Fistula Maturation

[lnardac1]

Hello, I am a graduate student in bioengineering at Stanford University. I am working on a team with other students in engineering, medicine, and business to design a medical device for dialysis patients. We are currently exploring the issue of fistula maturation in HD patients.  If you could share your experience with this problem, we would greatly appreciate it. Here are some more specific questions we have revolving this issue:
- How was the fistula placement chosen?
- How did you or providers notice that the fistula did not mature?
- What happened once the fistula failed? Did you have to go on to a catheter for dialysis?
- Did you undergo any interventions to recover your fistula?
- Did you do anything to try to improve your fistula maturation?
-How did you feel about the general process of getting and using a fistula?
Thank you in advance!

[cassandra]

Hi Inardac1 please introduce yourself in the Introduce yourself section.


Mod Cas

[Simon Dog]

How was the fistula placement chosen?  - By ultrasound in both arms, left arm radiocephallic

How did you or providers notice that the fistula did not mature? - Physical examination.

What happened once the fistula failed? Did you have to go on to a catheter for dialysis? - Never failed, going on 6 years now

Did you undergo any interventions to recover your fistula? - One intervention before use to tie off a couple of tributaries to increase fistula pressure.   

Did you do anything to try to improve your fistula maturation? - Squeezing exercises

How did you feel about the general process of getting and using a fistula? - It sucks, but I was lucky - painless and not that bad looking

Thank you in advance! you mean "advthankyouance" 

[lulu836]

How was the fistula placement chosen?  My choice

How did you or providers notice that the fistula did not mature?  Sight and Doppler

What happened once the fistula failed? Did you have to go on to a catheter for dialysis?  6 more unsuccessful surgeries all in one 24 hour period.  Put me to sleep.  Slice my arm(s) up. Close.  Wake me up.  Repeat.  Then place a graft.  Same routine, same outcome.  Then place a catheter.  Start dialysis.  Start 6 weeks of physical rehab.

Did you undergo any interventions to recover your fistula? No.  Body too beatup

Did you do anything to try to improve your fistula maturation? No

How did you feel about the general process of getting and using a fistula?  Horrified that my kidneys failed.  Thankful for dialysis.

[GA_DAWG]

The placement was chosen by the doctor. After it failed to develop, vein mapping was done and it showed it was very unlikely a fisula would mature, so I received a graft instead. They determined it was a failure because it did not "grow" in size and using a stethoscope they determined it did not mature. I did squeezing exercises with a ball, but it still did not develop. In fact, I still use a squeezeball in hopes that increasing the flow temporarily will dislodge any clots that may be beginning to form. Don't know if it helps, but it makes me feel like I have some ability to improve things. The fistula, and the graft, were done under a block. I thin k I really would have preferred a general anesthesia because of how my arm felt the rest of the day. It had to be supported by a sling and just felt like nothing more than a heavy dead weight. I kept the catheter I had placed upon diagnosis until the grat had been used successfully. At present, I go about every four months where they go in and scope the graft to try to prevent clots, but it still seems I get about one per year.