Mom's kidney appointment today

Hello everyone. Most of mom's numbers are better than they were in January.

January
creatine 3.5
Phosphorate 17
GFR 13%

April
creatine 2.9
Phosphorate 477
GFR 16%

Doctor put her back on calcitrate and added sodium bicarbonate to the list of meds. She has to get her blood tested monthly. Her next appointment is in three months. Doctor was very adament that mom decide when to get fistula placed. I have to call vascular surgeon to get a better grip on what he plans to do. Last appointment he said mom's veins were too weak for fistula. I want to know if he does the surgery can he attempt a fistula first and if he can't will he at that time put in a graft or would he have to close up and do a graft later in a different place.

Doctor also said that when she has knee surgery (in July) that her kidneys could become an issue and that is another reason to get access done before (mom wants to wait until after knee is healed). I should have asked him why the surgery could affect her kidneys? Also said to him that even if mom got a fistula, it wouldn't be mature by surgery anyway. He said that it may be too soon if they were going to do a graft because it could close up before it needed to be used. Timing is everything.

Mom was crying and visibly upset, but I reminded her she had good numbers and we would figure it out along the way. Her numbers improved, but could they just as easily drop so drastically that she would need emergency dialysis? The doctor could not give an answer. He just wants her to be better prepared with getting the access in place.

So, still in a hovering pattern. She feels good and hasn't felt nauseous. Her cholesterol and sugar are doing well. Her pcp adjusted her insulin and she gets reads of between 70 and 100 in the mornings.