fistula

[Sandi1313]

Has anyone had any problems with their fistula?Yesterday,the tech had a problem inserting the needle into my fistula.It turned out there was a blood clot on the top.He mention that I might need to have something done to prevent this from happening again.I'm wondering what is the name of this procedure?How long would it take?Would I need to miss dialysis?Does this work?I'm trying not to get upset over this.Is there anything that I can do on my part to prevent any blood clots in my fistula?Any helpful sigessstions would be nice.

[Dannyboy]

Sandy,
Yes, issues with fistulas are not at all uncommon.

A procedure termed a "fistulagram" can restore a fistula to better flow potential, etc.   This procedure in my area is done on an outpatient basis at an 'Access Center' that specializes in this sort of thing, with a minimal sedative.   Lasts 1 1/2 or longer.    I go into the home center to dialyze immediately after (I am on Home Hemo, a dye is utilitzed that is best removed ASAP after).

For me, it is not painful or scary, just another PIA that is part of the Dialysis picture.   I have had several fistulagrams since I started, how often this needs to be done for others depends on many factors.

No worries on this, if you need it done, its a good thing, helps the flow and helps cannulation.

Best wishes,
--Dan

[Sandi1313]

Thanks for the reply.Does one of the staff from my dialysis center make the appointment?Cause yesterday,the tech was going to talk to the head nurse about this.Thanks for reassuring me that this DOES happen to ALOT of people.The tech had me WORRIED for no reason at all.

[Dannyboy]

Sandi,

I have a lot of empathy for you, trying to come up to speed on all the stuff that is Dialysis.    When I was in-center initially, it was intimidating and I felt like everyone else understood EVERYTHING, and it was me that was somewhat clueless.    The staff in the center were doing the best they could I suppose, but educating me was not a high priority, and I had many things told to me as "gospel" that have turned out to be either not true at all, or only true in rare cases.

This forum (IHD) has been a great help for me and no doubt you as you educate yourself.   If you haven't, look around here, use the 'Search' function to research stuff that interests you.   A wealth of great info and encouragement here.    Especially comforting knowing there are lots of us in the same boat so to speak.

Technicians at a center can vary greatly in experience and understanding of the big picture.   Heck even a Dialysis RN can run into problems/issues that they just haven't seen before.   

As far as a Fistulagram is concerned, ultimately your Nephrologist makes the referral, but as a practical matter I've found they depend on the Dialysis RN(s) for an opinion/suggesting to have one done.

Sandy as you get more experience with all of this stuff it will get much easier.   You will become knowledgeable/aware on how your arm is doing, how you are feeling overall, and what likely steps might be needed in the event of fistula issues.

Best wishes,
--Dan

[mogee]

I am the king of fistula problems.  I had a fistula for six years, endured about thirty fistulagrams, three revisions and finally a covered stent that clotted after a week.  Not all clotting is preventable, but you can reduce the risk.  Maintain adequate blood pressure.  Low BP causes low flow which can cause a clot.  Take a blood thinner like warfarin if your doctor suggests it may help.  Do not put pressure on the fistula.  I once clotted my fistula by sleeping on my arm.  Fistulae can be unpredictable and difficult to manage.  Good luck.

[Whamo]

I had a similar fistula problem.  My blood vessels were blocked by something up near the top of the arm.  My fistula worked for a couple of months, then blew out when my nephro started using huge needles.  I had a new fistula surgery about two months ago, and they're going to flip the new vein over so it will be easy to access on Thursday.  I like my catheter when I'm on getting on and off dialysis because it's fast and easy, but hate it when I go home.  I hate getting poked, especially when they can't find the access, and poke again and again.  The worst part is that I am going to miss another summer in the ocean.  I love surfing so much it kills me to stay out of the water. 

[Sandi1313]

Just want everyone to know so far the techs have not a had any problems inserting the needles into my fistual.The tech on Tuesday uses the sharp needles.While the tech on Thursday & Saturday uses the buttonhole needles.Once in awhile the tech on Thursday will use the sharp needles.There's one elderly female patient that have been having problems(3 dialysis days in a row)wiith a tech inserting needles into her fistula.Not sure if she will be getting a fistulagram done on her fistula.

[sullidog]

I am also the king of fistulagrams accept I have a graft, but same deal.
My vascular surgeon checks on my graft every couple months or so using an ultrasound just so he knows what's going on and to prevent problems before they become a problem for me and the dialysis techs. He does his own procedures, no IVR does them, and I can call him anytime  I suspect there was a problem, my previous surgeons office would get all mad if I tried to schedule my own appointments.

[Whamo]

Just got back from fistula surgery.  I got to the hospital at 5AM, and left at about 6:30PM.  I got bumped by a transplant and had to wait for 6 hours.  Then the surgery was 3 hours, and then more hours in recovery.  They made a long cut on my left arm to flip the vein for better access.  It hurts like hell.  This is my 3rd fistula surgery, and it's the worst one yet.  I'm just glad it's over.  The weather in So Cal has turned humid and hot, like back East.  Thank God I have A/C and a room fan/cooler setup.  I pity my poor wife because I am grumpy to the extreme.