I Hate Dialysis Message Board
Dialysis Discussion => Dialysis: F.A.Q. (Frequently Asked Questions) => Topic started by: kevno on July 23, 2006, 05:11:30 PM
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I know that my pump speeds are low. Mine are only 200 - 250 can not go any higher. I was ask what is a normal pump speed. I have no idea. When my fistula worked ok used to get pump speeds of 300 - 350 never got a very fast pump speed. So can you please put down your average pump speed. The speed you can usually get.
Thanks
Kevno
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I voted 400 - 450, because that is what my speed is usually at, but once or twice it has been at 350, usually when there was a problem with the needle placement.
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They try to run us so we have a blood flow rate of 400 here. Makes pump speed around 420 for me.
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Well since my fistula is still pretty new I run at 250 but when they used the permath it was 400. They have me on the 15 gauge needles but when my fistula blew they are now back to doing the arterial in the permcath and just one 15 ga needle in the arm.
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That is one thing with a new fistula the vein as been stretched so much at the beginning it is very weak. On our unit we are given a ball to squeeze to strengthen the fistula. It does seem to work.
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That is one thing with a new fistula the vein as been stretched so much at the beginning it is very weak. On our unit we are given a ball to squeeze to strengthen the fistula. It does seem to work.
Does it? How much do you have to squeeze it and how can you tell when it has been enough? I am afraid they will try to use the fistula too soon so I want to have a better idea. Thanks.
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I used to squeeze the ball about 4 x 10 minutes a day. Even after the nurses started to use the fistula. I am sure there are a few renal patient on the site who used the ball the strengthen there fistulas. I thought it was common practice to strengthen a fistula this way.
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I thought it was common practice to strengthen a fistula this way.
My surgeon told me I didn't need to use it. Now the nurses are telling me my fistula is NOT strong enough...
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I use a Pumpspeed of 300, My fistula good just don't have the need to go any higher!
Pressure is around 100 - 120!
Please write down if u would like what your pressure is?
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We are given the stress ball thing too. No one really told me how often to squeeze it, so I just did it when I thought of it. Once they started using my fistula it got alot bigger and tougher. I dont use the stress ball any more. At home I run at 225 pump speed and my pressures are around -40 arterial and 110 venous. In centre I run at 250. Occaisionally I up it to 300 but dont let my venous pressure got past 150.
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COME ON >:( Surely more than TEN people out there on haemo. I thought this poll would be interesting to see what speeds most haemo patients can achieve. I was asked the question by one of the patients on this site. I do not know the answer. So come on, I would like to know what the average speed is. Plus what you keep your Venus pressure at your speed is. That is if you leave a post.
So come on do the POLL PLEASE ;)
You do not have the leave a post. Just your pump speed.
Thanks
Kevno
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Venus pressure 150-180.
As to the use of the ball for the fistula I am not sure it really works. Do not see the cause and effect there of squeezing the hand to having the fistula enlarge and toughen up. Anyone know the cause and affect? IMO it seems it may be more for letting patients think they have control over something when they are in a situation (dialysis) where they have no control.
As to pump speed the faster the pump the better your dialysis. Pump speed in combination with needle size can only go so fast before it crushes blood cells.
Also it might be interesting to know at what speed the dialysate is going for everyone.
Dialysate speed is set at 800 for me.
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365
and my art -150 ven 200 and tmp 80 and bp 90/60
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When they attempted a fistula in my right wrist, they told me that crushing the ball in the hand would strengthen the fistula and make it bigger. Because it is an artery entering a vein, the pumping action helps the vein to get larger. This important to do if you want a large really good working fistula.
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When they attempted a fistula in my right wrist, they told me that crushing the ball in the hand would strengthen the fistula and make it bigger. Because it is an artery entering a vein, the pumping action helps the vein to get larger. This important to do if you want a large really good working fistula.
Very very true! I wasn't doing it because the surgeon told me I didn't have to .. then my fistula has blown 3 times now ... I started using the ball and HAVE noticed a difference!
