45 degree angle until a flash and then to level it out and float it into the middle of the vein. Visulizing it in your head makes it pretty easy.
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Thanks for the tips. I just have to get up the nerve to try it. If I ever want to try
and travel I will need to learn this for myself because I don't trust any of the tech's
elsewhere and only 3 at my clinic!
How long should it be before I can see my fistula bulging? My surgery was 20 months
ago and does not looked like it is growing.
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A young lady in my unit does her own needles. Maybe someday I will pick up the courage. I have already made a small step, not using Lidocaine.
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How does one learn to stick themselves?
As Epoman said: there is only one way - take a needle and put it in. I tried to psych myself up for a couple of weeks about it, and wanted to "learn" as much as I could. In the end, after all the instruction I received from other techs - I realized there was really only one thing to keep in mind: angle.
Second point I would add is to think three dimensionally. Apparently most dialysis techs are genetically predisposed not to do this, which is why we all have so many infiltration horror stories.
When you put a needle in at your 25 degree angle, try to remember it has a tip on it, and that the tip is sharp. If the back of the needle has moved 10 mm, so has the sharp end. :) Picture the vein you're going into, and try to visualize where that tip is as you advance it.
You basically just insert the needle at a 25 degree angle until you see the "flash", then level out and advance.
Stick with sharps before beginning buttonhole sites, and insist on establishing you're own buttonholes. There should only be one person ever who sticks them, and it should be you.
My clinic did make me take a "test" on cannulation. I reminded them that I did a brief stint as an EMT, and that they really didn't need to test my medical101 vocab, but they insisted. I obliged of course.
(at this point I should mention that the tech giving me the test hadn't even heard of buttonhole when I first mentioned it in our clinic several weeks previously - suddenly DaVita decided all on its own to begin buttonholing in our clinic shortly after my original questioning - I felt as though I should be the one giving them the test.)
Fixed quotation error - Bajanne2000\Moderator
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I suggest that you try not to worry yourself about it too much. Once you get used to it you will wonder what all the fuss was about. I don't even think of them as needles anymore. Using blunts takes away a lot of that fear. You will get to learn the right angle once you start cannulating. Everyones fistula is different, so every angle is going to be different. In the spots where mine is very close to the surface, I need hardly any angle at all. In the deeper parts, its more of a 45 degree angle.
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what is a "flash"???
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When the needle goes into the vein there is a backwash into the needle, they call this a flash. You can tell when the tech sees it they change the direction of the needle from an angle to straight so they can stay in the fistula area or graft area.
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When the needle goe sinto the vein there is a backwash into the needle, they call this a flash. You can tell when the tech sees it they change the direction of the needle from an angle to straight so they can stay in the fistula area or graft area.
Ah okay! Thanks :) I want to learn all this so that I can eventually learn to stab myself ;)
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When the needle goe sinto the vein there is a backwash into the needle, they call this a flash. You can tell when the tech sees it they change the direction of the needle from an angle to straight so they can stay in the fistula area or graft area.
I never get a "flashback".
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Maybe you are doing it wrong???? >:D >:D >:D
Just KIDDING, Epoman. Don't get yer panties in a wad!
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Maybe you are doing it wrong???? >:D >:D >:D
Just KIDDING, Epoman. Don't get yer panties in a wad!
No, I'm just saying, I WISH I got "flashbacks" that way I would know if I am in. :(
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Maybe you are doing it wrong???? >:D >:D >:D
Just KIDDING, Epoman. Don't get yer panties in a wad!
No, I'm just saying, I WISH I got "flashbacks" that way I would know if I am in. :(
How come you don't get one? I would have thought everyone did.
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Maybe you are doing it wrong???? >:D >:D >:D
Just KIDDING, Epoman. Don't get yer panties in a wad!
No, I'm just saying, I WISH I got "flashbacks" that way I would know if I am in. :(
How come you don't get one? I would have thought everyone did.
I was told that when your fistula is as big as mine, flashback is not as common, it has to do with the space inside, you get flasback when the fistula is small and there is no room for the blood to flow except in your needle. But when the vein gets so big the blood can move around the needle instead of going in it. Make sense? ??? I know sorry. :(
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Maybe you are doing it wrong???? >:D >:D >:D
Just KIDDING, Epoman. Don't get yer panties in a wad!
No, I'm just saying, I WISH I got "flashbacks" that way I would know if I am in. :(
How come you don't get one? I would have thought everyone did.
I was told that when your fistula is as big as mine, flashback is not as common, it has to do with the space inside, you get flashback when the fistula is small and there is no room for the blood to flow except in your needle. But when the vein gets so big the blood can move around the needle instead of going in it. Make sense? ??? I know sorry. :(
Oh wow! Yes that does make sense!! Thank you for explaining that to me :) I wish all my questions were answered as fast and concise as this :) Thx! lol
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With my buttonholes I can tell I am in even if I didnt get a flashback (I do though). You can just feel that its in there. I do get clots though, so I withdraw about 5ml of blood before I flush with diluted heparin.
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With my buttonholes I can tell I am in even if I didnt get a flashback (I do though). You can just feel that its in there. I do get clots though, so I withdraw about 5ml of blood before I flush with diluted heparin.
Makes sense. I want to learn that but I was thinking how I use the Emla cream. If I have it on for exactly an hour or more then I won't be able to feel anything so I was thinking of only having it on for 50 min because then I can still feel it but it is less sensitive.
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The main thing I find painful is taking the scabs off, but thats just because I use the local after doing that. With the cream you wouldnt have that problem. I dont really find the local painful. If you are like others angie, you may not even need the cream at all if you are doing buttonholes.
