Fistula Questions.....

[Cordelia]

So I'm gettine a fistula on Monday morning, bright and early, 8 am my surgery is scheduled-I have to be at the hospital for 6 am sharp.

I have a few questions......maybe some of you can help me......I can't seem to get through to the renal clinic-a HUGE frustration to me since there are so-called cutbacks (what else is new) and  since no one is in the clinic MOndays and Tuesdays and then Wed thru Fridays they are only IN for half the day           I called today, left a voicemail message TWICE and nobody called me back                      

Anyways, what kinds of limitations will I have and for how long? I DO know I can't lift anything more than 10/15 pounds......can I bathe/shower? Or am I restricted on that for awhile too and if so, which I'm sure I can't for a few days likely.....how long specifically? I think the stitches I'll be getting are dissolveable, which I prefer........

Oh, and I'm wondering, will typing on the keyboard be a big concern? I love to write via using a keyboard on the PC in my free time and I'm just concerned I may be told I shouldn't be typing.....anyone here told or realized they couldn't do much typing post surgery?   I'm assuming pain might be an issue and I guess maybe its hard to guage that since everyone is different.

I'd love to know these things .........what your experiences were......

I'm hoping I will be out by mid afternoon if all goes well. How much time does one usually spend in recovery, does it really vary?

Thanks for answering all, or some of my questions     

I guess if I'm not around here much next week, post Monday....... it means I'm in a lot of pain post surgery and can't tolerate the typing. I'm stubborn and I may go crazy without being able to be on the PC much or hardly at all       

[fearless]

Hi, I'm assuming the fistula is in your wrist area?  If so, I can give you my experience:  it was OK.  Hey, surgeries never fun, but I went in in the morning, needed to have someone with me.  Woke up afterwards and was driven home by my friend.  It was later that evening that i realized it really hurt.  I took some pain killers, but I don't do well with those, so i only took 3 out of 30.  It was really not bad after a couple of days.  Then it just looked better and better.  I don't think it was very long before i could shower as usual.  I would put a waterproof bandage on it for good measure (and when I was facing the public, since it looked kinda Frankenstein for a while.

The fact that the memory has faded tells me it was inconsequential.  Make sure the person who's with you writes down any instructions, because even if you think you got it, you didn't! 

And exercise, exercise, exercise that fistula!

cheers

[Cordelia]

Hi Fearless, thanks for sharing!  Yes, I'm getting mine in my left wrist.

How soon before you start excercising it? I was advised two weeks..does that sound right?

I know you're not supposed to wear bracelets or nothing 'tight' around your wrist, but can you loosely wrap a bandana around it after a few weeks? If I'm out in public, and not wearing long sleeves, can I cover it loosely? Does anyone do that, I'm also afraid of looking like Frankenstein       

[fearless]

hi again,

my doctor told me to start exercising right away!  But whatever your doc says, that's what you should do.

I like the bandana idea -- i might use that myself!  Yeah, I don't want to wear any bracelets or anything that would irritate or injure my fistula.  But it really doesn't look bad anymore.   

[Cordelia]

Hi Fearless              I saw one at a dollar store the other day and thought, oh, that might not be such a bad idea to wear, just loosley wrapped around my wrist. I'll likely never wear it to my unit or I'll get in crap for doing so. (They already told me not to have anything 'tight' on it)     As long as I don't cut off circulation, I'm thinking it might be a not bad idea-I hope     

I've already mastered wrapping it around to see what it will look and feel like.          Since I can't use both hands to wrap, I've already mastered how to wrap it around with a little help of my teeth since I can only use my right hand     

[Riki]

I have an upper arm fistula, but I'll tell you what I remember.  I had my fistula surgery on a thursday, and I was at my cousin's wedding that saturday.  I had a sling, just to support the arm, I think, and I was prescribed tylenol 3's for the pain.  I didn't have a whole lot of pain, but what little I did, made me tired.  I still had my line in, so I don't know about the shower thing.

