Clotting Graft

[newgrl]

After about two weeks on dialysis, my graft clotted.  I had no problems with dialysis on Friday morning, November 2.  However, when I went in on Monday, November 5th it was not working.  At first, I was checking it every day.  I guess I just got busy over the weekend and I wasn't as diligent. 

Anyhoo, when I got to the clinic on Monday, it didn't work.  They sent me to Interventional Radiology.  I was scared to death, because I didn't know what was going to happen.  I didn't know if it would start back working.  And I didn't know if it would hurt.  They only gave me numbing medicine but it still hurt a lot... They eventually finished and sent me to Recovery.  However, the nurse in recovery said it wasn't working and the Doctor's came back and got me and I went back in.  Eventually I made it home around 10pm that night.  My mother spent the night to help take care of me.  We checked my arm at midnight, and it was working.  She woke me up again at 2pm and said it wasn't working.  So the next morning, I was admitted to the hospital.  I went back to surgery and my Vascular surgeon who placed the graft was able to fix it.  I ended up spending the night for observation and I had dialysis on Wednesday morning.

I am afraid that it will clot again.  If I clotted three times in only two weeks of being on dialysis, is this going to be something that happens all the time?  Is there any way to prevent clotting?  I don't know if I did anything wrong...  I don't sleep on the arm.  And I try not to use my left arm any more than necessary.  I don't lift anything too heavy.  Has anyone else experienced this? Do you have any suggestions?

Thanks,

Newgrl

[Chris]

Has your nephrologist been notified or said anything? Maybe a blood thinner is needed like cummadin (sp?) or a cardiologist maybe needed to help with this issue.

[Rerun]

I would not jump to a blood thinner as we use Epogen to get more red blood cells.  What is your hemoglobin?  I would not go above 11.  If you do receive Epogen maybe they need to back off for awhile.  Learn your blood numbers.

After a few of these declots you will ask for a little sedation and you will say "screw the Radiologists" I want the vascular surgeon the first time around! 

Access problems are a nightmare.  I'm just going through a new round of them myself.  Then things will be okay for a couple of years.  I'm sorry you have to go through this.   

[Traveller1947]

Best not to do anything drastic, newgirl.  I've had my graft for eight years now and it's still working well.  The first six months were not so easy though.  I had problems with clotting every few weeks and at one point it was the vascular surgeon who said it couldn't be fixed and it was the radiologist who fixed it!  Like you, I never slept on the arm or lifted anything heavy.  I think a new graft is just more prone to clotting.  All the best to you.

[newgrl]

Has your nephrologist been notified or said anything? Maybe a blood thinner is needed like cummadin (sp?) or a cardiologist maybe needed to help with this issue.

Chris,

Yes, I saw the nephrologist in the hospital.  I received blood thinners while I was there but they did not send me home on blood thinners.  I have started taking a baby aspirin though.

Newgrl

[newgrl]

I would not jump to a blood thinner as we use Epogen to get more red blood cells.  What is your hemoglobin?  I would not go above 11.  If you do receive Epogen maybe they need to back off for awhile.  Learn your blood numbers.

After a few of these declots you will ask for a little sedation and you will say "screw the Radiologists" I want the vascular surgeon the first time around! 

Access problems are a nightmare.  I'm just going through a new round of them myself.  Then things will be okay for a couple of years.  I'm sorry you have to go through this.   

Rerun,

I have to take the Epo every session.  I don't know the exact number, but I am pretty sure my hemoglobin is low.  I didn't know that I could have asked for my vascular surgeon instead of the IR doctor's.  If it happens again I will go straight to my vascular doctor.  He did a great job fixing my arm.  Although I have more cuts and scars at least it is working.

Newgrl

[newgrl]

Best not to do anything drastic, newgirl.  I've had my graft for eight years now and it's still working well.  The first six months were not so easy though.  I had problems with clotting every few weeks and at one point it was the vascular surgeon who said it couldn't be fixed and it was the radiologist who fixed it!  Like you, I never slept on the arm or lifted anything heavy.  I think a new graft is just more prone to clotting.  All the best to you.

Traveller1947,

That is wonderful news to me that you have had your graft eight years.  I was told that generally they only last for two years.  I am hoping that I have a transplant by then...  A girl can only hope....

Newgrl

[kitkatz]

My graft lasted ten years.  I was lucky.  Unfortunately infection got it in the end and it was removed.  I have a fistula now.

[newgrl]

My graft lasted ten years.  I was lucky.  Unfortunately infection got it in the end and it was removed.  I have a fistula now.

KitKatz,

That gives me more hope!  I hope my graft will last a long time.  I'm sorry to hear that your graft became infected.  But at least you have a fistula now.  Are you using the same arm for your fistula as your graft?  I would have to move to my other arm and I don't want to do that.  I am afraid I will run out of access locations.

Newgrl

[Chris]

Somehow my graft is still working after 12 years, but hasn't been used since December 2, 2000. Neph and transplant clinic check it with each visit or hospital stay I have. Thought I had a problem last month after knee surgery due to pain and swelling on one end. Luckily that went away by the  time I could call my neph. I didn't know who to call, but didn't like the PA answer either for the next time. She said to contact Primary Care, like they know what to do, they barely have a grasp of dialysis.

[newgrl]

Somehow my graft is still working after 12 years, but hasn't been used since December 2, 2000. Neph and transplant clinic check it with each visit or hospital stay I have. Thought I had a problem last month after knee surgery due to pain and swelling on one end. Luckily that went away by the  time I could call my neph. I didn't know who to call, but didn't like the PA answer either for the next time. She said to contact Primary Care, like they know what to do, they barely have a grasp of dialysis.

Chris,

After your transplant they didn't remove the graft?  Will they ever remove it?  Wow, I was hoping that I would get a transplant and get this graft removed but I don't even know if I will get another one anyway. 

[Chris]

Chris,

After your transplant they didn't remove the graft?  Will they ever remove it?  Wow, I was hoping that I would get a transplant and get this graft removed but I don't even know if I will get another one anyway.

They wouldn't remove it because I may need it one day and the risk of surgery for it isn't worth it to them I was told.
 
 I do not like having it, it itches bad at times, the skin easily breaks from scratching it, and it is unsitely to me. I do not think of it most days unless it itches or one of the pets comes to close for comfort.

[Rain]

It's good to know that grafts can last a long time.  I am meeting with the vascular access client to discuss a new access after my 4.5 year fistula clotted.