Can't hear fistula

[Rerun]

I went to the hospital and they send me to radiology.  That is the first bad sign.  Radiology is where they split my vein and had a hard time getting my last catheter in.  The next bad sign is when I saw the guy who was going to perform this "routine" little activity.  YES!  It was the same guy that split my vein.  He remembered me!  So, at least he didn't take what I had to say for granted when I said my veins are crap and very delicate.  He inserted a wire at both ends and got some clots out but could not get though the connection of the Atery and Vein.  So they sent me upstairs to room 312 to wait until my vascular surgeon could surgically revise my fistula.  He was a little shocked when I said "no catheter".  Either this one will work or it won't period!  I wouldn't mind if this fistula had lasted a few years, but 8 months does not impress me. 

I got back to my room about 9PM last night and got released today.  My dialysis at 2:30 went pretty rough.  The fistula worked fine, but the toxin build up was hard coming off.  My skin itches really bad and I'm so tired.

Thanks for all your prayers.

What I learned:  a clotted fistula doesn't have to be fixed the same day (so they told me).  DO NOT wear even the slightest snug shirts around your fistula or graft.  Even if it doesn't look too tight it will be or can be when you bend your arm.

My arm is pretty sore and I have no idea when to take the bandage off.  I'll call on Monday.

[charee]

So glad your home and they got it working hang in there Rerun

[angela515]

 

[goofynina]

Hi Rerun, i am glad they were able to get it working again and i hope your feeling better soon.  When i read that it was the same surgeon that split your vein i thought to myself, uh oh, Rerun isnt going to let this guy touch her,  glad to see that you did.      Am i getting this right?  The access i have in my upper arm (dont know if its a graft or a fistula)   But i have not felt the thrill for months now, do you think it would be possible for them to go in and try and unclog this one or do you think i will be having to get a new one?     I have always been curious about that and when i asked my neph, all he said was that we didnt need to worry about that at this time      I hope your able to get a good nights rest, glad you are home.  

[Rerun]

Well, Goofy if they could fix it right now I wouldn't do it.  You are on PD so just wait until you have to cross that bridge.  Why fix it now if you are not going to use it.  Now, if they ever tell you that your PD doesn't seem to be working then you need to look at this arm as a possible back-up.  I hope that never happens.  I hope you are on PD until they find a wearable kidney! 

             

It did cross my mind that I need to get through this so I can meet all of you in Las Vegas!!

[okarol]

Good news Rerun, I hope it keeps working and the soreness is gone soon! 

[Wattle]

   Hang in there Rerun. I hope you are feeling better soon.

How can they call it a "little routine activity". grrrrrrrr    

[Sluff]

  Stay with us Rerun you got a ride coming when we get to Vegas. Glad you had the fix done.

[Black]

Whew!  That's a relief knowing you're back home.  Glad it was not any worse than it was.  I would LOVE to have see that look  when you said "No catheter." 

I know you must be just wiped out and it will take a few days for the toxin build-up to get back down to a bearable level.  Hope they can do something for the itch in the meantime.  Get some rest and keep us posted. 

And thanks for the tip about the sleeves.  Mike is a big guy and some of his shirts, which he used to wear, may no longer be big enough in the sleeve.  With cold weather ahead I'm going to insist that he get out his winter shirts and try them all on.

[Rerun]

Yeah Black make sure they are loose. 

Today our court is having a Hawaiian Luau and I have this beautiful dress form Cancun but it has an elastic front that goes under my arms.  I gave it to the 15 year old neighbor girl to wear.  She looks beautiful in it and at least I get to see it even if I can't wear it.  I have on a MAN's big Hawaiian shirt.  The Big Kahuna!

[paris]

Glad you are home and hope each day you feel better.  Also hope the Luau is alot of fun--you deserve to relax and have fun.

[kitkatz]

Men's hawaiian shirts are the best things to wear on the arm. They are made to cover and yet be loose on the arms. I buy mine at the local thrift store that way when they wear out they were cheap to begin with!

I am sooo glad you are home. I was beginning to think a Northern California run was in order!

[kelliOR]

hi Rerun,

Happy to hear you are doing well  .  AND that you've still got your humor,    you Big Kahuna.............!

Hugs, Kelli

[Rerun]

Dialysis went okay today.  I got a chance to BLAST my Nephrologist for not calling me back or checking on me.  Probably wasn't all her fault, but I get so mad when this stuff happens to me that sooner or later I take it out on someone.  Anyone heard from Kevino lately? 

[poohkari]

Ugh, what a nightmare! Glad to hear youre feeling better. Good for you - speak up and speak your mind to your neph - it keeps them in check!

[Wattle]

Dialysis went okay today.  I got a chance to BLAST my Nephrologist for not calling me back or checking on me.  Probably wasn't all her fault, but I get so mad when this stuff happens to me that sooner or later I take it out on someone.  Anyone heard from Kevino lately? 

I am glad you are getting back on track Rerun. And good for you giving your Neph a  . She should have checked up on you.

I hope you had fun at the Luau!      

[mrhecht]

My unsolicited advice on a clotted dialysis access.......

