The two best options as far as survival are preemptive transplant or home nocturnal daily dialysis if the first option is not available. Learn as much as you can ahead of time. As an aside, those that are long term survivors have a common trait of maintaining their independence and decision making. There are no guaranties with any renal replacement treatment option, but many have achieved long term survival either with optimal dialysis strategies or transplant. The first major decision if dialysis is the choice is that of access with fistulas the best long term option. Protecting veins on both arms is key to learning how to preserve your own life in a very real sense. Between exercises designed to enlarge the veins and muscles to avoiding undo venopunctures and using hand veins as much as possible, even before you start dialysis if that is inevitable, you can begin to gain control of your own destiny in many ways.
I was going through another thread when I read this post from Hemodoc, one part of the post caught my eye. What would happen if my fistula stopped working. Right now it is on my left arm, What if the vascular surgeon needed to use my right arm because none of my veins in my left arm were unusable for another fistula. I know that a fistula is better than a graft and I would prefer using a fistula. The thing that worried me now is that after years of using my right arm for extracting blood or for IVs would I have many problems with a fistula. Those with grafts did the surgeon have problems finding a suitable vein in both arms or was the surgeon saving the one arm by putting in a graft. Another thing that Hemodoc brought up was that you should use your hand veins as much as possible. I will be in the future try to remind myself that when taking blood samples from my arm that I should use my hand instead(enen though it is more painful in that area) or maybe try having the D clinic do the drawing when they do the monthlies. Doing anything to preserve the veins for future fistulas.
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