Fistula too narrow--could it get better in the future?

[RightSide]

I had my most recent fistula operation on August 12.

Around the end of October,
I started using my upper-arm fistula for the first time.  It's working, but not perfectly. 

It's not straight, but has some zigs and zags as it goes up my arm.  And the ultrasound showed that there is at least one narrow area, maybe about 1.8 cm long, which my surgeon told me to avoid for now.

So my techs have had some difficulty cannulating me. They have to spend time futzing around with the needles to "point" them in just the right direction to follow the curves of the fistula and to deal with the narrow areas.  Otherwise the flow is poor or the pressure builds up.  And I've had one humongous infiltration already.

Is there any chance that these problems will get better over time?  Or am I looking at revision surgery here?

[BigSky]

They can grow in time with being used for dialysis.  It really varies from person to person whether it will grow or stay the same or try to narrow even more.

The problem is if your Kt/V is within the apprioate range.  If its not you really dont want to go months with low Kt/V's waiting for it to grow.

If it doesnt enlarge they can do a fistulagram and use a balloon to try and enlarge the narrow areas rather then doing a revision surgery.

[willowtreewren]

The more we use Carl's the bigger it gets. 

[Brianna!]

They can do a angioplasty, where they put a balloon in your arm, and "blow up" the narrow parts. Have they done a fistulagram on you? They inject dye in your arm and they see how the fistula looks. I had a angioplasty, but my venous is still messed up. The stupid doctor who did the fistulagram only looked at the arterial, when my nurse kept telling him, we were having problems with the venous. So, when they did the angioplasty, they only worked on the arterial. So my fistula infiltrated on friday.

If they do the angioplasty, try to make them put you under, or give you something to make you forget. I heard it is supposed to really hurt. I was under, when they did mine, and when I woke up, my arm was really sore.

[nursewratchet]

Exercise it.  Use the squeeze ball at any resting period.  The more it is used and exercised, the better and bigger it will get.