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Author Topic: Going from fistula back to catheter  (Read 509 times)
jambo101
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« on: May 22, 2019, 03:13:47 AM »

Just started using the fistula and am not liking the process. my arm is constantly black and blue, the nurse on needle extraction gets blood all over the place and keeping my left arm immobile for 4 hours is impossible, not liking the new procedure one bit. :thumbdown;
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Jim
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« Reply #1 on: May 22, 2019, 06:39:11 AM »

My advice would be to give it some time. A fistula takes time to develop but you will be much better off to lose the catheter if at all possible.
Try a cushion under your arm. Is the machine alarming at any movement of your arm? Where is your fistula, forearm or upper arm?
BTW - all stickers are not created equal.
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iolaire
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« Reply #2 on: May 22, 2019, 06:52:58 AM »

I agree with Cowdog give it some time.  The blood should not be going everywhere - to me that is a sign that the person helping you might not be so good, is a less experienced tech working on you?  Maybe you could ask a nurse or someone else to give it a go next time.
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Transplant July 2017 from out of state deceased donor, waited three weeks the creatine to fall into expected range, dialysis December 2013 - July 2017.

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lulu836
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« Reply #3 on: May 22, 2019, 08:27:46 AM »

Stay with the catheter  :thumbup;  It is painless (no needles), You can use your hands and arms during treatment. After the nurse disconnects you from the dialyzer, it's only five to 7 minutes (slow nurse) maximum time to pack up, weigh and take temperature to be out the door.
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Michael Murphy
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« Reply #4 on: May 22, 2019, 09:11:31 AM »

Iíve had known patients who have done well on a cath for a long time (over 20 years) I have also knew someone who went swimming and got a infection that killed him.
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jambo101
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« Reply #5 on: May 23, 2019, 03:16:59 AM »

My advice would be to give it some time. A fistula takes time to develop but you will be much better off to lose the catheter if at all possible.
Try a cushion under your arm. Is the machine alarming at any movement of your arm? Where is your fistula, forearm or upper arm?
BTW - all stickers are not created equal.
Have the fistula on my upper left arm, its working perfectly i guess as during the 4 hour hook up there are no alarms going off and pressure remains constant, at the moment the top nurse is administering the needle,hes very good as i feel almost nothing,removal of the needle is done by a regular nurse ,
I suggested on Wednesday maybe id like to just stay with the catheter  :laugh: he would have none of that attitude youll get used to the fistuala was his reply ::)
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Jim
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« Reply #6 on: May 23, 2019, 07:50:05 AM »

Good nurse.
 If you aren't alarming you may not have to keep that arm perfectly still. The alarm will tell you when you moved too much and you can figure out the range of movement you can get away with.
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GA_DAWG
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« Reply #7 on: May 23, 2019, 09:45:58 AM »

Ask for a prescription for the lidocaine/prilocaine cream. It makes the sticking part much easier to take.
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Riki
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« Reply #8 on: May 24, 2019, 08:18:16 AM »

Good nurse.
 If you aren't alarming you may not have to keep that arm perfectly still. The alarm will tell you when you moved too much and you can figure out the range of movement you can get away with.

I agree.  I have an upper arm fistula as well, and after 10 years, I've got it figured how much I can move my arm without causing any issues.  I don't like doing it, but I can type on my phone with one hand, but it's just a heck of a lot easier to watch Netflix than type
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Simon Dog
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« Reply #9 on: May 27, 2019, 07:27:21 AM »

regular nurse
RN => Registered Nurse, not Regular Nurse  ::)
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Charlie B53
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« Reply #10 on: May 28, 2019, 09:13:59 PM »


As Needle-phobic as I am I really did LOVE my cath.   But I did also understand the increased risk of infection and went along with Dr's recommendation and had a fistula created.  It didn't mature and needed reworked, and a few angioplasty's.  It took a whole year before it developed sufficiently to begin using it.

I still occasionally bleed, either during the 'stick' and again sometimes on withdrawal.

I suspect the bleeds occur when the Tech 'wavers' in the slightest, which causes the hole to elongate, just a hair, and the high presssure (arterial pressure0 blows right out alongside the needle.

When this happens during the initial stick we have to pull it, hold it until it is well clotted off, then re-stick another needle.   PITA and waste a lot of time.

Similar thing when pulling a needle, if it isn't pulled straight out, wavering even a little, the hole elongates, enlarges just enough it is difficult for that large of a clot to form.  And with that much pressure the leaks can make a big mess in a short time.

I must be Blessed as I rarely have an internal leak causing bruising.  Maybe my Techs are more confident, steadier hands, whatever.  I am Thankful.

Time and experience had got to be a large part of it.  My Tech's have been with this clinic over 10 years already.

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GA_DAWG
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« Reply #11 on: May 31, 2019, 08:52:22 PM »

We  are blessed with really great techs, but occasionally we have to have a fill-in when one is on vacation and another has an appointment. Recently tis happened and I was "lucky" enough to have the fill-in from another clinic. Naturally, I bled a bit extra when the needles were pulled and on top of it, the fill-in left while I was still holding the sites. One of our regulars, the one I trust most, looked at me and said "He gutted you and walked right out." Of course, then she took care of getting the bleeding to stop and put new dressings on.
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Alexysis
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« Reply #12 on: June 01, 2019, 04:29:47 PM »

I've managed to not only put my shoes back on (and tie them, too) near the end of dialysis, but also get my bag off the floor and stuff 2 pillows and a blanket into it without ever setting the pressure alarm off. Also, yes, blood is sometimes a problem. That's why most of us have dedicated 'dialysis shirts'.
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GA_DAWG
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« Reply #13 on: June 04, 2019, 04:37:52 PM »

That's me. I fold my blanket, stuff it into the bag, and put up earphones, neck pillow, gloves, and anything else, without setting the alarm off. Mostly it is done with my off hand doing the pushing and keeping the graft arm fairly straight. Only occasionally does the machine alarm.
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