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The main thing I find painful is taking the scabs off, but thats just because I use the local after doing that. With the cream you wouldnt have that problem. I dont really find the local painful. If you are like others angie, you may not even need the cream at all if you are doing buttonholes.
I have ZERO pain with the buttonhole technique. I just take the scabs off, again zero pain, then I just insert the needles and viola. I use no local what-so-ever. But even when I rotated and used sharps I had some pain but even then I never used a local of any kind.
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I've only been on hemo for 18 months, so Im hoping with time the buttonholes toughen up. I guess being on prednisone for over 10 years doesnt help either, maybe not, dont know.
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Epoman:
Are you using a tourniquet while cannulating?
If so you have a flash, visible or not.
Mine's very small, and used to be invisible. Blood pressure is also a consideration; I think someone with high blood pressure would have more of a flash compared to someone with lower blood pressure (assuming both fistulas are the same size).
Physics tells us that if there's less pressure inside the needle than there is in the fistula (which has to be true) there will be a flash, or some backwash of blood as the pressure equalizes.
The fact that the blood travels down the tube after you release pressure at the other end confirms this.
It could be though, that there isn't much of one, and it remains invisible, as it isn't traveling far enough up the tube to be visible. Your large fistula probably explains this, as the pressure inside your fistula might be considerably lower than someone else's smaller fistula.
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A couple of times when I first started hemo there was no flashback until I had a look under where the tubing connects to the wings, where there was a small flashback.
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A couple of times when I first started hemo there was no flashback until I had a look under where the tubing connects to the wings, where there was a small flashback.
When I watch the nurse I get flashback.
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I worry about when I will do buttonhole because I have troubles with my fistula (it is still new but also very "snakey" and rolls a lot as well) but am surprised that you worry so much. You seem to be such an informed person that sometimes I forget that you just like the rest of us. I hope things get better for you. I have a high pulse too and I don't know if it is because the heart and fistula don't want to share all that blood (I read that somewhere) but worry can't help your pulse at all. Good luck with it all. And I hope the nurses keep cooperating with you!
Angie, my fistula is snakey as well, and it moves around. If you start having problems with a buttonhole, you can just make another one in a better spot. I have had to move mine around a few times. I am now back to using the 2 original buttonholes. I also have a high heart rate, which Ive had since I first started getting rejection, but no one can tell me why. It has settled down a lot now and I think it usually hangs around 80-110 resting. Occasionally I have noticed it lower than that, but to be honest I don't really take notice of it. I mentioned it to the doctor yesterday (they actually did rounds at the home in-centre!), and she mentioned something about the high blood flow in my fistula. I think she also said something about a HR monitor, but as usual they don't talk to you directly, so I didn't hear what she said. I'll soon find out.
I decided to quote this here .. hope that is okay .. reason being .. it is related and don't want to take Epoman's thread off topic by talking about me :P lol
Anyway, that is good advice! Thank you! I haven't learned buttonhole yet but I am hoping it will be soon.
Anyone have any more advice for me and my snakey fistula?
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Epoman:
Are you using a tourniquet while cannulating?
No, I NEVER used a tourniquet, only the first couple of times.
If so you have a flash, visible or not.
Mine's very small, and used to be invisible. Blood pressure is also a consideration; I think someone with high blood pressure would have more of a flash compared to someone with lower blood pressure (assuming both fistulas are the same size).
When my pressure is 250/150 = No Flashback, when my pressure is 90/50 = No Flashback
Physics tells us that if there's less pressure inside the needle than there is in the fistula (which has to be true) there will be a flash, or some backwash of blood as the pressure equalizes.
The fact that the blood travels down the tube after you release pressure at the other end confirms this.
Of course there is a flashback, but we are talking about a VISABLE flashback, arn't we?
It could be though, that there isn't much of one, and it remains invisible, as it isn't traveling far enough up the tube to be visible. Your large fistula probably explains this, as the pressure inside your fistula might be considerably lower than someone else's smaller fistula.
Yeah, that's what I said earlier.
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Of course there is a flashback, but we are talking about a VISABLE flashback, arn't we?
Indeed, but with the importance of posterity here, I thought it important to make clear to those now (or in the future) who aren't familiar with what we're talking about that you are indeed flashing, you just aren't seeing it.
I would hate for someone to think something's wrong with their access just because they couldn't see the flash that all of the folks online were talking about. :)
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slothluvchunk, I NEED you to learn to QUOTE correctly, this is about the 3rd or 4th post that you have quoted incorrectly. This is NOT a quote:
Of course there is a flashback, but we are talking about a VISABLE flashback, arn't we?
THIS is a quote:
Of course there is a flashback, but we are talking about a VISABLE flashback, arn't we?
I need you to fix your posts.
- Epoman
Owner/Admin
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Of course there is a flashback, but we are talking about a VISABLE flashback, aren't we?
Indeed, but with the importance of posterity here, I thought it important to make clear to those now (or in the future) who aren't familiar with what we're talking about that you are indeed flashing, you just aren't seeing it.
I would hate for someone to think something's wrong with their access just because they couldn't see the flash that all of the folks online were talking about. :)
Exactly! I mean .. I am new to hemo dialysis and I didn't even know WHAT a flash was before I read it here. I just learn what ever you guys describe! Please be as detailed as possible so I don't need to DEPEND on my nurses who are too busy to explain every little detail .. thx. (Just a request but you can ignore me if you want because I am not that important anyway :P )