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When I was at highschool it was "cool" for the guys to have bulging veins in your arms. They just did lots of pumping and after a while the veins were prominent. I guess its the same with a fistula. My surgeon told me to go and pump weights at the gym lol I thought he was joking but he wasnt.
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When I was at highschool it was "cool" for the guys to have bulging veins in your arms. They just did lots of pumping and after a while the veins were prominent. I guess its the same with a fistula. My surgeon told me to go and pump weights at the gym lol I thought he was joking but he wasnt.
This makes more sense to me. Lifting weights causes vast amounts of blood to rush into the area to being worked.(the PUMP) I mean I squeezed the crap out of the ball as instructed and never felt a pump in the area at all.
But hey on a side note at the recent dialysis picnic we had, we were given a goodie bag of stuff. Among them a purple ball from sensipar. ;D Any buyers? Has low mileage! ;)
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When I was at highschool it was "cool" for the guys to have bulging veins in your arms. They just did lots of pumping and after a while the veins were prominent. I guess its the same with a fistula. My surgeon told me to go and pump weights at the gym lol I thought he was joking but he wasnt.
This makes more sense to me. Lifting weights causes vast amounts of blood to rush into the area to being worked.(the PUMP) I mean I squeezed the crap out of the ball as instructed and never felt a pump in the area at all.
But hey on a side note at the recent dialysis picnic we had, we were given a goodie bag of stuff. Among them a purple ball from sensipar. ;D Any buyers? Has low mileage! ;)
Aww you get a goody bag? You are so lucky! lol Only thing I got was a blanket from Eprex (Canada)
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From aranesp we got a blanket (which the cat has claimed), a great backpack, pair of socks, and a document folder. Not bad for a freebie. Its a shame the doctors get all the freebies usually, what about the suckers who take their meds?
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oops
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Last night was the first time I was put at a pump speed of 400 with both 15 ga needles in my fistula and it didn't blow!! :)
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Are you on conventional HD angie?
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Are you on conventional HD angie?
Ya.. inclinic hemo m/w/f 3.5hrs.
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What do you folks mean when you say your fistula "Blows"?
I use a pump speed of 425
15 gauge (blue) needle for the arterial (fistula), pressure -250-260 (I stick this one myself)
16 gauge (green) needle for the venous, pressure 260
I guess my pressure numbers are high compared to most of you folks. :-[
Maybe it's because my hematocrit is 41% ... and of course my preference for a smaller needle in my venous site.
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What do you folks mean when you say your fistula "Blows"?
I use a pump speed of 425
15 gauge (blue) needle for the arterial (fistula), pressure -250-260 (I stick this one myself)
16 gauge (green) needle for the venous, pressure 260
I guess my pressure numbers are high compared to most of you folks. :-[
Maybe it's because my hematocrit is 41% ... and of course my preference for a smaller needle in my venous site.
Am I suffering from Deja Vu? I thought I just answered to this post? :P I don't know if the term is correct but I call it "fistula blow" when they stick me and then I get a goose egg and they have to put ice on it and infiltrate another spot. :-\ It has been happening an awful lot :( I am afraid this is just something I will have to get used to and accept as part of my treatment 3x/wk :'(
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What do you folks mean when you say your fistula "Blows"?
I use a pump speed of 425
15 gauge (blue) needle for the arterial (fistula), pressure -250-260 (I stick this one myself)
16 gauge (green) needle for the venous, pressure 260
I guess my pressure numbers are high compared to most of you folks. :-[
Maybe it's because my hematocrit is 41% ... and of course my preference for a smaller needle in my venous site.
Am I suffering from Deja Vu? I thought I just answered to this post? :P I don't know if the term is correct but I call it "fistula blow" when they stick me and then I get a goose egg and they have to put ice on it and infiltrate another spot. :-\ It has been happening an awful lot :( I am afraid this is just something I will have to get used to and accept as part of my treatment 3x/wk :'(
Have you tried a smaller gauge needle? Maybe try a 16 gauge.
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Have you tried a smaller gauge needle? Maybe try a 16 gauge.
It would have to be 17 as my unit does not carry the 16 and won't order it just for me.
