Fistula question

[jojosmommy]

I have a question about my fistula.  I haven't started dialysis yet, but feel that it is probably going to be soon.  My fistula is almost a year old (got it last May).  Since the surgery, it's done very well.  However, I've developed some nasty looking varicose veins in my upper arm, and often have numbness in my hand and fingers sometimes turn blue.  My surgeon moved out of state, so I don't feel like I can keep bugging his office with questions, and my nephrologist just said as long as my hand didn't turn bright red then I don't have anything to worry about.   That just doesn't sound quite right to me, so I was wondering if anyone else has had similar issues and what they have been told about it.   I have to admit that I sleep on my arm quite a bit as I'm a side sleeper and can't seem to break the habit, so I figured that's what might be causing my issues, but just would rather be safe than sorry.  Should I bring this up with my doctor again?

[cdwbrooklyn]

I can understand the veins and numbness because its common, but I don’t understand the blue thing. The blue thing is unusual.  Maybe is can be that you are sleeping on the arm.  However, I will keep asking the doctor because the blue thing is not common at all.   

[monrein]

It sounds as though you are cutting the circulation off to the hand.  Remember that we normally have two arteries that supply blood to the arm and two that return the blood once the oxygen is used by the tissues.  Once we have a fistula, one artery and one vein are out of commission...this is why I often wear a warmer glove on my left hand than on my right, in the winter.
As hard as it is, you must try NOT to sleep on the arm...you could harm the fistula and even lose it if the blood gets stagnant enough to form a clot.  Bright red would likely indicate infection, I'm guessing, but blue means circulation impaired and neither is good.
I've had my hand go so numb during the night that I pick it up and it feels like I'm holding a dead person's arm...no feeling whatsoever in it...I clap my hands together, rub them together and wiggle my fingers like crazy.

[jojosmommy]

Yes, the blue fingers are a bit strange.  it would make more sense if they were blue first thing in the morning or in the night when I'm sleeping on it, but they will turn blue in the middle of the day when I'm at work, usually when I'm moving around and not in a position where I would be cutting off circulation.  It's only my first 2 fingers that turn blue, none of the rest.  If I wiggle them, and get them moving...sometimes squeeze a stress ball... then the blueness goes away.  My biggest fear is that I may have a clot in my arm somewhere.  Any thoughts?

[BASSMAN]

According to this you should call 911 immediately!

http://www.healthsquare.com/mc/fgmc6005.htm

The last paragraph:

  Seek Care Immediately If...

    * You suddenly have trouble breathing or start having chest pain. You could have a blood clot in your lung or an allergy to one of your medicines.
    * The fingers or toes below the fistula turn blue, go pale, or feel cool.
    * The fistula starts bleeding. Call 911. This is an emergency.

[jojosmommy]

Wow.  Bassman thanks for the info.  That's an eye opener! 

[BASSMAN]

Not trying to scare you, but it needs looked into.  Read about steal syndrome.  You can lose the use of your hand if it is bad enough.

[pdpatty]

YOU CANNOT sleep on your fistula arm!

Didn't they tell you this. Stop doing it ,you are cutting off the blood supply and will damage it. I was told no watches  that would bind or carrying purses or lifting anyting over 10lbs. No bp cuffs ond not to allow blood draws from that arm. AND  do not sleep on it ,NEVER!.