Call your surgeon's office immediately, tell them your access is clotted and you need to be scheduled to have it fixed. Don't take "no" or lack of a call back for an answer. Call again if they haven't returned your call within a couple of hours.
The only reason to call your dialysis unit is if it looks like you'll need to reschedule your treatment. There will only be a delay if you try to let them handle the access fix for you.
The sooner a clotted access is fixed, the better.....aside from the obvious reason to have it fixed sooner rather than later........can anyone say toxin/potassium overload?

I have found that no one is going to handle your situation better than you. The more insistent you are, the better results you will get. If your surgeon is not handling your access issues in the way that you feel they should be handled, find a new surgeon. If you have friends in the medical field, ask who they've heard about, ask the nurses or techs at your unit whose work have they seen as successful. A lot of times, the doctors refer each other based not on skill or expertise but on personal business relationships which may or may not be the best for YOU. You don't HAVE to use the one they recommend.

Clot prevention:
Be aware of how you sleep and try to alter your sleep position so that arm is not slept on or bent......sounds hard, but I've done it.
Don't let your blood pressure or pulse get too low....monitor your BP.

Taping after dialysis:
DON'T LET ANYONE WRAP TAPE ALL THE WAY AROUND YOUR ARM.
Don't use the clamps.
If you must be taped tightly to prevent bleeding after you leave, wait an hour and then modify or change the dressing so that it is not tight on your arm before you go to bed.

Sometimes, despite all your best efforts, your access will clot due to narrowing in the vessels above the graft/fistula.

I'm sure someone else has posted all this stuff somewhere else; I just didn't have time to look for it.

[Black]

Great advice, mrhecht.   

[talker]

I was in class all day and so I didn't notice until I got home but I can't feel or hear my fistula.  It is placed in my upper left arm and I feel a slight pluse down on the inside of my elbow where it is connected.  I called Davita and they said it can wait until tomorrow to be looked at.  I called my surgeon and am waiting for a call back.  The thing is if I go to ER I'll wait 5 or 6 hours and just see the idiots from hell. 

What should I do??

Here is an oldie that supplied information, regards what action needs to takes place 'if one looses the fistula sound(thrill?).

Had often wondered about that fistula sound, and what to do if one does not hear it.

[iolaire]

I was in class all day and so I didn't notice until I got home but I can't feel or hear my fistula.  It is placed in my upper left arm and I feel a slight pluse down on the inside of my elbow where it is connected.  I called Davita and they said it can wait until tomorrow to be looked at.  I called my surgeon and am waiting for a call back.  The thing is if I go to ER I'll wait 5 or 6 hours and just see the idiots from hell. 

What should I do??

Here is an oldie that supplied information, regards what action needs to takes place 'if one looses the fistula sound(thrill?).

Had often wondered about that fistula sound, and what to do if one does not hear it.

On Wednesday they could not feel/hear someone's fistula in my center.  They made a early AM vascular center appointment the next day for the person and said they could not do dialysis on the person and sent them home.  Our vascular center is owned/operated by the nephrologist group so that probably helps them get highly responsive scheduling. 

On a side note I don't think that my nephrologist group operates the center makes the center do unnecessary work, I went in this month because my KT/v is poor and he listened to my fistula and ran the dye and sent me home saying it was fine.

[talker]

I was in class all day and so I didn't notice until I got home but I can't feel or hear my fistula.  It is placed in my upper left arm and I feel a slight pluse down on the inside of my elbow where it is connected.  I called Davita and they said it can wait until tomorrow to be looked at.  I called my surgeon and am waiting for a call back.  The thing is if I go to ER I'll wait 5 or 6 hours and just see the idiots from hell. 

What should I do??

Here is an oldie that supplied information, regards what action needs to takes place 'if one looses the fistula sound(thrill?).

Had often wondered about that fistula sound, and what to do if one does not hear it.

On Wednesday they could not feel/hear someone's fistula in my center.  They made a early AM vascular center appointment the next day for the person and said they could not do dialysis on the person and sent them home.  Our vascular center is owned/operated by the nephrologist group so that probably helps them get highly responsive scheduling. 

On a side note I don't think that my nephrologist group operates the center makes the center do unnecessary work, I went in this month because my KT/v is poor and he listened to my fistula and ran the dye and sent me home saying it was fine.

iolaire, was there any reaction from the dye used? My understanding is that the contrast dye's used, are very hard on those with kidney problems!
This is supposedly due to requiring ones kidneys to rapidly excrete/urinate the dye as soon as the bodies willingness to do so, does it.
How hard on the body is it if that urinating process does not happen? Will have to recheck with my Neph.

[iolaire]

iolaire, was there any reaction from the dye used? My understanding is that the contrast dye's used, are very hard on those with kidney problems!
This is supposedly due to requiring ones kidneys to rapidly excrete/urinate the dye as soon as the bodies willingness to do so, does it.
How hard on the body is it if that urinating process does not happen? Will have to recheck with my Neph.

They always say they only use a very small amount so it doesn't affect the kidneys, being nephrologists they are sensitive to it. But when they do the angioplasty, my arm absorbs the dye and it looks very bad for a week or so, looking all bruised.

[Simon Dog]

The term is contrast induced nephropathy, and there is a nice risk calculator at: http://www.renalguard.com/educational/contrast-induced-nephropathy-risk-calculator