Today I asked the nurse I had to stick me in the usual arterial spot but to do farther up my arm for the venous. It seemed to work (today at least)! I just came back from dialysis.
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Zach, why dont you use a 15g on your venous? Ive used 15g almost all along. 260 is very high, I would be going for the 15g, unless there is some reason why you cant.
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It's just my own craziness. I want to be different >:D
Actually, part of the reason is my crit is kinda high ... right now about 43.1. And I don't even take EPO. (that's for another thread) :)
In the mean time, when I exercise the arm (dumbell curls) the number goes down a little.
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What does hematocrit have to do with what needle you use?
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What does hematocrit have to do with what needle you use?
Just that the higher your hematocrit, the thicker the blood gets as you remove fluids, the higher the resistance through the needles.
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So wouldnt you need a bigger needle with a higher HCTto get lower pressures? I cant say we use HCT to determine needle size here. Usually we start on a smaller needle then work up to a 15g, which seems to be what most people are on. I had to move up to a 14g because of clotting, and then started on aspirin so I could go back to using 15g.
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So wouldnt you need a bigger needle with a higher HCTto get lower pressures? I cant say we use HCT to determine needle size here. Usually we start on a smaller needle then work up to a 15g, which seems to be what most people are on. I had to move up to a 14g because of clotting, and then started on aspirin so I could go back to using 15g.
Like I said, just call me crazy. ;)
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Zach, dont be silly, go to 15g!!! They really arent a big deal. I dont even think of them as needles anymore. I think of them more like straws lol
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I hear the crowd in the background: Go 15g ... Go 15g ... Go 15g!!! :o
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I hear the crowd in the background: Go 15g ... Go 15g ... Go 15g!!! :o
Zach, you do what ever works for YOU, man you have my respect when I first read you bio, 24 years in-center (No transplant) AND you work FULL-time AND you are a very well informed patient. So just keep doing what you do. :)
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15g sounds big to me ::) when one of the three decide to have a go at my fistula (which they do about every 3 months) they use a green 17g needle :-\ because the needle is so small, the pump speed is still only 250. With Venus pressure about 130.
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Well yes 15g are big, but if it helps the pressure well why not change. Theres not that much difference in size. Once your used to it its a breeze. I hate pressure problems!
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She is right! I use the 15ga and I went straight to them from 17ga since my unit does not have the 16ga! It is not so bad.
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I would rather use a bigger needle then screw up my fistula
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If my post show up with just a character and nothing more, blame it on the cat jumping into my lap. I have seen blood pump speeds upwards of 500 with accompanying dialysate flow rates of 800ml/min with high flux dialysis.
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i run at 525 most of the time my transonic said it works at 1990 and i use 15 gauge needles and 14 on test day and i go 2 1/2 hours 3 x 's a week
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Naive27 do you have any renal function left?
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i run at 525 most of the time my transonic said it works at 1990 and i use 15 gauge needles and 14 on test day and i go 2 1/2 hours 3 x 's a week
14? Damn that is huge! I didn't know they do go that big!
What is the difference between a800 and just plain 800 for dialysate flow rate? I am now at 400 pump speed with 3 days no blow outs (ever since the 2nd fistulogram last Monday ;) and now they no longer have to run me back the old way !!)
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i run at 525 most of the time my transonic said it works at 1990 and i use 15 gauge needles and 14 on test day and i go 2 1/2 hours 3 x 's a week
I am wondering why 14's on test day? Wouldn't that actually give a false blood lab workup because it would enable more blood to be processed over what you normally run at? Or is it the same?
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I am wondering why 14's on test day? Wouldn't that actually give a false blood lab workup because it would enable more blood to be processed over what you normally run at? Or is it the same?
Sounds kind if fishy to me. :-\
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i run at 525 most of the time my transonic said it works at 1990 and i use 15 gauge needles and 14 on test day and i go 2 1/2 hours 3 x 's a week
I am wondering why 14's on test day? Wouldn't that actually give a false blood lab workup because it would enable more blood to be processed over what you normally run at? Or is it the same?
