I Hate Dialysis Message Board
Dialysis Discussion => Dialysis: General Discussion => Topic started by: smile24x7 on July 18, 2008, 11:18:38 AM
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Hi guys,
I hope someone can shed some light on this for me. I have had the darnedest time trying to get an access put in. The whole saga started about six months ago when my graft in my left arm started to clot. The graft was declotted twice before the doctor decided to give up on it and put a new one in in my right arm. The doctor put the new graft, but it did not work. He went back in to fix it or try to declot it, but ended up just taking it out. Then he tried to put in another one in my upper arm, but the vein he was trying to use burst. My arm swelled and he canceled the surgery to let me heal before he try again. Now I have to wait three weeks for another surgery. The doctor says that I am having so many problems because I am diabetic and my veins are small. Anyone else going through similar issues. Is the doctor right, or should I maybe get a second opinion. Any advice would be appreciated. :thx;
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He's right about the veins being effected my diabetes. This is a by-product of the disease. It really complicates things and there's little that can be done to change that. They need to find ways around it. I hope, in your case, they do!
-Devon
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Yes small veins and deep ones here too...however a wonderful Vein Surgeon in Charlotte built a fistula in my left forearm and then elevated it after 3 weeks to my upper arm and it is healing very well and I'm going to work on doing the Buttonhold technique so noone else messes with my fistula. I now know to only have Vein Surgeons work on my fistula. The first time the graft was done by a general surgeon and did not last etc.
Good Luck to you.
Ann
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As being a diabetic and then having a fistula put in, it clotted off 4 months later due to poor veins. I read his report after getting my medical records and wondered why if he knew my veins where that bad and knew it would not have lasted, why do the fistula. I ended up getting a graft in my upper left arm after searching for another doctor. Basically I interviewed him to see what he could do for me and if he worked with diabetic patients. He did scanning test before surgery to better plan for a better outcome and where to place the graft. So far this graft is still working for more than 8 years, although unsightly to me me.
So my opinion is get a second opinion if you can
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My husband Rob has a fistula in his lower arm that still works, but recirculates. He had an upper arm fistula put in that never worked well. About 7 months ago he went to a couple of ascula surgeons and found one that makes a "natural" graft. They took a large arterial vein from his right arm and grafted it to his left arm upper fistula. It took a couple of months to mature but man this thing thrills like you wouldn't believe. It works great! Right now he uses his lower arm fistula for arterial and upper arm graft for venous.
Perhaps your doctor could look into doing something like that? Oh by the way, Rob is a 30 year Type I diabetic.
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I did a lot of shopping for vascular surgeons when I needed my access put in. My veins are deep and twisted, and after a few mappings, my transplant surgeon was able to create a working fistula for me in my left up arm.
If you are in a place that has multiple vascular surgeons, please get a second (and maybe third) opinion. Your access is your life.
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Thanks everyone. I am currently in search for another doctor. My current surgeon is a general surgeon, but he is supposed to have 20+ years experience in putting in grafts. He is supposed to be the best in the city, from what I have been told. My area is short on vascular surgeons. Does anyone ever find that they may have to leave a city or state to find better health care? And how do you go about that anyway?
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I first started asking my doctors if they knew anyone. Some mentioned my first doctor who I didn't care fore and other suggested doctors they knew. Then I used the internet to search for doctors in the city at the eading hospitals. Some allow you to look up and schedule a doctor by their specialty. Then I searched other hospitals that I have been to throughout my life and ended up only having to drive 21 miles away. have your questions handy, your past surgeries and medical problems for discussion to give them an idea of the complexity you are going through.
Good luck