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Author Topic: numbness in arm after fistula placement  (Read 11129 times)
tyefly
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This will be me...... Next spring.... I earned it.

« on: July 20, 2009, 12:34:57 PM »

Hello to everyone....  I had my fistula placement last week in my upper arm and I am experiencing numbness in my lower arm.....  has anyone had numbness after the placement....  my whole lower arm from the bend in the arm to the wrist is number from the incision down to the wrist....  is this normal ...  is this nerve damage....  I am a little worried about the total numbness....and the tingleing that I have in the numb area... I do have the thrill  above the incesion where they hooked the veins together.... I think that is a good thing.....  I am a little worried about the numbness.... its not like its just around the incesion part its the whole lower arm.........  thx kathy


Edited: Fixed error in subject line - okarol/admin
« Last Edit: July 21, 2009, 11:44:57 AM by okarol » Logged

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.....

I am learning to live close to the lives of my friends without ever seeing them. No miles of any measurement can separate your soul from mine.
- John Muir

The clearest way into the Universe is through a forest wilderness.
- John Muir
draven
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« Reply #1 on: July 20, 2009, 01:48:25 PM »

Hi tyefly

I had the numbess after i had my fistula placed, it got better once the fistula matured. i was told this was fairly normal. so long as you have that thrill, everything should be ok :)
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BigSky
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« Reply #2 on: July 20, 2009, 01:53:18 PM »

Sounds like they might have cut the nerves down to the lower part of your arm when they put the fistula in.



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Hemodoc
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« Reply #3 on: July 20, 2009, 03:23:41 PM »

Any skin incision can cut through nerves.  Usually over time that will become less noticeable.

As in any issue with your fistula, make sure you bring up these issues with your physician if it appears concerning.

There is at least one condition that can be very dangerous that can present with numbness.  It is called compartment syndrome but that is usually also noted for severe swelling, pain and loss of blood flood from the excessive swelling.  That would be very unlikely, but once again, you should always check directly with your medical team on any unusual issues.

I had some numbness distal, or below my incision after my fistula. That was just due to transecting the superficial nerves.  It has been nearly 3 years and I don't notice that at all anymore.

Take care and keep your medical team aware of all issues.

Peter
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Peter Laird, MD
www.hemodoc.info
Diagnosed with IgA nephropathy 1998
Incenter Dialysis starting 2-1-2007
Self Care in Center from 4-15-2008 to 6-2-2009
Started  Home Care with NxStage 6-2-2009 (Qb 370, FF 45%, 40L)

All clinical and treatment related issues discussed on this forum are for informational purposes only.  You must always secure your own medical teams approval for all treatment options before applying any discussions on this site to your own circumstances.
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« Reply #4 on: July 20, 2009, 05:10:49 PM »

The doc nerve damaged my wrist trying to put a fistula in.  It hurt like crazy for ages, then faded into the same weird tingling numbness you describe.  Even that has completely gone now, after a couple of years - other than one small spot on the side of my hand.  Yours will hopefully get better, too.  I found that a heat pack helped it a lot, and I still take one to dialysis to put on the numb spot.
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tyefly
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This will be me...... Next spring.... I earned it.

« Reply #5 on: July 21, 2009, 07:18:58 AM »

