Opinions Please

[angellady07]

I came from a follow-up with my vascular surgeon today. I feel as though I left with more questions than answers. I had graft surgery on the 26th. of last month. I'm still experiencing pain and numbness. My surgeon said that my graft access should be ready in a year. What? I don't have a year to wait. He said some people heal faster than others and i need time. He also said that he didn't intentionally snip a nerve.After which be blamed the numbing on the nerve block.My upper arm is in pain and my lower arm underside included is numb.I don't mean to ramble however, I'm scared and i don't know what to think at this point. He told the receptionist my next follow-up was "PRN" as needed for questions. Meanwhile, he didn't answer any of mine.I feel like my graft is useless.Thanks again.

[carolynt]

I thought a graft was ready in two weeks after surgery.  I get pain in my upper arm like a soreness  where my graft is.  Did you start the dialysis yet?  I hope this pain is not forever.  I wish doctors could be more explicit. Also does anyone know if you can wear rings and watches on the graft arm?

[angellady07]

No, I'm not on dialysis yet. However, my GFR is 12 and I'm worried. My nephrologist said he didn't know "a few months maybe'. It's unpredictable.

[kidney4traci]

I was told not to wear a braclet or watch ( but I have a fistula) but I do wear a ring.

[livecam]

I came from a follow-up with my vascular surgeon today. I feel as though I left with more questions than answers. I had graft surgery on the 26th. of last month. I'm still experiencing pain and numbness. My surgeon said that my graft access should be ready in a year. What? I don't have a year to wait. He said some people heal faster than others and i need time. He also said that he didn't intentionally snip a nerve.After which be blamed the numbing on the nerve block.My upper arm is in pain and my lower arm underside included is numb.I don't mean to ramble however, I'm scared and i don't know what to think at this point. He told the receptionist my next follow-up was "PRN" as needed for questions. Meanwhile, he didn't answer any of mine.I feel like my graft is useless.Thanks again.

I can't speak to the pain issues but I am assuming this graft is actually an A/V fistula.  Did the doctor or anyone else go over the arm excersizes that are needed to help the fistula develop?  I was given tourniquets and a semi hard rubber ball to use.  A tourniquet was tied around the upper arm (fistula was in the forearm) and I was told to tightly squeeze and release the ball until I was too tired to continue and do that repeatedly throughout the day.

This was needed for a number of months until the fistula was fully developed and able to be used.  Let me add that this was my second fistula...the first one was used too soon and failed immediately when that use was attempted.

From your post I'm not sure where they put your fistula.  Please don't try the excersize I mentioned because that is obviously dependant on where the fistula is and other factors.  Ask the surgeon and your primary Nephrologist for advice on how to properly develop your fistula.

[angellady07]

Hi livecam, thanks for your reply.A fistula wasn't an option for me as my veins/arteries are too small. It's actually a graft, starting where my arm bends at the elbow extending to my upper arm.That's why I don't understand the time issue.

[jbeany]

The graft is essentially a plastic tube.  They don't heal after a needle stick like a natural fistula.  The outside of the graft is covered in a sort of fine mesh.  The tissue surrounding the graft must have time to grow into the mesh and "seal" around the tube.  This is so the tissue will seal around the needle holes after you pull the needle.  Perhaps you are not healing as fast as the surgeon expected? 

My surgeon hit a nerve with one of my surgeries as well.  I had a huge numb spot that felt like your foot does when it falls asleep.  It took almost two years for the numbness to go away - I've only got one small area now that bothers me much at all.  The pain eventually faded as well, but it was a very long time - over a year.

You don't really exercise a graft, so you don't have to worry about that.

As for starting dialysis without a ready access - they will give you a temporary cath if you need to start before the graft is ready.  They can put those in very quickly, so there's no need to get it done ahead of time.

As for rings and watches - the rings shouldn't be a problem.  If it's a loose watch, like a bracelet, then it shouldn't be a problem.  They just don't want you to wear anything that might pinch off circulation.

angel - as you think of questions for the surgeon, write them down.  Take them with you to the next appointment, and read them off to him one by one, and don't move on to the next one until you are satisfied with the answers.  I think some of the docs do so many of these procedures that they forget that it is all very new and very scary to us!

[angellady07]

Thank you jbeany. I feel better now. I appreciate your response more than you know. Whenever, I do ask the surgeon a question his standard reply is " I simply don't have an answer for you". Sometimes I wonder if these people are even human. I think the docs feel those of us that ask questions are problem patients. I'm seriously considering a second opinion for a vascular surgeon and nephrologist.The quality of care I've received to this point stinks.Please excuse my rant.

[Rerun]

I think I would look for a different vascular surgeon! 

Remember not to put your purse over that shoulder.  It constricts circulation. 

[angellady07]

Thanks Rerun. I'm looking into a new vascular surgeon.