Moving On To A Fistula

[jg]

After  a couple years  of pd, I am getting mediocre  dialysis. So on Thursday March 25 I am going for day surgery for an arm fistula to prepare for hemo.
The doctor  said there is a 30% chance of failure over the course of time with most failures being in the first 6 weeks.
Any advice/feedback?     
In the meantime, I hope to keep going on  pd for about 2 months until the fistula is accessible.
 

jg

[monrein]

Main piece of advice is try very very hard never to sleep on your fistula arm, cutting off circulation.  Also, don't lift too much weight with that arm and watch how you carry bags or things...again don't cut off circulation.  Good luck with the surgery and also the maturing process.

[GeeWillikers]

I had my fistual done at the beginning of February, and had my PD cat placed yesterday..

My fistula is maturing nicely - the only thing bad I can say about it is the fingers in that hand (pinky and ring) tend to go to sleep easily if I put pressure on them while sleeping.

It's no bggie, I squeeze a tennis ball type toy and it wakes right up, and it's happening less and less..

Good luck with the fistula - it's amazing the amount of "action" you'll have in that arm...

[MooseMom]

I had my fistula surgery last week, and it is weird.  The bandages aren't off yet, but I already feel the thing buzzing away.  My surgeon didn't give me any restrictions and he said I had a 90% chance of it working, but I guess each patient is different.  Good luck with it all!!

[jg]

An update.  Last Thursday I had the fistula put in.  The surgeon opened up my left wrist and could tell my veins and arteries were too small
for a fistula so he closed the area. Then he opened the inside of my left elbow area and put the fistula there. The next day I saw the access
nurse who removed the outside bandages. Both wounds are covered now with clear bandage strips. I see her tomorrow for another followup.
My arm is still red, with some soreness and rare sharp pain. I can hear and feel the fistula working! So I continue to heal. In the meanwhile I
continue to muddle through with mediocre pd.

Oh by the way, the day after the surgery I threw up for the first time in several years.     (lol)

jg   

[MooseMom]

I could feel nausea coming on as I lay in recovery, but they gave me something wonderful that made it go away.  I've had that sharp pain, too.  Seems it is entirely normal.  I hope all continues to go well for you.

[monrein]

I'm curious about how come the vein mapping didn't make it clear that the veins were too small in your forearm?  They did do a vein mapping right?   

[jg]

They didn't do a vein mapping, MRI or xray. 2 weeks before the surgery a kidney intern did a visual inspection of my left arm.  When I asked him about vein mapping he said the dye would
destroy kidney function. Made no sense to me  . Minutes before the surgery, I asked the surgeon. He said these tests do not always give the correct results. I will ask my nephrologist when
I see him.
Normally I would have demanded the mapping. But time is crucial. MY pd is mediocre and I am conserving energy to get by. The faster I switched to hemo, the better.
I decided to have faith in the medical people.

Update: saw the access  nurse today. Everything is ok. Next Thursday she will take the bandage strips off.

jg     

Happy April Fool's Day and then Happy Easter!

[monrein]

Sounds quite odd to me since it's an ultrasound type test...I don't recall dyes being involved at all.  Anyhow, that's all water under the bridge now and I'm glad your access is healing well.

[galvo]

jg, good news about the fistula. Long may it thrive!

[M3Riddler]

They didn't do a vein mapping, MRI or xray. 2 weeks before the surgery a kidney intern did a visual inspection of my left arm.  When I asked him about vein mapping he said the dye would
destroy kidney function. Made no sense to me  . Minutes before the surgery, I asked the surgeon. He said these tests do not always give the correct results. I will ask my nephrologist when
I see him.
Normally I would have demanded the mapping. But time is crucial. MY pd is mediocre and I am conserving energy to get by. The faster I switched to hemo, the better.
I decided to have faith in the medical people.

Update: saw the access  nurse today. Everything is ok. Next Thursday she will take the bandage strips off.

jg     

Happy April Fool's Day and then Happy Easter!

Hearing that they did not do any mapping of any kind is poor treatment in my opinion. An Internests Visual Perspective I guarantee is not as good as a Doppler or Ultrasound. Yes, Ultrasounds are not 100%, but it would have been better than eyes looking at your arm. They use dye with venograms, not ultrasounds/doplers. I have never heard of this. That is one scar that could have been avoided.
Yes, Time is cruicial, but an ultrasound takes 20 minutes. Was there any communication with your nephrologist beforehand?
Learn as much as you can about your condition and hemo dialysis. You should be involved as much as possible with your medical team.

For more information on caring for your fistula, visit the following link for information.

Cannulation Camp

///M3R