does anyone have a leg fistula

[hephziba]

I was on Ca pd last time I wrote, I got peritonitis twice in a short space of time and was forced to have the tenkoff catheter removed and sent back to Hemo, this time however it was much better for me, My time slot has been 7am 3 times a week which is really cool cos i am half asleep and manage to miss most of the session, Ive taken control of most of my treatment and set myself up to come off and plug my own heparin in and am gradually being taught to program my own weight. uf ect onto the machine.

so just as I am getting settled and my wife is enjoying the regular four hour break from me I finally get my appointment with fistula surgeon only to be told that the fistula gram has shown both of the main veins in my arms are blocked or scarred, I will never be able to have a fistula in my arms.. and as a result I am being sent back to pd. I asked what would happen if I got peritonitis again and was told leg fistula and the Dr then mumbled something about nasty scar removal of a vein and to young..

sorry for the length but just thought to give some history, so does anyone have a leg fistula or experience of one?

I mean obviously I'm hoping pd will last much longer than six months this time round, but if It doesn't id like to know what I am in for..

Hephziba.

[goofynina]

Hey Heph,  Good to see you back, glad you are doing ok, sorry to hear about your peritonitis, hopefully it will work this time around, i (we) will be praying for you   Tell the "little lady" we said hello and hope to see you back here again soon,   

[Bajanne]

Best wishes for a wonderful 2007.  We are glad to be in contact with you guys again.  Our best wishes and prayers are with you and this present challenge you are going through.  But we know that "He is able".

[Joe Paul]

Good luck, and Gods Speed! Hope this all works out   

[charee]

Welcome back Hope things get better for you soon. I can't help with info about a leg fistula but i think Redheaded Angel had one She hasn't posted for awhile but maybe you could do a search as i think she mentions it in some post. Sorry I'm not much help. 

[Ohio Buckeye]

Good to hear from you again.
Have been wondering about you.
Hope pd works out for you and hope that transplant comes for you soon.
Happy 2007.

[angieskidney]

WOW! I really feel for you Hephziba! I mean, I have so many fears of them telling me that I have too much scar tissue in my arms but so far my fistula (2nd one) is working great! I would hate to ever have on in the leg but if you do eventually have to have one, you might be highly interested in checking out the accesswear site that I got my sweatshirt at. They have pants with a zipper so you would not have to strip down or wear shorts.

Hopefully your PD goes well this time around but I wanted to ask you, do they know what caused the Peritonitis (prounounsed as peh-rit-oh-NYE-tis incase anyone doesn't know)? If you know the cause it will be easier to prevent! When I got my Peritonitis it was so bad that I can't do PD anymore. There are only so many times you can get Peritonitis before you won't be able to do PD anymore. Your Peritoneal Lining can only take so many infections.

Some advice for Peritonitis infection can be found here:
http://www.springerlink.com/content/valh398fgeqmtx4g/

Abstract  Methods to prevent peritonitis are an essential component of any successful peritoneal dialysis (PD) program. Careful attention to training of the parents and child on the proper technique of PD and avoidance of manual spiking by using an assist device for the cycler, or use of the double-bag system for continuous ambulatory PD, should decrease risk of peritonitis from touch contamination. Secondly, reduction of peritonitis can be achieved through reduction of exit site infections by use of mupirocin antibiotic cream at the exit site of the PD catheter as part of routine care. If an exit site infection develops and is refractory to therapy, then the PD catheter can be successfully replaced as a single procedure, to reduce the risk of peritonitis. The third step in reducing the risk of peritonitis is to avoid repetitive episodes with the same organism. This may again involve replacing the catheter; as long as the effluent can be cleared, this again can be performed as a single procedure, thus allowing the child to avoid the trauma of hemodialysis. The focus in pediatric PD programs must always be on preserving the peritoneal membrane, and not on preservation of the catheter. With careful attention, peritonitis can become an uncommon event.

I know that is meant for children on PD but I didn't know before I read through it myself

http://www.upmc.com/HealthManagement/ManagingYourHealth/HealthReference/Procedures/?chunkiid=11626

Peritonitis is a serious condition. It requires immediate treatment. If not promptly treated, it can be fatal.