The guage of the cannula doesnt determine the amount of blood processed as far as Im aware.
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i run at 525 most of the time my transonic said it works at 1990 and i use 15 gauge needles and 14 on test day and i go 2 1/2 hours 3 x 's a week
I am wondering why 14's on test day? Wouldn't that actually give a false blood lab workup because it would enable more blood to be processed over what you normally run at? Or is it the same?
The guage of the cannula doesnt determine the amount of blood processed as far as Im aware.
All I know is that when they were using the 17gauge on me they couldn't run me as fast as they now do with the 15gauge.
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You do have a very good point there Angie! Im not sure thats what was meant in the previous post, which is why I questioned it.
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Hi,
I run a pump speed of 400 for 4 hours 3 X a week. I use 14 gauge needles. This does not change the blood flow, but it reduces the pressure. My pressure is about 140 for both art (-) and ven (+).
I do not want to run a faster pump speed as this puts more strain on the heart.
Cheers
Alasdair.
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I dont know how you guys can handle running at 400+ I am on 225 at home, but when Im in centre if I even push it up to 300 I get giddy.
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I dont know how you guys can handle running at 400+ I am on 225 at home, but when Im in centre if I even push it up to 300 I get giddy.
Giddy?
They said I could run as high as 800 (but won't ever do that) so I know running at 400 is easy for me .. now that my fistula is finally working without blowing
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Pump speeds vary, depending what your Doctor prescribes. Most patients with good working fistulas should be able to reach 450 to 500. Needle placement is also very important. If you have a new fistula and when they first access it. They should access it with 17gauge needles to be on the safe side then work up to the standard 15gauge. Max pump speed on 17 gauge needles should be no more than 300. Another thing not all fistulas mature some just fail so be aware.
I also noted someone said on lab day they use a bigger needle.. Well they are suppose to go by your prescription. If it says use 15 gauges then they should be using 15 gauges unless the doctor tells them otherwise. why use a bigger needle on lab day? to meet your URR and KT/V goal if that is the case then they should be using them all the time not just on lab day. You should be meeting your URR and KT/V every time you dialyze not just on lab day..something to think about..
have a good evening!
Kelly
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I have a question! What happens if they put you up on a faster pump speed? In my unit they don't have pump speed written down on my sheet. I pretty much have to tell them or they just go with what ever they feel like.
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The faster the pump speed the better your clearance. I try to run my speed at my maximum comfort zone, but there is a practical limited as to how much strain your heart can take. Age plays a big role in your pump speed. Younger people will be able to run at a higher pump speed without getting giddy.
I don't know how you guys can handle running at 400+ I am on 225 at home, but when I'm in centre if I even push it up to 300 I get giddy.
What is yor age? How long is your session?
It also depends how much fluid you have to take off as this will also make you feel tired. Being overloaded will add extra strain on your heart. I would aim to run at a constant speed so you know what your clearance is and able to make adjustments if need be. I would only change my pump speed if my pressure was above average. This would normally be down to the position of the needles.
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You do have a very good point there Angie! Im not sure thats what was meant in the previous post, which is why I questioned it.
That is kinda what I meant. Seems to me if a larger needle was used on that day it would lower the pressure thus letting them run a faster pump speed which in turn would process more blood.
Sorry for not being more clear.
On another note.
I heard there was a limit to speed at which a patient could be run as if it runs too fast it will crush or destroy the red blood cells. Anyone know if this is true or not?
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I heard there was a limit to speed at which a patient could be run as if it runs too fast it will crush or destroy the red blood cells. Anyone know if this is true or not?
I am curious about that too since I am in a self care unit. I want to understand everything. The nurse I had on Wed was from the States (I live in a border Canadian city) and she said I was able to run at 400 and have 3.5kg taken off in one sitting (3 1/2 hrs) because I am so young (32). I know they put my pump speed at what ever number is as close to 400 as possible without my Arterial and Venous pressures going crazy. I am still not sure of how to know myself .. but they seem to know what they are doing.