Sounds like that is my problem with  nerve damage due to the cut on my lower arm next to the bend between the upper arm and lower... I have another cut right above the bend in my arm and another cut down under my arm...Three total cuts...the one that was made on th lower are is where the numbness starts and continures for 12 inches down to my wrist.... no other numbness is felt with the other cuts...  I cut my hand years ago which gave me nerve damage to my index finger and I had that repaird with surgery, it has work fine.  That finger was the same as my arm is now... feels numb and asleep.... but was corrected by surgery... I was told that my nerve would probably reconnect in my index finger but would take years and that is why I had surgery.... it was a workman comp deal even though my insurance company did the repairs.   I really dont want to wait for years to see if the feeling comes back in my arm.... I believe that nerves can be repaired..... I might be wrong...  I am going to talk to my doctor about this and see how my arm is in a few weeks.... But I am glad that for most of you the numbness was gone in time..... That is a good thing....   I did call my doctor yesterday and was able to talk to the nurse about this problem.....she simple told me that this was normal and that most dialysis patients deal with numbness all the time.....I talk to her about the nerve repair that I had done on my finger and she said that they usually dont do any type of repair to dialysis patients.....   again she told me that numbness is normal and I will have more of this......   Scares me to think that...... anyway.....
   All I can do is try to get the best treatment for myself and look at as many options as possible..... Asking questions to me is good..even though I do get the feeling at times they would like you to ask nothing and just do what your told.....  I dont really like to buck the system, but I do like a good explaination as to why .....  and when the answer is    " just because"   my alarms go off.....   But now that I am older and I guess wiser   I try to me more tackful in my approach.....   At least I have learned that after all these years.......
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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.....

I am learning to live close to the lives of my friends without ever seeing them. No miles of any measurement can separate your soul from mine.
- John Muir

The clearest way into the Universe is through a forest wilderness.
- John Muir
Hemodoc
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« Reply #6 on: July 21, 2009, 10:08:30 AM »

Maintaining your independence while in a dialysis unit is very difficult even with an MD after your name.  I had many people retaliate against me simply for wanting them to wash their hands.  Unbelievable as it sounds, this is the reality of many dialysis units.

My solution was to go home.  But even here, you still have to deal with your home dialysis staff.  You will need to know the literature to know when you are getting correct advice as it comes to dialysis issues.  You will need to know what works best for you within the confines of current medical literature always trying to maximize your benefits and minimize your risks. Unfortunately, nephrologists and vascular surgeons often have only a minimal knowledge of the dialysis issues.

For instance, I choose a blood flow rate of 400 in center to maximize my clearances but to keep my pressure readings in the arterial and venous lines below 200.  At home, I am using 370 blood flow and my arterial yesterday was 130-140 and my venous was 150-160.  Theoretically, having a lower blood flow rate should translate into less turbulence in the fistula and a longer lifespan of the fistula.  I have been advised differently, but for me, it appears that I get a high clearance with low turbulence.  It was my own trial and error that set these numbers.  I must confess that in this case, having my MD after my name made it easier to set these limits myself.  The point is that you will need to find people that will work with you and know the issues at hand.

My first dialysis tech had also been my patient for several years, so we already knew each other.  She was simply a fantastic dialysis tech that really knew her stuff.  I learned so many things from her in the 4 months she helped me out before moving that I still use today at home.  If you find someone like that hold onto them and learn everything you can from them.  The way that needles are placed and taken out is very important.  I finally gave up trying to get the techs doing it the correct way that I went and learned how to place the needles and take them out myself.  Amazing as it sounds, I had only one tech that pulled the needles out the same way they went in.  All the other techs hurt coming out as well.  All you have to do is pull the needle out the same angle and direction it goes in.  Well, only one of 10 did that.  I was amazed to find out that it shouldn't hurt coming out as well.

You may want to go through the Kidney School at Home Dialysis Central as a starting point for understanding the basics of good dialysis technique.

You are venturing into a completely different arena where the rules of engagement are different than anything you have ever encountered.  In this world, you must be knowlegeable of all aspects of your own care.  If you find medical people that really know their dialysis stuff, then hang onto them.  At the same time, you will have to listen and learn from these people as well.  For myself, already knowing many things that were right or wrong, it drove me crazy seeing shoddy practice patterns even in the best units.  Nevertheless, for our own survival, we must learn these issues well to know when we have had good or poor care.  It is simply imperative for our own protection in this new world.  I believe most on IHD will agree with this sentiment.
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Peter Laird, MD
www.hemodoc.info
Diagnosed with IgA nephropathy 1998
Incenter Dialysis starting 2-1-2007
Self Care in Center from 4-15-2008 to 6-2-2009
Started  Home Care with NxStage 6-2-2009 (Qb 370, FF 45%, 40L)

All clinical and treatment related issues discussed on this forum are for informational purposes only.  You must always secure your own medical teams approval for all treatment options before applying any discussions on this site to your own circumstances.
Hemodoc
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« Reply #7 on: July 21, 2009, 11:43:48 AM »

Another cause of numbness after arm surgery is from compression injuries to the nerves when the arm is kept stationary for a long period of time.  In this case, diagnosing this early is a must, but usually the treatment is simply time.

