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Author Topic: Fistula initiation?  (Read 2801 times)
cuteangrylittlemuppet
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« on: December 06, 2010, 11:18:15 AM »

(N00b alert!) This is very basic self-canalization stuff.

So I have a permcath and a 10 week old fistula. Do have to use my permcath as we initiate home-hemo? Aren't there people who get the fistula placed preemptively and go directly to using it sans the catheter middle step? Can't I remove the catheter and just use my fistuala.

Honestly the tube going to my heart is surrounded by scar tissue and is terribly uncomfortable, is there any REAL reason (besides this is how we are used to doing it) for me to do the catheter-fistula combo treatments?

Is this possible and/ or safe?
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Diagnosed IgA Nephropathy -10/09
Pre-Dialysis
Deanne
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« Reply #1 on: December 06, 2010, 11:42:00 AM »
I can't answer your question. I'm still pre-ESRD. Have you considered PD as an alternative since you're having so many problems with your medical team about home hemo? 
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Deanne

1972: Diagnosed with "chronic kidney disease" (no specific diagnosis)
1994: Diagnosed with FSGS
September 2011: On transplant list with 15 - 20% function
September 2013: ~7% function. Started PD dialysis
February 11, 2014: Transplant from deceased donor. Creatinine 0.57 on 2/13/2014
MooseMom
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« Reply #2 on: December 06, 2010, 11:46:23 AM »
Well, I'm pre-dialysis but had my fistula created back in March, so it is ready by now to be used when necessary (which won't be for a long time, I hope! ::) )  I don't know anything about permacaths, but I would think that the only real issue is whether or not your fistula is ready to use.  If it is fully mature, then I would guess you could start using it.  Is your fistula mature yet?
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monrein
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« Reply #3 on: December 06, 2010, 11:51:03 AM »
You'll have to wait for the fistula to mature a bit...ten weeks might or might not be enough, it's quite variable.  Some do go straight to fistula but that's because the fistula was placed well in advance of starting D.  Until you've used the fistula totally successfully for a while, it's important to keep the permacath otherwise you have no access and therefore no dialysis.  You should be using the fistula and not the catheter for home hemo and it's wise for the fistula to have been stuck by experienced nurses before you start self cannulating.  New fistulas can be quite tricky and delicate.  Sometimes with a new fistula, one needle will be in it while the other will use the cath..again a part of the toughening up the fistula.
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Pyelonephritis (began at 8 mos old)
Home haemo 1980-1985 (self-cannulated with 15 gauge sharps)
Cadaveric transplant 1985
New upper-arm fistula April 2008
Uldall-Cook catheter inserted May 2008
Haemo-dialysis, self care unit June 2008
(2 1/2 hours X 5 weekly)
Self-cannulated, 15 gauge blunts, buttonholes.
Living donor transplant (sister-in law Kathy) Feb. 2009
First failed kidney transplant removed Apr.  2009
Second trx doing great so far...all lab values in normal ranges
tyefly
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« Reply #4 on: December 06, 2010, 11:59:51 AM »
  Yes I had to use my fistula for a few months to get it toughen up..... infiltrated many times at first.....  Now I have been using it and sticking my own needles for over 6 months..... never infiltrated at all..... 
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IgA Nephropathy   April 2009
CKD    May 2009
AV Fistula  June 2009
In-Center Dialysis   Sept 2009
Nxstage    Feb 2010
Extended Nxstage March 2011

Transplant Sept 2, 2011

  Hello from the Oregon Coast.....

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Joe Paul
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« Reply #5 on: December 06, 2010, 12:07:15 PM »
My fistula, as some may recall, was only 3 weeks and a day old. A couple battle wounds, I just had it removed but the thrill never left it, rest in peace old friend, you served me well for 5 years.
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