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Author Topic: Got my fistula created Tuesday  (Read 3861 times)
GraphicBass
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« on: November 26, 2010, 10:06:43 AM »

After some delays due to schedule, I finally got my fistula created this past Tuesday! Now it's just a matter of time before I can stop using the permacath, with which I've had fairly few problems, but it will be good to take a long, hot shower again!

The procedure, to me, was one of those in which the anticipation was worse than the actual event. I recall laying on the table, chatting with the prep folks about how their telephone sucks because it's a wall phone that keeps dropping the receiver, and the next instant, I was in recovery, wondering how I got there!

No real problems so far, not even much pain — just some soreness when I bend my left arm (the incision is right across the inside crook of my elbow). Very neat, very clean. Probably won't leave much of a scar with which to cause strong men to weep and woman and children to flee in terror!  :)

While waiting for  the fistula to mature, I'm heavily researching, and leaning towards, starting with the "buttonhold" procedure from the very first stick, including doing the sticks myself. We'll see how that holds up when I'm holding the sharp, pointy object aimed at my tender body!

Later...

g
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GoingThere
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« Reply #1 on: November 26, 2010, 11:11:18 AM »

I was there in July. I had my cath for the whole summer and it really sucks. People (without cath) just don't realize the enjoyment of taking long, hot shower :bandance;

Regards,

GT
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1995 - kidney biopsy - IgA
2002 - BP 220/140 - hospitilized
2004 - stage 3 of kidney failure
2005 - stagae 4of kidney failure
2009 - on the edge of stage 5
july 2010 - stage 5
14 july 2010 - catheter inserted and first D session
15 july 2010 - AV fistula created
dec. 2012 - tx with major rejection (plasmapheresis, atg, prednisone pulses)
apr 2013 - kidney function stable
kitkatz
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« Reply #2 on: November 26, 2010, 12:51:18 PM »

Just had that hot shower yesterday!  My fistula buttonholes are coming along. had to remind the center one person was to stick me.
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silverhead
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« Reply #3 on: November 27, 2010, 09:22:13 AM »

Congratulations on the procedure, and glad it was relatively easy on you.
I'm sure your center will strongly advise you to not start right off with Buttonholes, They will start with the ladder method to get the fistula built up in a good long line and to toughen it up, then you can go for the Buttonholes and you will know the best, pain free areas to use.......
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calypso
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« Reply #4 on: November 27, 2010, 10:26:15 AM »

Congratulations on the procedure, and glad it was relatively easy on you.
I'm sure your center will strongly advise you to not start right off with Buttonholes, They will start with the ladder method to get the fistula built up in a good long line and to toughen it up, then you can go for the Buttonholes and you will know the best, pain free areas to use.......

What would make you think that? If you "toughen it up" you are only damaging sites where new buttonholes may be started later when the first ones fail. And if you're planning on long term D, they will, eventually fail.
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Desert Dancer
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« Reply #5 on: November 27, 2010, 10:28:40 AM »

Congratulations on your new fistula!  :clap; It was also my experience that the anticipation was much worse than the actual procedure.

IMHO, buttonholes are the way to go. My center started me right off on buttonholes - no extraneous sticks and they're coming along beautifully. I hope you have the same anticlimactic experience with your buttonholes - if you choose them - as you did with your surgery.
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August 1980: Diagnosed with Familial Juvenile Hyperurecemic Nephropathy (FJHN)
8.22.10:   Began dialysis through central venous catheter
8.25.10:   AV fistula created
9.28.10:   Began training for Home Nocturnal Hemodialysis on a Fresenius Baby K
10.21.10: Began creating buttonholes with 15ga needles
11.13.10: Our first nocturnal home treatment!

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GraphicBass
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« Reply #6 on: November 28, 2010, 09:25:31 AM »

Thanks, all. Buttonholes are definitely the way I want to go, but I won't rush it. I started chatting with the techs yesterday about them. About half of the others on my shift use a buttonhole. 2 or 3 self-cannulate that I've been able to see.