Once again, anytime you have anything unusual, you need to be seen and examined by a physician to exclude unusual causes of numbness.  A knowledgeable physician should be able to examine your arm and be able to tell whether it is a superficial nerve or a major nerve suffering from a compression injury which fortunately is rare.

Learn as much as you can, ask questions and keep in touch with your medical team. This is one issue that you can't diagnose over the phone or online.  An exam of the arm in question must be done by a competent physician.
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Peter Laird, MD
www.hemodoc.info
Diagnosed with IgA nephropathy 1998
Incenter Dialysis starting 2-1-2007
Self Care in Center from 4-15-2008 to 6-2-2009
Started  Home Care with NxStage 6-2-2009 (Qb 370, FF 45%, 40L)

All clinical and treatment related issues discussed on this forum are for informational purposes only.  You must always secure your own medical teams approval for all treatment options before applying any discussions on this site to your own circumstances.
tyefly
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This will be me...... Next spring.... I earned it.

« Reply #8 on: July 22, 2009, 09:14:34 AM »

It has been a week since my surgery in placing my fistula... my incisions are healing find with no numbness  around any of the incisions.  However my forarm down to my wrist is still somewhat numb but feels like its on fire.... like a very bad sunburn and is in constant pain. The pain is becoming quiet annoying. Very pain full to even slightly touch it....  just like a sunburn..... My arm is not swollen, not red, and has no rash....  I called my  doctor but he is out and talk to the nurse who said that I may be having a allergic reaction to ..... she didn't say....   I am not clear about that statement.... She told me that I could come in tomorrow and see another doctor who does the same types of surgery.  So I am hope to have some type of direction as to why so much pain.... I have had surgeries before and Yes I know about the numbness in the local area  but Have never had stinging pain like this and this is not even around the incision area....   my Thrill is still there  and I have a big pulse movement where the thrill is located....   So wish me luck... I just hope that this is something that can be easily fix and will not create permanant problems to my arm which I love dearly.......
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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.....

I am learning to live close to the lives of my friends without ever seeing them. No miles of any measurement can separate your soul from mine.
- John Muir

The clearest way into the Universe is through a forest wilderness.
- John Muir
tyefly
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This will be me...... Next spring.... I earned it.

« Reply #9 on: July 22, 2009, 09:55:58 AM »

  reading some of the steal syndrome information on line...   I ran into  a topic on  the websit fistula first  talking about   Ischemic Monomelic Neuropathy....    I do not know the flow rate of my new fistula which means that I do not know the reduction of flow rate to my forearm...  I am thinking that  there maybe too much reduction of flow rate to my forarm and this the   "steal syndrome that they are talking about...   I am not a medical person   and   but I do have a science background so I do understand basic biology  and   well   I know that this pain that I am having in my lower arm is not right..... I either have a nerve problem  or blood flow problem or both... this is something that I will not be able to just get use to..... as the pain seem to be worst everyday....
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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.....

I am learning to live close to the lives of my friends without ever seeing them. No miles of any measurement can separate your soul from mine.
- John Muir

The clearest way into the Universe is through a forest wilderness.
- John Muir
tyefly
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This will be me...... Next spring.... I earned it.

