fistula veins and arteries.....

[tyefly]

   Ok    I have got a question......   I had my fistula looked at by the surgeon  and he said that it is ready to go after 6 weeks.....  so I guess I can use it now...   I ask him  how will someone know where to stick both the needles.....    he said that they will   and they will probably stick them here ( pointing to a area ) and then stick the there ( to another area...)   these areas are with in a inch or maybe  a inch in a half of each other....  its that too close to gether..... also... He said that we only stick the vein.... never the artery.... So both needles will go in to the vein.....   I thought that we stick the artery and a vein... so that we can get arterial pressure amounts and venous pressure amounts....    I guess I don't get it.....  Do we only stick veins.....    and how far apart should they be..... 

[tyefly]

sorry   wrong  place  to post


Moved to correct topic
Rerun - Guest Moderator

[Rerun]

The whole thing you see is a vein.  A fistula is when they connect an artery to a vein.  That way the forceful artery blood goes into the vein and makes it expand creating an access for you to dialyze with needles.  You will be amazed how they fit 2 needles in and how they find a new spot everyother day.

[Ang]

i sometimes  have  my  needles  kissing,  there  that  close(1 up 1down),never  had  a  problem thus,  i  find  it  good  so  when  you  hold  you sites  you  have  some  wiggle  room  if  you  fingers  get  tired  or  cramp

[tyefly]

   So   when a person is talking about  sticking their venous   and how sometimes their venous is hard to  stick.....   what makes it a venous and why would it be harder to stick..??     
 
   is it called a venous because that is where the blood comes back.....  and the arterial still the same  vein but it where the blood comes out....

  Sorry about the really dum question .... I just had a completely different picture in my head.....

[willowtreewren]

There are no dumb questions!

The arterial stick is the one that has the blood coming FROM the body into the machine and the venous stick has the blood coming FROM the machine into the body. The arterial stick is lower on the fistula and the venous is higher.

I hope that helps.

Aleta

[dwcrawford]

So why is the highest one on the arm (venous?) the hardest for them to stick and the most painful?  And why does it sometimes have a burning sensation during the dialysis?  And why won't they let me press on it to relieve the buring?  And why  does it go in too far sometimes and you can feel the stick (on the other side I think)? 

And the surgeon made them a picture of it with depths, etc. so why didn't they look at the picture?

Well, at least mine is working now -- a full week now and it hurts a little less each day.  Maybe I am becoming a "Man" about this?

[silverhead]

If you reversed then Venous and Arterial lines you could get a loop of  the returned blood being pulled back into the machine endlessly.  Venous blood is going back to the heart for recirculation so you want it closer to the heart.....

[tyefly]

     Thx  guys...... sometimes it is   just that easy.......     Sometimes I can make things harder than they need to be.....   too much time on my hands.....

[monrein]

So why is the highest one on the arm (venous?) the hardest for them to stick and the most painful?  And why does it sometimes have a burning sensation during the dialysis?  And why won't they let me press on it to relieve the buring?  And why  does it go in too far sometimes and you can feel the stick (on the other side I think)? 

And the surgeon made them a picture of it with depths, etc. so why didn't they look at the picture?

Well, at least mine is working now -- a full week now and it hurts a little less each day.  Maybe I am becoming a "Man" about this?

The venous is often deeper, sometimes way deeper, than the arterial because the vein that becomes the fistula (once they hook the artery into it during fistula surgery) is closer to the surface in certain spots and deeper in others.  This is especially true for an upper arm fistula.  A picture of the depths is useful but sticking still requires some experience with the feel of the vein and the gauging of the depth by feel.  That's why it takes skill to become a good sticker and why you need someone with excellent skills to teach a patient or a new tech how to develop this skill to insert needles.  If a fistula is too too deep then surgery can be done to raise the thing closer to the surface.   Pain depends on nerve endings and the deeper a needle must go the more chance of running into nerve endings.  Over time, pain can lessen as scar tissue has less sensation than fresh flesh.  I think the burning is the nerve ending saying "hey bud, what's with all this abuse and assault?"  Enflamed nerves can feel like burning.  When or if you rub the area, there's a needle in there and you run the risk of sending the point through the fistula wall which will "blow" or infiltrate the vein, sending blood into the surrounding tissue (big bruising).

I don't understand what you mean by "go in too far sometimes and feel the stick on the other side".  If you stick the needle in too far, meaning you go into the vein and then out the other side, well that's just a bad stick and your vein is "blown".  In the beginning the fistula is tender and can blow quite easily but it toughens up as it gains experience...much like us people.

[tyefly]

   Thx  Monrein...... you always have a nice way of describing things.....   The surgeon did not give me any idea how deep or anything,,, he just took a look and did some feel and said its good to go....... I ask him where he thought someone should stick me first...... he said  into the vein .....   and smiled..... he said do worry they know what they are doing......   and he left...... so I am hoping when its my turn for my first stick.... I will have someone who is good and not just saying they are good......
       thx again