[Cordelia]

I never thought of a sling if its in the upper arm. I have neck issues, I hope that wouldn't pull on my neck if I ended up having to have one.

[fearless]

i see that you are doing hemo - how are you doing that without a catheter or fistula?

regarding the bandana: you have special talents!  Once i made a bracelet by taking a piece of felt and simply putting snaps on it.  Very soft and not tight in any way.  Then I was planning to sew beads and stuff on it - but i never got around to that!  i found it in an old jewelry box a few years ago and the snaps were rusted.  I'm thinking about trying to make a new one.

[MooseMom]

You will probably get a list of post-op instructions before you leave the hospital, and that will give you a better idea about showering, etc.  Having a fistula created is no different from having any other procedure where there is a wound.  I would imagine that the surgeon will not want you to get the bandages wet, so I would think that once the bandages are removed, showering would be ok.

As for pain control, the very best thing to do is to take your pain pills before pain really sets in.  It is much easier to control pain before it gets bad than it is to dampen it once it gets ahold.  My fistula is further up my arm, so I hesitate to tell you anything because it may be different than what your fistula will feel like.  But as a general rule, the pain from the wound is pretty minimal.  I had more trouble with weird nervy sensations for up to 8 months afterwards.

As for exercise, my understanding is that you should wait a couple of weeks until the wound itself heals, then you can begin exercising.  Get specific instructions from your vascular surgeon.  Both my surgeon and my neph told me not to bother doing special exercises.  My surgeon told me to use my arm as usual and not to favor it.  The more you use the arm in every day activities, the better the blood flow will be.  Both docs told me to "ignore it", and that's a direct quote.  Again, you want to use your fistula asap, whereas I have not had to use mine yet, so I was in no hurry....our circumstances are different.

I see no problem with having some sort of loose fitting bandana type decorative thingy on your wrist.  You know that the whole idea is to keep the blood flowing and not to restrict it by something tight.  You're not stupid...you know what is OK and what is not.

I think you should be able to type as soon as the numbness wears off and you can move your fingers well enough to type something coherent.

[mcclane]

My fistula is in the left bicep.

I was told about 6 weeks after the surgery not to lift anything too heavy, 10 pounds - ish.  I wound up using my right arm for most of that period.

I showered that evening, I had my wife saran wrap the whole left arm, and I showered around it, trying hard not to get the saran wrap wet.

I think it was around 2 weeks before I showered with saran wrap.

If i remember correctly, they use steri strips to hold the wounds together.  I had abit of an infection in the bicep area, but the nurses at home hemo took care of that.

The only thing the hospital told me not to do for about 6 weeks is lift anything heavy, so you maybe able to type, worse case senario you use one hand and to the peck on the keyboard. 

They wrote me a prescription for T3s, i never got 'em filled out, i just grinned and beared it.

They kept me in day surgery for observation for about 4 hours.

[Traveller1947]

Hi Cordelia!  Best of luck with your fistula surgery!  I have a graft, but I would think the same advice applies for either.  Don't lift anything heavy, that's an obvious one, as is don't get the wound wet.  I put a waterproof bandage over it to bathe for the first couple of weeks.  Don't wear anything tight on that arm--you won't want to anyway, but no harm in a loose-fitting bandana or a felt cuff, as fearless suggested.  Typing shouldn't be a problem--if it hurts to type in the beginning, use one hand.  Time in the recovery room varies, of course.  They kept me four hours, but it's often two, people tell me.   As for pain--it hurts a lot that first night.  For me it felt like a really bad burn, but I have a graft.  It may be different with a fistula.  The pain got less and less and by the end of the week I wasn't bothered by it at all.  Thinking of you on your journey...

[Cordelia]

i see that you are doing hemo - how are you doing that without a catheter or fistula?

regarding the bandana: you have special talents!  Once i made a bracelet by taking a piece of felt and simply putting snaps on it.  Very soft and not tight in any way.  Then I was planning to sew beads and stuff on it - but i never got around to that!  i found it in an old jewelry box a few years ago and the snaps were rusted.  I'm thinking about trying to make a new one.