« Reply #10 on: July 25, 2009, 11:12:35 PM »

 did go back to the surgeon who placed the fistula and he told me that I had a agitated nerve..... I asked why I feel so much pain in a area that is not even close to the incision.. He told me that my nerve is mad..... my pain is now a burning like a really bad sunburn or when you burn your self getting something out of the oven and you hit the top rack.... When I touch it, it feels like a burn..... really hurts at the surface. I do notice that when I place my arm in a vertical position it hurts more..... So He said that it should go away in a few weeks.... but he said that sometimes when he does surgeries he will have to go in and cut the nerve and just make that area numb.... and remove the pain..... I ask him about nerve surgery repair.....he said that can not be done.... I told him that I did have nerve repair on my finger when I cut my hand really bad a few years ago....he told me that was different as You need to have feeling in your finger..... But he reassured me that I did not have steal syndrome and That is a good thing.... I have plenty of blood going to my hand...... My fistula is buzzing away...... incisions are healing nicely......no pain in the fistula part and no pain around the incisions.... lots of feeling around those areas too.... So I will wait a few weeks and hopefully the burning pain will go away.......The numbness is the lower part of my arm doesnt botter me.... its the burning pain that really hurts.. The nerve pain is like  I have a really bad sun burn   or I burned myself getting something out of a oven and hit the top rack....  we have all done that ..... that hurts.....  What a baby I am .....
   I have never had nerve pain like this before.... the burning is really bad....
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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.....

I am learning to live close to the lives of my friends without ever seeing them. No miles of any measurement can separate your soul from mine.
- John Muir

The clearest way into the Universe is through a forest wilderness.
- John Muir
Hemodoc
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« Reply #11 on: July 26, 2009, 10:10:16 AM »

Glad to see you were able to see your surgeon and have his impression.  He is likely correct that things will improve over time.  If not, there are things that can be done including certain medications.  Simply ask your surgeon for all alternative treatment options if if persists.  Good luck and i am glad you have an access developing well.  Use this time to get up to speed on the issues of transplant and dialysis as much as you can.  Once again, Home Dialysis Central has a Kidney School that is very helpful.
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Peter Laird, MD
www.hemodoc.info
Diagnosed with IgA nephropathy 1998
Incenter Dialysis starting 2-1-2007
Self Care in Center from 4-15-2008 to 6-2-2009
Started  Home Care with NxStage 6-2-2009 (Qb 370, FF 45%, 40L)

All clinical and treatment related issues discussed on this forum are for informational purposes only.  You must always secure your own medical teams approval for all treatment options before applying any discussions on this site to your own circumstances.
Buzzard97
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« Reply #12 on: January 23, 2018, 09:32:56 PM »

Bump...

Numb arm... check!
Cold hand... check!

Relieved that it is a ďnormalĒ side effect from the av fistula... check!
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Michelle2016
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« Reply #13 on: February 22, 2018, 05:57:05 AM »

After fistula placement on my left arm, I have had partial numbness of my left arm since. I know it was from the fistula placement. It it didnít affect my arm movements. I left it alone.

 For about one year, I have a frozen shoulder. Then I have numbness on my left arm every time when I sleep on my left side. I know itís from nerve pinching due to the frozen shoulder. I left it alone.
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PrimeTimer
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« Reply #14 on: February 23, 2018, 06:53:46 PM »

After fistula placement on my left arm, I have had partial numbness of my left arm since. I know it was from the fistula placement. It it didnít affect my arm movements. I left it alone.

 For about one year, I have a frozen shoulder. Then I have numbness on my left arm every time when I sleep on my left side. I know itís from nerve pinching due to the frozen shoulder. I left it alone.

My husband's fistula is in his left arm, just above the elbow. He was told never to sleep on that arm to avoid putting pressure on his fistula. Took him a while but he got use to it. Another example of avoiding pressure is believe it or not, the winter coat he wears. He drives himself to/from dialysis. One time after getting home and removing his coat we discovered his fistula had re-opened and bled thru the gauze. We figured his thick coat had bunched up near the elbow area and put pressure on his fistula while he was driving. He wears a thinner coat now to/from dialysis.
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Husband has ESRD with Type I Diabetes -Insulin Dependent.
I was his carepartner for home hemodialysis using Nxstage December 2013-July 2016.
He went back to doing in-center July 2016.
PattyTricia
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« Reply #15 on: February 27, 2018, 09:02:02 PM »

I have permanent numbness because my surgeon hit a nerve. I had very small veins and he told me it was a possibility. My fistula failed after 4 days and I now have a graft. I have learned to live with the numbness.
Patty
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