Failed fistula

[calypso]

So I had a fistula created in my left wrist  a week ago. It worked for all of about 2 hours then clotted off. Now they want to make a new one in the upper part of the same left arm. I want a different surgeon, I want to get the surgeon that did my chest catheter to do it, but to do that I need to see my PCP to get the referral for insurance purposes, and I can't gt an appt with PCP for a month (all booked up)

Advice? Thanks.

[paul.karen]

No APPT for a month??

That is a shame to say the least.  Cant you say it is a matter of great concern.  Not like you have a runny nose.

Good Luck...

[MooseMom]

It sounds like you are on an HMO like I am...is that right?  I don't know about your PCP's practice, but in mine, they have a separate person who deals with referrals.  I don't have to actually see/consult/have an appointment with my PCP for a referral...he just has to provide one.  Try this...give your PCP's practice a call and tell them exactly what you told us here.  Does the surgeon who did your chest catheter do vascular surgery...find this out first; find out if he does fistulas.  If so, and if that's who you want. tell your PCP's office that that is who you want and that you want a referral for a consult AND a doppler ultrasound.

When my neph told me it was time to get a fistula, I was really upset, and I whined about all of the paperwork that was going to be involved.  He told me that he'd make sure I got everything I needed, and I did.  Your PCP doesn't have to examine you just to provide you with a referral to a vascular surgeon.  Let us know what happens, OK?

[okarol]

Jenna had the same issue. The original surgeon wanted to abandon the site and create a new one. We switched surgeon's (the local Children's Hospital gave us the name of the surgeon that did all the tiny arms and difficult cases.) That doc reworked the existing fistula and it worked perfectly.

[dyann]

The one in my wrist failed then they put one in my middle arm it failed now I have my 3rd one in my upper left arm and so far so good..  I heard from my doctor that they fail about 30% of the time when put in the wrist area  well at least that is what he told me

[sullidog]

I'm on my second graft. My second one they decided to leave alone when it clotted off for the second time. This new one is in my corax vain or at least that's what I think it's called in the upper arm. My surgeon has never used this vain for anyone before.
I'd say get a second opp if you can.
Troy

[calypso]

It sounds like you are on an HMO like I am...is that right?  I don't know about your PCP's practice, but in mine, they have a separate person who deals with referrals.  I don't have to actually see/consult/have an appointment with my PCP for a referral...he just has to provide one.  Try this...give your PCP's practice a call and tell them exactly what you told us here.  Does the surgeon who did your chest catheter do vascular surgery...find this out first; find out if he does fistulas.  If so, and if that's who you want. tell your PCP's office that that is who you want and that you want a referral for a consult AND a doppler ultrasound.

When my neph told me it was time to get a fistula, I was really upset, and I whined about all of the paperwork that was going to be involved.  He told me that he'd make sure I got everything I needed, and I did.  Your PCP doesn't have to examine you just to provide you with a referral to a vascular surgeon.  Let us know what happens, OK?

Yes I'm on an HMO. And yes I will call them and tell them what I told you all here. And yes the surgeon that did my cath also does fistulas. Now doppler ultrasound, I've never had that done, what is that? Will that show why the wrist fistula died? The surgeon said it most likely may have clotted.

Should I request that the wrist fistula be reworked or to start a new one? I'm kind of young: 38 yrs old, and don't want to run out of options for fistula placement sites anytime soon if they all clot at some point. Also is a fistula in the bicep not without side affects? Sorry I have so many questions and i know I should be asking the surgeons this and I do but I never know if I'm getting a straight answer from them or just their opinion so the more opinions or first hand accounts I can hear the better decision I can make. Thank you all for being so supportive, I'm learning a lot here.

Also I was put under general anesthesia for the wrist fistula and it made me vomit a lot even though they gave me double dose of an anti emetic, whereas when I had the catheter put in the general anesthesia didn't make me so sick, although I had peritonitis back then and was under other medications as well so I don't know but I think the catheter surgeon's choice of anesthesiologist was better as well which is why I want to have him do it. I'm rambling aren't I? Sorry. Ok well thanks for all the advice keep it comin, I'll be sure and let you know how it goes.