Oh shoot! I'm sorry LOL     I should have explained.....I've been doing in center hemo .....I have a central cath. That's how I've been doing hemo for over a year. That's an awesome idea with the felt too, Fearless, I will definitely keep that in mind too as an idea! Thanks for your compliment! I couldn't believe that I was knotting the bandana with my teeth! LMAO!          I was pretty impressed I was doing that and got it on the first try! LOL

MM, I want to take painkillers and I know they'll want me too. Even though I eat a lot of greens, etc, the T2's and T3's constipate me horrible-I may have to ask for a really good laxative I think!        You reminded me with the mention of that I need to ask for a script for laxatives.   If my posts are short everybody will know I'm typing with one hand-I may not be too coherent        I can type 72 wpm with 2 hands, not sure how fast I can type with one, I'll take it easy and take my time   

Mcclane, did you have complications that they kept you 4 hours? I found out today a nurse told me I should be out by noon if no problems. My surgery is booked for 8 am.  I sure hope they don't keep me all day!          

Traveller1947, thanks for your best wishes         I am expecting it to hurt a lot the first day or two......like you, I hope my pain tapers off by the end of the week!

You all are so helpful with your advice/insight!     

[mcclane]

i see that you are doing hemo - how are you doing that without a catheter or fistula?

regarding the bandana: you have special talents!  Once i made a bracelet by taking a piece of felt and simply putting snaps on it.  Very soft and not tight in any way.  Then I was planning to sew beads and stuff on it - but i never got around to that!  i found it in an old jewelry box a few years ago and the snaps were rusted.  I'm thinking about trying to make a new one.

Oh shoot! I'm sorry LOL     I should have explained.....I've been doing in center hemo .....I have a central cath. That's how I've been doing hemo for over a year. That's an awesome idea with the felt too, Fearless, I will definitely keep that in mind too as an idea! Thanks for your compliment! I couldn't believe that I was knotting the bandana with my teeth! LMAO!          I was pretty impressed I was doing that and got it on the first try! LOL

MM, I want to take painkillers and I know they'll want me too. Even though I eat a lot of greens, etc, the T2's and T3's constipate me horrible-I may have to ask for a really good laxative I think!        You reminded me with the mention of that I need to ask for a script for laxatives.   If my posts are short everybody will know I'm typing with one hand-I may not be too coherent        I can type 72 wpm with 2 hands, not sure how fast I can type with one, I'll take it easy and take my time   

Mcclane, did you have complications that they kept you 4 hours? I found out today a nurse told me I should be out by noon if no problems. My surgery is booked for 8 am.  I sure hope they don't keep me all day!          

Traveller1947, thanks for your best wishes         I am expecting it to hurt a lot the first day or two......like you, I hope my pain tapers off by the end of the week!

You all are so helpful with your advice/insight!     

I had no complications, except that i was hungrier than hell because they didn't want me to eat anything past midnight (I think mine was 8 am too).  They just kept me around for 4 hours, I believe it was hospital policy.

when my fistula was put in, I already booked 1.5 months off from work as medical leave (for home hemo training).  Next day after surgery, I went down to the unit to continue my training. 

I'm not sure how much sedation they will be giving you, but they didn't give me enough.  I was 3/4 concious for my fistula surgery, so I first felt the surgeon dig around in my forearm, then when that didn't work out i felt him dig around in my bicep. 

[Cordelia]

That'll be me too, Mcclane, hungrier than hell!                

Yup no eating or drinking after Sunday night for me, only tiny sips of water for my pills the next morning     

[mcclane]

That'll be me too, Mcclane, hungrier than hell!                

Yup no eating or drinking after Sunday night for me, only tiny sips of water for my pills the next morning     

that's one thing i dislike about these day surgeries, it really throws off the appetite. 

[Cordelia]

That'll be me too, Mcclane, hungrier than hell!                

Yup no eating or drinking after Sunday night for me, only tiny sips of water for my pills the next morning     

that's one thing i dislike about these day surgeries, it really throws off the appetite. 