Really missing my showers, so I just found some dressing covers that are intended to protect wounds such as permacath lines, are waterproof, seal around the edge to the skin and are large enough to cover the cath line outlets. I'll give one a try in a shower and see if it protects a non-critical area (like a leg with some tissue under the clear dressing) before I try a full-on shower!

gary
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Bruno
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« Reply #7 on: December 02, 2010, 02:49:35 AM »

Button holes are the way to go if you want to self cannulate. We started my button holes once my fistula had matured and I was needling myself within 8 weeks of starting. I was saying elsewhere that they start you on on small gauge sharps, work up to a 15 gauge sharp and then you go to a 15 gauge blunt and then doing it yourself.
The blunts are the ultimate for a couple of reasons: the bleed time on the access sites after sessions is much, much less (compared to sharps) and on an established button hole site are often less painful, but most importantly the combination of button holes and blunts opens the way to doing it yourself which opens the way to dialysis at home and a little bit of your life back again.
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RightSide
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« Reply #8 on: December 04, 2010, 06:40:28 PM »

Congratulations on getting through the procedure successfully.

Now take VERY good care of the arm with the fistula.  Don't lift heavy weights, don't sleep on that arm at night, etc.  And hopefully, it will mature and be ready for use early this coming year.
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billmoria
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« Reply #9 on: December 09, 2010, 08:19:30 AM »

 :bandance;  I had 7 days of sharps to make the tunnel for the buttonhole. The buttonhole has been very, very good!!
Good Luck
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WMoriarty
GraphicBass
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« Reply #10 on: December 14, 2010, 05:49:01 PM »

Talked to my nephrologist yesterday and she's a big fan of buttonholes. And I've been watching the techs and nurses in the center; there are actually quite a few buttonhole patients they work with. They told me the buttonholes are easy, easy, easy.

That's the way to go, I am sure.

Heh -- on fistula arm care, I don't even let my wife grab that arm when she wants to walk arm-in-arm. "Other arm, please, dear!" Fortunately, she takes no offense....

gary
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huldafolk
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« Reply #11 on: January 17, 2011, 08:16:38 AM »

Must have been nice to have a very deep IV sedation or Ga for the fistula surg. I remember ALL of the procedure. From the start with a deep penetration injection of local at the surgical site(elbow) to the cutting pressure and discomfort of all the skin tension and vessel tugging. Finally , you can't forget the multiple sutures and the tugging for that.  Wish my surgical team would realize that the placement of a fistula is a traumatic event( oh yeh, this was the second fistula that I had made, first one in wrist clotted off after just one use).I had to keep my arm in a sling for about a week after the surg. for the elbow fistula.   Glad your experience went better than mine!!
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1980 diagnosed with ADPKD
2003 EMERG. Bi-lateral nephrectomies IVC STENT
2003-now 3x/week 4hours each hemo at clinic
2003-2004 multiple complications /ileostomy
2004 reversal of ileostomy
2010 colostomy
2003 to now ,on transplant list(on and off due to complications)
8 years on list> said to be at top of list for transplant.
2010 RCA Heart STENT
2011 Restent RCA with Drug Eluting (70% closed in 3 months)
LAD stent with drug eluting (66mm long stent)
On transplant list again!!2011/3
tyefly
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« Reply #12 on: January 17, 2011, 01:26:16 PM »

Everyone is different   I am sure   but I will agree with Silverhead   that I thought I could start buttonholes too  right from the first stick.....   well I needed to ladder to toughen up my fistula so that it would keep infiltrating.....  I had one person stick me the whole time...  Fistulas need to be toughen up....  I have buttonholes now and they work wonderful....  I had to do laddering for the first 7 or 8 sticks....then on to buttonholes.... no matter    I cannulate myself and I have no problems..... but then I only learned how to cannulate myself with button holes......   I HAVE NEVER STUCK MYSELF WITH A SHARP.....   I high recommend that you learn to cannulate yourself with a sharp..... and get the laddering in control.... cause if you have to create a new button hole   you will have to use a sharp.....

    just my two cents.....
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IgA Nephropathy   April 2009
CKD    May 2009
AV Fistula  June 2009
In-Center Dialysis   Sept 2009
Nxstage    Feb 2010
Extended Nxstage March 2011

Transplant Sept 2, 2011

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