Fistula Failed

[Vt Big Rig]

Had angioplasty done on fistula on Wednesday. Pressures very high  yesterday and could not get started today. Very nervous!

[cassandra]

What's happening?

Love, Cas

[Vt Big Rig]

I don't know. Just can't get running. Arterial pressure skyrockets. I fear vessel has collapsed. Sounds good but will not run. Have tried several sticks.

[cassandra]

Have you rung the hosp already?

[Vt Big Rig]

Nurse came to house yesterday. Still could not run. I should be thankful. 12 months ago surgeon told me it would fail. We had another put in opposite other arm then. So it lasted a year longer than I was told it would. We will go to clinic Monday to start on the new arm.  Just must be careful with fluid and potassium for a couple of days.

[cassandra]

Glad to hear you already have a 'spare' fistula. I'm scheduled to have a gazillionst plasti on my failing one, so the new fistula in other arm can be created (still no date) I'm now thinking to cancel that plasti next Wednesday.
Anyway, good luck Monday!

Lots of love and luck, Cas

[PrimeTimer]

When a fistula fails do you no longer feel/hear the bruit and thrill? Is there no longer a flash when you stick it? Does it mean there's no blood flowing thru it anymore or is it all clotted up? And lastly, what if anything, is done to a failed fistula? A lot of questions I know but thanks in advance to those who can answer.

My husband and I always have known the signs of when he needs another angioplasty. Seems he has needed one every few months. We don't get too upset anymore because we've realized it has been those balloon jobs that have kept his fistula alive. We've always put it to use right away after he's had one. Don't know if the center will do that for him. Pressures always seem high for awhile, even a couple of weeks. The improved flow seems to move the needle track inside his buttonhole so we had to learn where the new sweet spot is. A lot of alarms and "mute, stop and GO" action while I made adjustments. Then it got to the point where just because I could get the pressure down enough to stop alarms, I'd say, "Nah, hold on, I'll bring it down a little more". I admit, kind of felt cocky to be able to do that. The center deals with all that now but we still check his fistula every day.   

[Vt Big Rig]

My old fistula still sounds and feels fine. We get a flash, it primes well, and seems fine when checking with syringe. But if we try to go over 200 speed I get an immediate 24. We ran at 200 for 29 minutes aND it alarmed.  If you press on my arm above the sticks, arterial goes down. Classic stenosis. We had angioplasty done Weds, barely got a run in Thursday and have been unable since. Even with nursing help.I don't understand how it can close so quickly, but there is very little I understand these  days.

[cassandra]

My failing one still feels fine, bruit, high venous pressures at the start, normal for mine with the collateral veins, but last plastis they couldn't get in at all to open up some stenosis. It's the flow in the fistula which has dropped from 1100 (after successful plasti) to 250. Clearance is pretty bad and I feel it. Could sleep all day and that's not 'normal' me.

Also the fistula is completely calcified. Apparently the calcification consists of a combination of calcium, phosphate and pth. If I get a sharp in to create a new buttonhole it's incredibly tough, sometimes a piece sticks to a needle and it's like plastic. Last plasti-try two people had to force the scalpel (sp?) in (ridiculous so I told them) I think it's a vicious circle, low flow and calcification cause more turbulence in the fistula which causes more calcification which causes lower flow etc.

Anyway the fistula has a severe narrowing near my heart (due to several catheters) from the start and has lasted twice as long as expected (18 years) Just a pitty that the new fistula has not been created yet.

[Rerun]

I hope the new one works well. 

                       

[PrimeTimer]

Thanks for sharing your experiences Vt Big Rig and cassandra. We check my husband's fistula every day but now that he's going to the center I have to put my faith into them in knowing all the warning signs too. We both still have so much to learn, glad I can count on our friends here on the site! Big thanks!! Sure hope things go better for the both of you. Fistula's are your lifeline!

[Vt Big Rig]

Just got home. The new one worked OK for a brand new vessel.  Now just need to build it up. Strange using other arm and now upper arm. Only did 3/4 of a run since the clinic closes but tomorrow morning tech will come to my house and my bride will do cannulation. This fistula is more prominent than the first.

[cassandra]

Sounds good! Good luck tomorrow to the both of you

   


Love, Cas

[Michael Murphy]

This seems strange to say but I hope this fistula serves you well, it's funny how those strange bumps on our arms are both a blessing and a curse. Good luck . I just decided I don't like the word fistula from now on I am going to call mine Buford, after a Cival war general.

[kickingandscreaming]

I've never like the word "fistula" either. It's a very unpleasant word--totally aside from what it is.  It's a gooey, very visceral word.