Inflitrated, clotted and very confused!

[jessshar]

Please excuse me if use the wrong terms in explaining my self. On Friday it took 45 min. to get the my dads session started. Every thing started off great and they got his first arterial stick just fine but the it went down hill from there. It took four different techs and five different attemps to get access for the venous. They kept getting clotts and finally after the fifth attempt I told them enough was enough and was taking him home. I mentioned to one of them that all of this poking around CANNOT be good for his fistula and a tech said its not us its his fistula. Finally a nurse came over and said we will get our best poker- and he got it no problem.

Now his arm is swollen, bruised, and I believe inflitrated. I cannot feel the "Thrill" on his upper part of his arm I can feel the arterial one. Its still warm- the nurse said thats still a good sign. The have set up a appointment with the vascular center first thing tomarrow morning to find out what is going on with his fistula. We have been using it for seven months now with no problems until now.

I would like to know could they have done this to him by insisting on trying to cannulate him when they had been so unsuccessful? Are there any protocols saying how many times they can try before they have to stop? Can I insist that only the ones who are good actually cannulate him? Any other suggestions on how to protect his arm?

Im not only very confused but very angry too. What they did to him was cruel. They kept poking around where there was no creme moving further up his arm to try this spot that spot etc. He clotted up three times and on two of them they got nothing back. Now that I write this they poked him more than six times. It just is so frustrating.

[iketchum]

I have been stuck up to five times sometimes because they had a hard time with the veineous line. I clot fast sometimes and have had to change out the kidney twice because I clotted it up. The upper part of my fistula is not growing as fast as the bottom part and they still have some trouble with it. They are talking of doing a fistulagram and try to expand the vein some. Sounds like your Dad is having about the same problem. I hope they get it fixed for him.

[RichardMEL]

Remember that they keep trying to get the access going because he needs dialysis to keep him alive! They're not doing it for fun, or to cause him pain/bruising etc on purpose. I'm not sure what the solution is to him clotting so easily when just put on - maybe a baby asprin in the morning before dialysis might help a little to thin the blood just a bit? I'm not sure. It is good that he's got a cardiovascular appointment to check things out - maybe a fistulagram too to check how things are going there.

Some days they just can't get it going sadly.

[Zach]

If there is clotting, have them try using "wet" sticks, attaching a syringe with saline to the needle tubing.  That's what I do.  Even adding a little heparin to the saline in the syringe can help with those who have high hemoglobin.

This used to be standard operating procedure.

[jessshar]

Thanks for all your replies. Here is an update: we went in this morning and they did a angioplasty, removed some clots but there is one they could not really get too. His vein is really narrow and they are hoping with all the heprin they gave him that it will disolve. All the work they did caused a hemotoma in his shoulder but the blood flow is good. There is a chance this may happen again with them being so narrow but if it does we will just go back to the catheder. For now all is good.

I would like to say thanks to everyone on this site. It feels good to have a place to go and vent and get good advice from people who truly understand what it means to be on dialysis or a person caring for someone who is. The support found here is greatly appreciated!!!

[kitkatz]

Excuse the language, but access problems are a bitc**!