Causes
Primary peritonitis--occurs when there is a buildup of fluid in the abdomen. This is called ascites. It is caused by chronic liver disease, among other conditions.

Secondary peritonitis--caused by bacteria that enter the abdominal cavity. Can be due to an injury or a condition, such as a ruptured appendix..

And when it comes to a Leg Fistula have a look at these links:

http://www.therenalnetwork.org/images/access_booklet2000.pdf

Do not cross your legs if you have a leg AV Fistula

http://www.davita.com/bbs/archive/index.php?t-728.html

http://secure.facs.org/spring_meeting/2004/gs02scher.pdf for this one start at page 36 since that is where they first make any mention of the femoral (leg) AV Fistula.

Which brings to mind another question. Did they say it will be a thigh graft or a femoral fistula?

You can also do a search for:
GSV-CFA AVF
which means greater saphenous vein to common femoral artery loop arteriovenous fistula

I got that term from here: http://cat.inist.fr/?aModele=afficheN&cpsidt=15747128

The GSV did not increase significantly in diameter. Use of a GSV-CFA AVF for dialysis access has acceptable results for alternate-site hemodialysis access. Secondary procedures were common.

[angela515]

Why did they take your catheter for PD out after your peritontis? Was it b/c your cath no longer worked? If so, why didnt they just re-insert a new one then? I have had peritonitis 3 times, the first time was the first day of PD training, they told me it was probably dormant in me and the diialysis solution probably activated it. The second time was a year later, and they didn't know what caused that. The 3rd one was directly after the 2nd one and they said that was probably from the 2nd one not being completely gone. However even though I had it 3 times, I never had to stop PD. Whew!

I totally understand your situation with the hemo access though. The main reason i started looking for other dialysis options to begin with was because I had a chest cath for my hemo access b/c I can no longer get a graft or fistula in either arm b/ of scar tissues and vien problems and old non-working access's already there. I was told next time I get an access for hemo other than a chest cath they will be putting it in my thigh. Thats when I found PD and switched to that b/c the thought of an access in my thigh just freaked me out. Of course if I can no longer do PD anymore, I will most likely get the access in my thigh and hope it works well b/c I *HATE* chest catheters with a passion.

I'm sorry I can't be of more help, but if you have to get one before me, let me know how it works out, I'll do the same.

[hephziba]

Hi, From the first month I had the tenckoff catheter in I had exit site infection called psudimonus(not sure of spelling) they decided that was the cause of the peritonitis so removed the line as after months of antibiotics they couldn't kill the exit site infection.

I actually prefer the permcath to the pd catheter I find the hemo one really discreet

hephziba

[angieskidney]

Why did they take your catheter for PD out after your peritontis? Was it b/c your cath no longer worked? If so, why didnt they just re-insert a new one then? I have had peritonitis 3 times, the first time was the first day of PD training, they told me it was probably dormant in me and the diialysis solution probably activated it. The second time was a year later, and they didn't know what caused that. The 3rd one was directly after the 2nd one and they said that was probably from the 2nd one not being completely gone. However even though I had it 3 times, I never had to stop PD. Whew!

Was that addressed to me? I had to switch because my Peritonitis was the worst case they had seen in 20 years. I think because they couldn't find the cause (something lying dormant like you said) they didn't want to risk it.

[hephziba]

Hi yes my last reply was to you,

well I had my tenckoff catheter inserted two days ago, and feel a bit sore and bruised but other than that recovering nicely.

I was a bit angry with them though, when I came round, I discovered the new exit site was not covered. O would I have breathed fire if it had got infected because of them......

I was also suffering from a completely dry mouth for the first twelve hours after the op as they didn't give me a drip during surgery an anathetic drys you out some...

anyway lines in 4 weeks and ill get my new cycler machine and equiptment .

Blessings

Heph

[goofynina]

Hey Heph,  glad to see you here and posting (even if it is a quickie)   at least we know you are doing allright, and that is all that matters, that YOU are allright    Keep us posted on how you are doing and tell the "Little Lady" we miss her too