My vein is too low. So another operation.

[BigSteve]

I took the advice from many of you on this site and from fellow members of
the AAKP and had my fistula operation well in advance of my possible
dialysis. It was done on April 5th and finally my GFR is down into dialysis
territory. But now my neph says that while the vein above the fistula
is strong it is too low for the needles sticks. I went to the surgeon yesterday.
He will have to raise the vein along my forearm. I am somewhat pissed
at my neph since she could have seen this two months ago. Has anyone
else had this problem?

[okarol]

Unfortunately BigSteve, this seems to be a common problem - everyone's anatomy is different and they can't predict what your veins will do. But you're right, it seems as through they should be checking on the progress so you will have a working fistula when you need it, because you planned ahead! I am sorry you have to have another surgery. Good luck to you! 

[Sluff]

Sorry this has happened to you but I hope the new surgery fixes the problem.

[Black]

Yes, it happened to my husband as well.  He had fistula surgery almost exactly a year before he started dialysis and did all of the exercises before to enlarge the veins and after the surgery to develop his fistula.  NO ONE noticed until he went to the center to start dialysis that it was too deep and that collateral veins had formed!

The revision to lift the vein and tie off collateral veins went very well, he had very little pain, and he started dialysis 7 weeks later with no problems.  Just be sure the vascular surgeon knows to make the incision well away from the area where the needle sticks will be.  They didn't allow enough room for the expanding vein on my husband's arm and he has several inches of his fistula where the stick would have to be THROUGH THICK SCAR TISSUE.  He has buttonholes so it has not been a problem yet, but it may be in the future.

Good luck.

[Mimi]

Know how you feel Big Steve.  I went 7 weeks ago and had my fistula put in, now my neph says
it is not sounding right and he thinks it is dying.   I am beginning to believe I'm too old for all of this.
Pray the new surgery straightens it alll out.

Love, Mimi

[BigSteve]

Yes, it happened to my husband as well. He had fistula surgery almost exactly a year before he started dialysis and did all of the exercises before to enlarge the veins and after the surgery to develop his fistula. NO ONE noticed until he went to the center to start dialysis that it was too deep and that collateral veins had formed!

The revision to lift the vein and tie off collateral veins went very well, he had very little pain, and he started dialysis 7 weeks later with no problems. Just be sure the vascular surgeon knows to make the incision well away from the area where the needle sticks will be. They didn't allow enough room for the expanding vein on my husband's arm and he has several inches of his fistula where the stick would have to be THROUGH THICK SCAR TISSUE. He has buttonholes so it has not been a problem yet, but it may be in the future.

Good luck.

Black, thank you very much for the advice. The surgeon described the
operation to me, but now I can ask him about the incision.

[Black]

Black, thank you very much for the advice. The surgeon described the
operation to me, but now I can ask him about the incision.

You are most welcome.  Hope it goes well for you.  Keep us posted.

[BigSteve]

Well, I had the surgery on Monday. I now have "train tracks" on my
left arm from wrist to elbow. I hope the vein doesn't take too
long to "cure" since I am getting anxious about starting
dialysis already after having it hanging over my head for years
as my labs slowly went down.

[Black]

Mike started dialysis 7 weeks after his revision.  After just a few sessions he was running at 500 with no problems.   So don't worry.

[BigSteve]

Sorry, I don't know which labs you mean when you say "500".  My GFR is now
at 9 which means I should be in dialysis, but since I still urinate I can wait
until the vein cures. I am still somewhat angry at my nephologist for waiting
this long for the second surgery after I made sure to get my fistula done
long before I needed dialysis.

[Black]

My apologies, those of us already dealing with dialysis forget those who are not yet on dialysis are unfamiliar with some of the numbers and lingo.  Mike has been on his NxStage since Feb and I still get lost in detailed discussions of settings and numbers.

The 500 I referred to is the speed of the machine blood pump while on dialysis.  It indicates 500ml per minute is going through the machine and the fistula.

[kellyt]

I had my 2nd fistula placed on the 31st of Oct. in my upper arm.  While he was in there he "repositioned" my vein so that it would be closer to the surface.  Other than the huge incision and extreme pain and swelling, my fistula is running like a river.  I can't wait for the swelling and pain to go away!

[BigSteve]

Luckily I have little pain and no swelling with my "repositioning". I will probably
remain anxious until the arm is OK to proceed with dialysis. I felt more weak than
usual yesterday with achy muscles throughout my body, but I am feeling better
today. I will be extremely pissed if I would have to be catheterized after having
the fistula put in months early.

[Black]

Luckily I have little pain and no swelling with my "repositioning". I will probably
remain anxious until the arm is OK to proceed with dialysis. I felt more weak than
usual yesterday with achy muscles throughout my body, but I am feeling better
today. I will be extremely pissed if I would have to be catheterized after having
the fistula put in months early.

Yes, I can understand why you would be really pissed.  We were worried about that as well.

Being very careful with your diet and fluid intake can sometimes postpone dialysis for several weeks and allow a minimal amount of kidney function to keep you going with little risk to your general health.  If you have not yet seen a renal dietitian, tell your neph you want to see one ASAP.

[BigSteve]

I went to the surgeon today and he took the stitches out.  He said to wait
4 weeks and then to let my neph and the dialysis techs take a look to see
if the arm is ready. So far I don't have fluid retention. I guess then the next
month will be waiting and hoping. Thank you all for your concern.

[MyssAnne]

Hang in there, the hard part is waiting, I know!!!

[goofynina]

Thanks for the update BigSteve, hang in there my friend, i hope all turns out well for ya,