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The faster the pump speed the better your clearance. I try to run my speed at my maximum comfort zone, but there is a practical limited as to how much strain your heart can take. Age plays a big role in your pump speed. Younger people will be able to run at a higher pump speed without getting giddy.
I don't know how you guys can handle running at 400+ I am on 225 at home, but when I'm in centre if I even push it up to 300 I get giddy.
What is yor age? How long is your session?
It also depends how much fluid you have to take off as this will also make you feel tired. Being overloaded will add extra strain on your heart. I would aim to run at a constant speed so you know what your clearance is and able to make adjustments if need be. I would only change my pump speed if my pressure was above average. This would normally be down to the position of the needles.
Im 27 and pump speed is 225, I dont need too change the speed.
I couldnt even imagine running at up too 800?!?!?! WTF? The blood would be pumping like mad! I do know if the pump rollers are stiff it can crush the red cells. Dont know about pump speed, but Im sure your heart wouldnt like it.
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I think someone was mistaken about a blood pump speed of 800. They may be thinking of dialysate flow of 800.
Even the best High Flux filters usually have a maximum blood flow (pump speed) of 600 mL/min. This means any speed faster will not result in better clearance of toxins. You're just spinning your wheels, so to speak.
In fact, some Hi Flux filters have a maximum blood flow of 500 mL/min., such as the Fresenius (Optiflux) F160NR. Standard flux filters have even a lower threshold.
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woa some people have 500 that is really fast. It's like the Porsche of Fistula's
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I think someone was mistaken about a blood pump speed of 800. They may be thinking of dialysate flow of 800.
Even the best High Flux filters usually have a maximum blood flow (pump speed) of 600 mL/min. This means any speed faster will not result in better clearance of toxins. You're just spinning your wheels, so to speak.
In fact, some Hi Flux filters have a maximum blood flow of 500 mL/min., such as the Fresenius (Optiflux) F160NR. Standard flux filters have even a lower threshold.
Well I am not sure what to call it but I was talking about this test they do where they use different tubing than normal where they reverse the lines 1/2 way through the test.
Anyway, yes. It my dialysate flow is a800.
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Never heard of "crushing"blood cells, only thing I was cautioned about, was to high a temperature on the machine (blood warming), can cause the red blood cells to explode.
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Well I am not sure what to call it but I was talking about this test they do where they use different tubing than normal where they reverse the lines 1/2 way through the test.
Anyway, yes. It my dialysate flow is a800.
They are measuring the actual blood flow of the access itself when they do that.
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Well I am not sure what to call it but I was talking about this test they do where they use different tubing than normal where they reverse the lines 1/2 way through the test.
Anyway, yes. It my dialysate flow is a800.
They are measuring the actual blood flow of the access itself when they do that.
Ah ok THAT is what I meant when I had said 800 previously :)
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Damn >:( not typing it again >:( Bloody computer >:(
The short version.
Pump speed never over 220 and going down.
Lines in for 3 years now, not bad really.
Infection in lines, they want to put new ones in. Lab results, well to put it one way Crap!
Can not have lines put in usual way. Tried two times, failed two times. Needles Phobia, that held down child keeps coming out of me >:( So have to be put in down in theater. Not sure what to do. See if the antibiotics work. But even if they do work will never get good pump speeds out of these lines :-\ The lines are just to old, I was told lines last 3 months to a max of 1 year :-\
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And you said yours is a Fistula Kevno? I thought they lasted a lot longer than that :( .. well depending on certain circumstances...
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No My lines have been in for 3 years now. I have not mentioned my fistula, or should I say my so called re-vamped fistula. Had the first needle in the fistula today since about March. This fistula I have had since 1980, it stopped 2000. The surgeons had a go at starting it again 2001. After a 3 hour operation 2 surgeons, one was not too sure how to compleat the operation. 44 staples a cut from my wrist to my shoulder. I have a 2 inch stretch which can be needled. Pump speed today was a little bit better 250 WOW! Not happy about being needled.
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Wouldnt needling more regularly help your fistula a bit kevno?
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No Amber, The vein below it is fully blocked, and the vein above is the artery, but too small to do anyting with :-\ So just this small stretch which can never in prove.