Fistula surgery

[dkerr]

Saw my vascular surgeon today.  He said my fistula was doing great but mentioned doing surgery to bring it closer to the skin surface.  Said it would bring it a couple of millimeters below my skin surface.  Also said it would make dialysis easier.  The scar line would indicate where the vein was and would allow access without pain.  Anyone hear about this before?

[okarol]

I have heard of this kind of surgery where the vein is too imbedded to use.
It seems like this would have been a good thing to do the first time he performed surgery. Didn't he do vein mapping first?

[dkerr]

They did a sonogram.  I'm not sure why not first.  Maybe to see how it went first ... I don't know.

[monrein]

http://www.springerlink.com/content/01ee2mxy8ry4y88e/


I found this article and there is more if you Google "av fistula too deep".

[dkerr]

 :Thanks ...  At 188 and 5'9 I know I'm overweight, but it refers to obese individuals which makes me laugh since I wanted to pop him one  this morning as he grabbed my 58 year old sagging arm and said I needed to get more of it off .... sigh.


Fixed Stik Icon: Boxman, Moderator

[flip]

A deep fistula can present a problem because, once the needles are in, they are basically horizontal. The closer to the surface, the easier the sticks are and much less painfull.

[Joe Paul]

I have known a couple patients at my clinic, who have had the same surgery. Before the surgery, infiltration was common, as the fistula was very deep and hard for the techs to find. After the surgery, healing and exercising the fistula, they said it has been a world of difference. No more "fishing" for the fistula (pushing, pulling and twisting the needles) and the dialysis runs much smoother with less alarms due to poor flow. I think you are fortunate your surgeon wants to bring your fistula closer to the surface, it should save you lots of pain when you do have to start dialysis (assuming you haven't as of yet).

[Earlinda]

I am one of those people who have had this procedure.  My fistula was created in October of 2003.  It was located very near the bend of my left arm which I am assuming that the mapping indicated that this was the best placement for me.  In June of 2004 after the fistula had a chance to develop I had the surgery to move the vein closer to the surface.  It was an incision that went from right above my left elbow to right under my arm.  It is a long curving scar but isn't that bad.  The surgeon was very good and I have had no problems with it after 4 years and 4 months.

[dkerr]

Thanks . . . mine is an upper arm fistula as well.  I think I'll go for it.

[devon]

Good luck this time DKerr! 

I hope it goes well and makes your Fistula more easily accessible.

-Devon

[dkerr]

Devon - Thanks for your posts.  Your down the road just ahead of me and you are setting a great example . . . thanks for your positive encouragement.

[devon]

So DKerr!  What's the latest?  I hope it's going well.

-Devon

[dkerr]

Friday was my last day as the secretary at the job I've held for the last 13 years.  I've been training my replacement for more than a month.  I will work as kind of a floater until dialysis starts.  The plan is that I will meet with my kidney doc again on the 17th and schedule surgery to move my fistula closer to the surface at that time and start dialysis two weeks later. 

I am taking a trip to Utah to see my daughter early in November.  Its been a trying month and an emotional one.  But, I am moving onward.  Thanks for asking Devon.

[devon]

I am not a doc, of course, but doesn't the fistula need time to mature after the surgery?  Two weeks seems a short time between the two events.  In my case, they figured 4-6 months to allow it time to mature.

Best of luck DKerr!

-Devon

[Joe Paul]

I am not a doc, of course, but doesn't the fistula need time to mature after the surgery?  Two weeks seems a short time between the two events.  In my case, they figured 4-6 months to allow it time to mature.

Best of luck DKerr!

-Devon

Mine was used 22 days after it was put in.

[devon]

Did you have any problems with the fistula, Joe Paul?  Did anyone say anything about it being "mature" enough? 

Granted, I had the opportunity to wait out the time for it to mature.  I had my surgery in March and started dialysis in August.  It was still considered "new" and I'm still waiting for it to be 100 percent. My poor bruised arm is evidence of that!  LOL.

[kimcanada]

I have never had a problem with my fistula, and I waited 8 weeks,  I then used it for a year with little to no problems...  then I was on home dialysis for 5 months, and now that I am back on the fistula, it is working amazing!  I am getting pump speeds of 500, I think that it needed even more time to mature