Anyone Heard Of This ?

[angellady07]

Please forgive me if I'm bringing up a topic that has already been addressed. I'm really at loss as to what to do. I've been dealing with graft complications since placement a couple of months ago. I spoke with my vascular surgeon today. He suggested " tieing my graft off "  essentially removing the graft. He mentioned putting a new one in either my right dominant arm or my thigh. Has anyone heard of tyeing off a graft? I'm strongly considering PD now although my nephrologist is against it. Any suggestions would be greatly appreciated.

[KT0930]

I'm sorry, I don't know anything about grafts or fistulas, as I do PD. May I ask why your neph is against PD, though?

[angellady07]

Thanks so much for your reply. I value this board more than words can say. My nephrologist says that PD is pushed on many patients and he prefers hemo for his patients. I respect my nephrologist however, everyone is different and what might be right for one patient may not work for another.

[jbeany]

Statistically, patients do better in the long term on hemo.  The lab results tend to be better, and the chance of infection is lower on hemo if you have a fistula or graft than it is on PD.  PD also doesn't work well for diabetic patients - the glucose in the fluid is often hard on the blood sugar levels.  I couldn't do Pd because of being diabetic, but from what I've read on here, a large number of patients prefer it for a number of reasons, including the lack of needle sticks, the ability to do it easily at home or on the run.  They get a choice between manual or cycler, and doing it at night if they want to do nocturnal.

Do you have a goretex graft or a natural fistula?  I've never heard anyone suggest removing a graft before.  The gore-tex ones have a mesh on the outside that your tissue is supposed to grow into.  I would think that removing one would be nearly impossible without doing major damage to your arm.  Tying it off just sounds like he's planning on inserting some sort of clamp.  Is he trying to fix steal syndrome?

[KT0930]

jbeany, thanks for the explanation about grafts. I had one put in when I was a young child, and it was never used, and eventually stopped buzzing. I asked my neph once about taking it out, and he just said it would be major surgery and many months of recovery, didn't explain why.

[angellady07]

I have a gore-tex graft. I asked him what he meant by tyeing it off he said he would be removing the graft and making my arm as it was before the graft. I'm scared of the procedure to put it mildly. Thanks so much for your input. I don't know what I would do without this board.

[jbeany]

My first one failed within a week, and it's still in there.  Wonder why he's thinking the whole thing has to come out?  I'd love to get rid of the odd lump it makes in my lower arm, but I'm not the least bit enthused with any more surgery!

[angela515]

Wish they would remove my 2 grafts in my right arm, one overtop the other.... blah...insurance.

[angellady07]

I would rather leave mine in than risk further damage to my arm. I don't have much confidence in my surgeon. I know what you mean though.

[goofynina]

When i asked my neph if it was possible to remove it he said no because over the years the amount of tissue that has grown around it and something about nerve damage, i dont know, i never listen to him anyways 

[angellady07]

I really don't know what to think. I doesn't make sense to me either. Thanks for your reply. I appreciate everyone here.

[Bajanne]

My first graft never worked and so I have this oval track on my lower left arm.  But it doesn't hurt, and hardly shows and I don't intend to do anything about it. 

[thegrammalady]

if it were me, i'd find a different surgeon and get a second opinion.

[angellady07]

Thanks for the replies. I don't feel comfortable with the situation. Sometimes, we just have to go with our instincts. The way my arm feels right now I wouldn't trust him to remove a hangnail. Thanks again. I love this board.

[keefer51]

I had two fistulas in my right arm done by some idiot.They never worked and he used my dominate arm. I now have a good one in my left arm. It's a beautiful one too!! 

[Lucinda]

Hey Angel.  You are talking to the graft queen here.  I had mine put in about a year ago and it blocked five times because they used some new graft that did not work so they told me they were going to replace it with the old style and they would not remove the old one but tie it off as well.  As it turned out, the old one just slipped out easily and had been rejected by my tissue.  The reason they don't remove grafts is because your tissue grows around them and makes it very painful and difficult to get them out.  I now have a new graft that seems to be hanging in there much better.  I haven't started hemo yet....in a couple of months but I feel it would suit me a lot better than PD.  Talk to Goofynina about PD.  She is on it and much prefers it to hemo.  Everyone it different and I think it is very much a suck it and see exercise but don't panic about your graft.  Initial problems seem to be part of the process.  I am sure they will get it right for you. Mine is buzzing a treat now.  Take care and let us know what you decide.  Love, Cindy. xx

[angela515]

Yeah..my graft in my left arm is all grown into my arm... it actually feels kewl though...but can never be removed b/c its a part of me... wierd,

[angellady07]

Thanks again for the replies. This board is truly a blessing in my life.

[Sluff]

So what have you or your Neph decided to do? Have you made a decision yet?

[angellady07]

Thanks for the question. I'm scheduled for a fistulagram on the 14th. The decision will be made after that. At this point, it looks as though the graft will be tied off and I'll have another one put in my right dominant arm.

[angellady07]

Update. I had the fistulagram Friday. I received a call later in the day from the vascular surgeon. Luckily, there were no blockages. The plan is to schedule surgery to drain the excess fluid surrounding the graft. If the surgery to drain my graft fails then he suggested tyeing the graft off and using my right arm for access.I'm in pain 24/7 so I hope the surgery is a success. I'm keeping positive thoughts.

[okarol]

I hope they'll do whatever they can to make you comfortable! 

[angellady07]

Thanks Karol.