Post-op care for AV fistula procedure

[RightSide]

This Friday, April 3, I'm finally going to have the AV fistula procedure on my left wrist, or maybe a little higher up than that.

What should I expect regarding post-operative care?  Are there any supplies (bandages, etc.) that I should buy ahead of time to have on hand after I come home from the hospital?

Also, should I engage the services of a visiting nurse to care for the incision?  I live alone, and I don't have anyone to help me care for the incision after I come home from the hospital.

[monrein]

All I can remember doing was resting the arm by not lifting anything, taking pain meds and keep listening for the sound it makes and feeling for the buzz.  If you don't feel or hear it call the doc right away.

[jbeany]

Get some good quality plastic bags and some soft wide tape, like painter's tape.  They usually don't want you to get it wet for the first week, but you can tape a bag over your hand/arm if you want to take a shower.  They will tell you how many days to leave the bandages on - usually not more than 24 to 48 hours, then under the bandages are these sticky little tape things called steri-strips that they use to seal the incision.  I had stitches under the steri-strips.  After the first week, you can take a shower, with the stitches and steri-strips on.  You are supposed to let the steri-strips wear off by themselves.  In two weeks, I went back for a check-up and to get the stitches pulled.
I doubt you'll need a visiting nurse to do anything.  There's not a lot of care involved with most fistula surgeries - just peeling off the bandage in a couple of days, and keeping it dry and elevated after that.

My first fistula surgery, they damaged a nerve, and I was miserable with the pain, but that's not common.  The second one I did, I didn't need more than Tylenol to deal with the pain, and I had to keep reminding myself not to lift anything the first week, because I kept forgetting it had been done.

[Tinah1968]

Yeah I agree with Jbeany there isn't much to it. The only thing I had trouble with was putting on my clothes. i had to have help with that but the incision I just made sure to keep it clean and Dry. No lifting anything... I tried to lift something becasue I forgot since i was not in pain anymore and I was sore for a week. once they give  you to go ahead you can get a stress ball to help mature your fistula. but again that is not til they tell you to do that.  Hope it all goes well for you...

[Savemeimdtba]

All I can remember doing was resting the arm by not lifting anything, taking pain meds and keep listening for the sound it makes and feeling for the buzz.  If you don't feel or hear it call the doc right away.

I don't mean to sound ignorant but I don't know a lot about fistulas.. they make noises and buzz??

[jbeany]

Yup, they make lots of noise as long as they are still flowing properly.  If you get one, you need to check regularly to see if it is still vibrating - they call that the "thrill".  If you get a stethescope, you can listen for the whooshing, ocean noise as well - what the docs call a "bruit", pronounced brew-ee.  I can hear mine as well if I just put it up to my ear.  My cat loves it - she lays her head on my arm to listen to me purr.

[Beth35]

When I got my fistula, I was shocked at how good I felt.  I only took the first round of pain killers and then I thought I didn't need them during the night.  HA!  BIG mistake!!!  I woke up screaming in pain and had to take the pain meds right away.  It was horrible.  So my advice is to take the pain meds at least for the first day and night. 

My fistula is now dead so I will need a new one when I need to start dialysis again. 

[kellyt]

My first fistula was in my left wrist and I had little to no pain, really.  Unfortunately, that fistula didn't work so I had my 2nd fistula placed a month later in my left upper arm.  The incision was much larger (he moved the vein closer to the surface) and I had some pain, but nothing too debilitating.

Just plan on taking it easy for a while, especially with that arm.  Work your exercise ball!   Good Luck!

[RightSide]

Yup, they make lots of noise as long as they are still flowing properly.  If you get one, you need to check regularly to see if it is still vibrating - they call that the "thrill".

Well, I'm home from the hospital.  And yes, I can feel a little pulsation in one area north of the stitching.  But it sure isn't very strong. Hopefully it will get stronger over time.

No pain whatsoever.

This was the second operation in a row in which an anesthesia drug hit me the wrong way.  For sedation, last time they gave me Fentanyl; this time they gave me Versed.  Both times the drugs didn't clear from my system for 12 hours!  Could this be due to ESRD, or could it be a sign of something else?

The biggest problem I'm having right now, is with the Tegaderm bandages over the stitched area.  Every time I flex my wrist to do anything (like preparing dinner), the damn bandage starts popping loose.  I've got some Tegaderm tape; and I've been trying to keep ahead of the bandage, fastening it down before it can pop loose some more.

[kellyt]

Congratulations!  Yes, it should get stronger as you start to work your exercise ball in the next week or so.