Well, maybe if I lose a pound from fasting for surgery, I won't mind   so much then          

[mcclane]

That'll be me too, Mcclane, hungrier than hell!                

Yup no eating or drinking after Sunday night for me, only tiny sips of water for my pills the next morning     

that's one thing i dislike about these day surgeries, it really throws off the appetite. 

Well, maybe if I lose a pound from fasting for surgery, I won't mind   so much then          

hmmmm, since going on home hemo i've gained about 8-9 kilos, and that isn't fluid weight either.  maybe i should sign up for 9 day surgeries then 

[Cordelia]

That'll be me too, Mcclane, hungrier than hell!                

Yup no eating or drinking after Sunday night for me, only tiny sips of water for my pills the next morning     

that's one thing i dislike about these day surgeries, it really throws off the appetite. 

Well, maybe if I lose a pound from fasting for surgery, I won't mind   so much then          

hmmmm, since going on home hemo i've gained about 8-9 kilos, and that isn't fluid weight either.  maybe i should sign up for 9 day surgeries then 

                     

You just reminded me, I had a blood volume monitor on my machine today. Turns out they weren't taking enough fluid off of me, so I left a half kilo roughly lighter than usual        I didn't mind     

[Mr. B 123]

Had my fistula installed in June was in recovery for about 1 1/2 hours then wife drove me home and could shower in 24 hours.  I had no problem typing the next day and pain wasn't too bad.  I asked my doctor about the squeeze ball and he said it was something they used to reccomend but no longer do, each doctor is different I guess.  If you lift something too heavy you will know it right away, I got a sharp pain if I put too much strain on my arm.  Take it easy.  Hope all works out well for you!

[Cordelia]

Had my fistula installed in June was in recovery for about 1 1/2 hours then wife drove me home and could shower in 24 hours.  I had no problem typing the next day and pain wasn't too bad.  I asked my doctor about the squeeze ball and he said it was something they used to reccomend but no longer do, each doctor is different I guess.  If you lift something too heavy you will know it right away, I got a sharp pain if I put too much strain on my arm.  Take it easy.  Hope all works out well for you!

Thanks, Mr. B!     

[Whamo]

They told me to sleep with my fistula arm elevated.  That means above the heart, or so my wife told me.  I changed my sleeping position, and wound up with a painful crimp in my back.  It's getting better, but it hurt something awful. 

[Cordelia]

Oooow!

Whama, wouldn't the "thrill" sensation be worse though being elevated? I'm curious.

Does anybody sleep on the same side as their fistula? Does it cause problems for any of you?

[dinks]

Hi Cordelia
I had my fistula done in May, it was done late in the afternoon and I stayed overnight in hospital.  I am not sure if you will be put under for the surgery, here they give you a nerve blocking injection in the neck to deaden the arm.  It was rather strange watching the operating room staff carry on with there duties while you lay there bored out of your mind.  The pain was not too bad and I did not take the strong pain killer prescribed, just took over the counter meds.  I had no problems bathing as I had a waterproof dressing.  I battled a week or two with using the arm but managed to get by.  I had a numb area from the wrist down my thumb for a few weeks but it wore off eventually. As far as it looking ugly or strange, I don't think anyone has commented on the scar at all, it is there but not really note worthy.  The installation of my permcath was far more traumatic than the fistula.
I hope all goes well for you on Monday and that your fistula is up and working soon.

[Cordelia]

It's really amazing how one surgery, well, any surgery for that matter how each and every single person reacts differently. I really appreciate hearing everyone's views     

Thanks Dinks     

[jonsal]

Oooow!

Whama, wouldn't the "thrill" sensation be worse though being elevated? I'm curious.

Does anybody sleep on the same side as their fistula? Does it cause problems for any of you?

I often have the fistula arm under my pillow (i like to sleep on my belly, great when you have a permcath NOT). I have no problems. You should however try not to block the flow. A funny thing is that a pillow really amplifies the sound of the fistula, anyone else who noticed that?