Bad clearances due to messed up fistula

[skyedogrocks]

Rob saw his Neph for his monthly visit yesterday and the Neph isn't happy at all with his monthly clearances.  Rob does Nx Stage home hemo and his Neph knows he is doing wonderful with that, not missing treatments on purpose.  However, since Rob's access is horrible, it's been giving him horrible clearances these past 2 months.  Neph feels that the unclean blood is getting recirculated back into his bloodstream. 

Thankfully, Rob has another fistula that is about 6 months old, in his upper arm.  So, the plan of action for now is that Rob will do 4 days at home, 1 day in the center for a full 4 hr 15 min session.  In that time they will start using his upper arm for the venous and lower arm for the arterial.  Once the venous is working great, they will start using his upper arm access for both lines.

For the past 2 months Rob has been having nausea and some vomitting...not a lot.  Neph said if you are getting good clearances, you should never throw up or get nausea.

Hopefully next month his clearances will get better.  I'm glad his Neph caught this.  He said last month his clearances weren't good, but perhaps it was just that month.  After 2 months his Neph didn't want to play games.  He's a really great guy and has really helped my husband....we both love him.

[KT0930]

Glad you have a neph who's on top of things. Hope the new fistula works well for him!

[Joe Paul]

Sorry to hear Rob is having troubles. Hoping it gets straightened out soon 

[MyssAnne]

Sure glad the neph caught that!! I sure hope Rob gets better clearances now.

[BigSky]

Something that should be have been done is to have a baseline of what his fistula flow rate was when he first started dialysis.   They could then do a test now to see if the flow rate has dropped or not.  This test can help determine if it is just a couple bad runs or if the fistula is developing problems without the unnecessary procedure of having to have a fistulagram.

With NxStage it would be very important to have a good fistula due to the NxStage machine having a very low dialysate flow rate compared to incenter machines.

[goofynina]

I hope that extra day is just what Rob needs to get rid of that nausea    Will this be a permanent thing or just temporary until he can start getting good clearances again?  Sending good thoughts and prayers your way

[skyedogrocks]

Something that should be have been done is to have a baseline of what his fistula flow rate was when he first started dialysis.   They could then do a test now to see if the flow rate has dropped or not.  This test can help determine if it is just a couple bad runs or if the fistula is developing problems without the unnecessary procedure of having to have a fistulagram.

With NxStage it would be very important to have a good fistula due to the NxStage machine having a very low dialysate flow rate compared to incenter machines.

His fistula has always been messed up, he has had access issues for the past year (which is how long he has been using it).  That is why they put a new fistula in his upper arm.  Fistulagrams are useless for him, since they know it is defective.  His nx stage nurse tried using his new access 2 months ago and infiltrated it.  They think that it is nice and strong now.

[skyedogrocks]

I hope that extra day is just what Rob needs to get rid of that nausea    Will this be a permanent thing or just temporary until he can start getting good clearances again?  Sending good thoughts and prayers your way

Thankfully this is just temporary until his new fistula is up and running with no issues.   

[silverhead]

Do you have to wait for monthly tests?, surely they could be doing weekly checks until this is resolved, it should show pretty soon with the changes he proposes....