Any bass (or guitar) players with fistulas? Which arm would you use?

[DaveM]

The Doctors are talking about a fistula.  They want to get things rolling A.S.A.P.  I have played guitar for about 40 years and bass for 24.  I am normally a Lefty (Writing and eating), but I play guitar and bass right handed.  Should I get the fistula on my Right (Plucking/strumming) hand or the Left (fingering) hand?  I don't play guitar much any more, but I play the bass full time.  I usually still make 3 to 5 gigs a week.  I do pretty heavy lifting with both hands at work, so that won't matter.  They want to start planning the fistula in the next few days.  I don't want to do anything that will risk my ability to play.  With guitar, I would be tempted to go with the fingering hand, as the strumming arm can get moving around a bit on the acoustic.  Bass might be a different story.  I plant the right thumb on the side of the pickup cover and pluck the strings with the fingertips.  The left hand is basically a grip exercise as I am fretting some pretty heavy strings.  Is the fistula more susceptible to damage from the movement and being bumped, or will the constant gripping of the hand cause more problems?  Thanks in advance for any of you answers.  I would have started out with more basic conversations and gotten to know you all a bit better, but they are going to want an answer right after the weekend.  Things are getting real! 

I couldn't come up with a sentence that deserved to end in an emoticon, but I saw this guy and had to use him in this post!   

Thanks again,
Dave

[Paul]

Your biggest problem is not the guitar, it is this:

I do pretty heavy lifting with both hands at work

You cannot lift heavy stuff with your fistula arm. The limit I was given was "nothing even as heavy as four pints of milk". You can cheat, but if you do your fistula will soon give out, and there is a limit to the number of suitable veins they can use. Alternatives are a fistula in the leg (no idea about the rules on that) or a PD cannula in the chest. A lot of people who cannot stand the thought of needles go for the cannula, but you have to keep it scrupulously clean, always dry (which makes washing that area difficult and swimming a really bad idea - although some do with a waterproof top), and with a cannula there is always the risk of infection, which is bad.

[iolaire]

Welcome to the group. My left forearm fistula has grown to take most of my forearm. I don’t know exactly how the guitar lays in the hand or on the arm but if it touches the arm then  I’d investigate a fistula in you left arm above the elbow if that is an option.  I would not worry too much about the weight restrictions but talk it over with your surgeon. I feel the standards are designed for fairly frail people, I’d expect you have stong large veins from your work.

But there is a risk of loose motor control or feeling in the fingers for the fistula surgery. I don’t know the odds on that but given the risk the groin fistula might be something you want to look into as well.

When I was on dialysis I saw a few patients with groin fistulas. Those didn’t look so bad. The guys would have long shorts and pull them up for access. It’s not like it’s in your private parts.   

[cassandra]

Hi Dave, I used to play acoustic guitar. I had a fistula in my left wrist, and could not play (fingering) side any more. The second one above the elbow in my right arm makes play impossible.
Like Paul said, heavy lifting won't be poss either.


Is PD not an option? You still can't lift anything heavy, but you can play your guitars.


Luck, wisdom and strength, Cas

[cassandra]

Sorry only now read your other post about PD not being an option.


   

[kristina]

Hello Dave,
I don't play any bass or guitar, but I am very keen to play the piano and before I needed dialysis-treatments, I asked doctors/nephrologists about what to do about it and from asking them and from my own research I gathered that a chest-cath would probably suit me best. Mind you, I don't do any heavy lifting etc. and I am also not a "piano-basher" either, as my nature and my very old and "ancient" piano only accept a very gentle touch when playing my favourite Bach-pieces.
... I have had my chest-cath for nearly four years and of course I have to be diligent about it, but it has worked out well for me so far and touch wood, it hopefully continues like that in the future as well.
Good luck and best wishes from Kristina and welcome to IHD.

[DaveM]

Thanks everybody.  I was posting here with very little information and almost no idea of what I am getting into.  I didn't realize what a problem lifting was going to be.  I just thought the bumping the fistula and gripping were going to be a problem.  I really can't afford to lose any of my income right now!  I am pretty much looking at lots of overtime and a second job to pay for all of this.  (Third of you count my life as a (Semi) professional rock and roll idol.  )

They don't think PD will be an option because I have had over a dozen abdominal surgeries and they are very afraid of putting in a line for it.  I wrote off the leg fistula because I bicycle well over 100 miles a week.  I am going to have to do a lot of rethinking about everything in my life if I decide to follow through with dialysis. 

I am only a few days past the big panic call from the Doctor and I have just worked my fifth 12 hour shift this week, so I haven't had time to get everything figured out yet.   I just walked in the door this afternoon and Amy told me I am scheduled for surgery on Wednesday.  I tried calling back, but the office staff must be gone for the weekend.  I will have to call them first thing Monday morning if I am going to change that plan.  I'm not even sure I can get anybody to cover for me on that short notice!  I think I will put a few hours into research tonight.

