fistula

[Marley]

Hello everyone--this is my second post and I wasn't too sure where to put it. 

My hubby was scheduled last week to get his left arm ready for dialysis, he is currently using his right arm, which has a bovine.  He also has serious heart problems.  On the morning of surgery, his chest started hurting bad enough that he needed a nitro pill.  He had to take one more until the pain got under control.  He called his doctor to tell him what happened, thinking "nothing to eat or drink after midnight" and "I better tell them about the nitro"........ and his surgeon cancelled his surgery and he is going in to see his cardiologist tomorrow morning (this morning, I mean) to get a "cardiac clearance" and then he can have surgery.  A little history:  He is currently on hemo almost 3 years now and has developed a very large annurism on the inside of his elbow that everyone is worried about.  It didn't help when one of the techs told him a woman had one just like his and during her dialysis one day, it burst and she died right in the clinic!!  Thanks!!  Anyway, his nurses have been trying to get his doctor to have a vascular surgeon take care of it and once he gets his heart checked out, he can have surgery again. The plan was to disconnect the blood flow to the annurism, create a fistula on his left arm and put in a pick line in his neck so clinic can use that for dialysis.  Two weeks ago he was talking to his nurse and told her when his surgery is and told her about the pick line.  She freaked out!!  She told him you cannot have a pick line, that would be desasterous!!  He had MRSA staph infection last summer--what started out what we thought was a boil turned into one mess~~
After a few days of IV antibiotics not working, a surgeon debraded his leg and they added another antibiotic and he did get better.  I didn't know pick lines become infected easily--that's what his nurse told him.  She called his surgeon and told him about the MRSA and her worry about the pick line.  The surgeon agreed and he was just going to set up his left arm for dialysis---until the chest pain.  So, they will continue using his right arm being very careful until his left arm is ready, we're hoping sometime SOON!!!  Then, once he is using the left arm, the surgeon will take him back into surgery and disconnect the annurism.  It will be nice to not be so worried about it, it is so big that people stare at it. 
What bothered me about this whole surgery thing and the pick line is this:  shouldn't his surgeon have already known about the MRSA???  I mean, he was going to do surgery on my man without knowing his whole history?  Incredible!!!  Who's fault is this???  The clinic?  The surgeon?      

[G]

Hey Marley,
Wow, what a pain in the arse eh? Good questions. Pick lines can become infected fareley easy. However, like everything else, it is up to the individual circumstances. I have had at least 8 perm-cath’s and only one infection. Who is at fault you ask(?) Doctors sometimes get so busy they fail to read the whole chart. For that…they are to blame. I had an emergency room doc get mad at me because I failed to tell him I had no spleen! And that was after I brought with me a document that briefly showed my medical history! All this at a hospital that I had visited 6X in the previous year! As for your husbands dialysis clinic(?) If they knew of your husbands heart condition (as they should), they are way out of line scaring him and you in that manner. Everyone needs all the information they can handle. However, it is all in the method in which it is presented. You need to contact whoever is in charge! As for the surgeon(?) You should seriously express all your concerns with him and let him know you expect more from him than you have received. If you haven’t already, discuss all these details with your husband so you can both be on the same page with your expectations and ultimate goals. I’m no pro, just a veteran patient with an attitude. The best thing you and your husband can do (and it sounds like you’re on the right track) is be proactive and never, NEVER, be afraid to ask WHY, WHAT, WHERE and HOW!
Good luck and stay strong
G