I apologize for being a bit disorganized with my questions.  I'm pretty new to this.  I have felt just fine the rest of this week, but something in my Sunday labs has sent the Doctor reeling.  I will have smarter questions when I figure out what is going on.  Thanks again for all of the responses.

[kickingandscreaming]

I'm really sorry you seem to be between a rock and a hard place.  All of us are forced to make concessions to this f&*(ing disease.  l hope you can find ways to modify your life that allows you to participate in this sucky but life-prolonging treatment.

[Paul]

I Really hate being the horseman of doom, but I think you are unaware of a couple of things:

You say "I am pretty much looking at lots of overtime and a second job". This will probably be impossible with HD. You are looking at three day a week on dialysis. This will eventually (not at first) be four hours of dialysis. Another half hour to be put on and taken off. Waiting time because the staff will be dealing with several patients at a time and there will be some delay between being ready to be put on/taken off and it actually happening, and travelling time to and from the dialysis centre. You are looking at a minimum of six hours, three times a week. With an understanding dialysis centre and an understanding boss it is possible to do a full time job, but this will involve picking hours to suit (e.g. taking the late dialysis, and getting your boss to agree you come in an hour early so you can leave an hour early). You could also fit in a bit of overtime, if you are prepared for your life to be just work and dialysis, with no time for anything else. But a second job on top of that? You'd have to go on the night shift and give up sleeping!

You may think you can fit this all in (late dialysis Mon, Wed, Fri - overtime Tues and Thurs evening - second job Sat and Sun) but could you really live like that? And if your job involves heavy lifting, could your body take that kind of punishment?

Also. you say "if I decide to follow through with dialysis". From the "if" I'm assuming you are considering not going through with dialysis. Are you aware that the only alternatives to dialysis are to get a transplant very quickly (which won't happen unless you have a donor ready, and even then it may take too long) or to die. And if you choose the latter, it gets pretty nasty. Your lungs will fill up with liquid, reducing lung capacity and you will feel tired all the time. Work will become impossible, and playing music will eventually become too exhausting. Choosing to refuse dialysis is not a decision to take because dialysis screws up your life too much. Choosing dialysis is only a decision to take if you decide that you cannot take a life on dialysis and consider suicide the only option. If you decide that, it is your choice, we will understand. But I urge you to think carefully before going down that path, and at least trying dialysis for a while before deciding that being dead is the better option. Remember, if you go on dialysis and decide that it is not for you, you can always change your mind later. But if you choose to refuse dialysis then later decide that you don't like being dead, you cannot then change your mind and come back to life for a bit of dialysis (apparently it is really difficult to set up a fistula in the arm of a zombi).

Sorry again to be the pourer of oil on your life, but you need to know these things to make an informed decision.

[DaveM]

Sorry to have been so slow to respond.  It's been a whirlwind.  I saw the Doctor again this Morning.  She is waiting for the results of the labs, but she said she doesn't need to see the exact numbers to have a rough idea of what is happening.  Yesterday, on her advice, we cancelled the Fistula surgery that would have taken place tomorrow.  She pointed out that we can always reschedule it on short notice, even before the weekend, if we have to.  She wants to see another set of labs and have a slight idea of what is going on before we run off willy nilly for random surgery.  While she is being very serious about this matter, she is also the calm in the eye of the storm right now.  She also refuses to set aside her sense of humor, or her sense of humanity.  Amy is all "Gloom and Doom", in a panic right now, but our Doctor is being gently upbeat and positive.

The first thing they did in Urgent care was to discontinue my heart medications.  Evidently, it can interfere with kidney and liver function.  For the long term, she wants me to lose a few pounds, so that we can manage my blood pressure without a beta blocker, and to exercise and stay as active as possible.  (Again to keep my blood pressure low and stable)  I was not on any medications that messed with fluids in the body, though. ( No diuretics or similar drugs.)  I do have an arrhythmia.  It is back after not taking medication for a week. 

Thanks for all of the replies and the help.  Paul, I appreciate the reality check.  It jives with most of what I have learned over the weekend about lifting, exertion, fistulas, HD and the like.  I am not going to be a suitable transplant candidate due to my other underlying conditions, so keeping as much function as possible in my remaining kidney is key.  The Doctor is tempering us on the dialysis until we have a better idea of what the kidney is going to do.  I was more than "unaware of a couple of things"  I actually had no idea whatsoever of what I was even looking at.

[Paul]

WRT "I do pretty heavy lifting with both hands at work": If you haven't seen the thread already, I would guess, from his introduction, this member could help you with advice on this.

http://ihatedialysis.com/forum/index.php?topic=34824