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Author Topic: When is your fistula "mature"?  (Read 6185 times)
MooseMom
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« on: June 17, 2010, 11:42:11 PM »

My fistula was created back in mid-March.  After several weeks had gone by, my surgeon and my neph both said that it was "excellent".  God knows it buzzes all the time, and I can feel the thrill and the bruit and the samba and the waltz and the jig and the jog and just about everything else you can think of.  I think I can see where the vein is getting bigger, but I'm not sure.  Anyway, I haven't had to use it yet, so I don't have any way of knowing if it is ready.  How do you know?

Oh, yes...I CAN see a little part of my upper arm throbbing.  Oh, this creeps me out.  Does that mean it's mature?
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"Eggs are so inadequate, don't you think?  I mean, they ought to be able to become anything, but instead you always get a chicken.  Or a duck.  Or whatever they're programmed to be.  You never get anything interesting, like regret, or the middle of last week."
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« Reply #1 on: June 17, 2010, 11:44:49 PM »

I'm asking myself the same question!!!! Two days ago my neph told me that next wednesday I'm going to have my first session of HD....and newxt wednesday will be 30 days since my fistula was created!!!!! Seems a little early for me....but what do I know right??? lol
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1993 - Diagnosed with Alport Sindrome
April 2010 - Fistula surgery on right forearm
May 2010 - Started HD
Still waiting for the call!!!!!
MooseMom
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« Reply #2 on: June 17, 2010, 11:59:15 PM »

I'm asking myself the same question!!!! Two days ago my neph told me that next wednesday I'm going to have my first session of HD....and newxt wednesday will be 30 days since my fistula was created!!!!! Seems a little early for me....but what do I know right??? lol

Yes, I remember your thread about your first session coming up, and I'll be very eager to hear how your fistula responds.  Thirty days seems pretty early, but it's different for everyone.  Have you been exercising yours?  I asked my neph and my surgeon about exercising it, and they BOTH told me to, and I quote, "Ignore it."  So, I've just been carrying on as usual, lifting heavy bags of mulch and picking up heavy cast iron pots for cooking.
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"Eggs are so inadequate, don't you think?  I mean, they ought to be able to become anything, but instead you always get a chicken.  Or a duck.  Or whatever they're programmed to be.  You never get anything interesting, like regret, or the middle of last week."
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« Reply #3 on: June 18, 2010, 12:12:26 AM »

My surgeon and my neph told me to simply be careful with it...avoid heavy wights..not bend my arm too much in the first couple of weeks....they never mentioned excercise! I admit that I close and open my fist alot in a attempt of minimal exercise! lol
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1993 - Diagnosed with Alport Sindrome
April 2010 - Fistula surgery on right forearm
May 2010 - Started HD
Still waiting for the call!!!!!
Des
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« Reply #4 on: June 18, 2010, 01:44:03 AM »

I am a newby on dialysis.

Had my fistula done on the 29 Jan and had my first successfull dialysis on the 5 April.

I did not have the most wonderfull experiences my first few time. First time I got stuck 9 times and was sent home with an icepack without dialysis OUCH!!!! I had to excercize it often with a "stressball" to speed the maturity up. I have had lots of bad things happen since. 2 infiltrations- this is where the needle goes through the vein and the blood goes into the mussle - VERY VERY painful. Was rushed to ICU with a very high pulse and chest pains. Crashed- where your bloodpressure drops so low that you loose conceshness (sorry about the spelling) But I have had some good things happen too. My fistula can handle a pumpspeed of 300ml. And I have moved from a 3 hour session to a 4 hour session. My bloodpressure is under control and I have started using bigger needles and off course I FEEL FAB now that the toxins are clearing out. 

So what I am trying to say is.... take one day at a time and no two people are the same.I still battle emotionally but physically I am coping with it all.
Good luck and DO excercize it often and dont' pick up heavy stuff as you can tear it.
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Please note: I am no expert. Advise given is not medical advise but from my own experience or research. Or just a feeling...

South Africa
PKD
Jan 2010 Nephrectomy (left kidney)
Jan 2010 Fistula
Started April 2010 Hemo Dialysis(hate every second of it)
Nov 2012 Placed on disalibity (loving it)
Stoday
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« Reply #5 on: June 18, 2010, 11:06:02 AM »

I FEEL FAB now that the toxins are clearing out. 
I hope you don't mind my asking, Des, but how long was it before you started feeling fab? I'm told that I won't feel good again as soon as I start, it will take a bit of time.
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Diagnosed stage 3 CKD May 2003
AV fistula placed June 2009
Started hemo July 2010
Heart Attacks June 2005; October 2010; July 2011
MooseMom
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« Reply #6 on: June 18, 2010, 12:04:58 PM »

Oh Des, your post about your first day on D is seared in my memory.  Did anyone specifically say that the reason you had such problems was because your fistula was not yet mature?  The day you were due to start, did you look at it and think, "Oh yeah, this baby is ready to go!", or did you think, "Where the hell is it?"  I know everyone is different, but what criteria is used to determine maturity?

Stoday, I've been told the same thing by IHDers and various doctors.  I guess not only are you full of toxins, but also your body needs to get used to the rather violent fluid overload/withdrawal.  D is an unnatural process, and I can see how the early days are difficult for many reasons.  Yours is a good question.
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"Eggs are so inadequate, don't you think?  I mean, they ought to be able to become anything, but instead you always get a chicken.  Or a duck.  Or whatever they're programmed to be.  You never get anything interesting, like regret, or the middle of last week."
monrein
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« Reply #7 on: June 18, 2010, 03:40:15 PM »

2 to 3 months ought to be enough time for a fistula to mature and be ready to start being used but even a mature fistula can be delicate in the beginning.  Everyone's so different it's really hard to be too definitive on this stuff.   They'll start most likely with smaller (17 gauge needles) and gradually move up to the larger ones (15 gauge) as the fistula toughens up with repeated use.
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Pyelonephritis (began at 8 mos old)
Home haemo 1980-1985 (self-cannulated with 15 gauge sharps)
Cadaveric transplant 1985
New upper-arm fistula April 2008
Uldall-Cook catheter inserted May 2008
Haemo-dialysis, self care unit June 2008
(2 1/2 hours X 5 weekly)
Self-cannulated, 15 gauge blunts, buttonholes.
Living donor transplant (sister-in law Kathy) Feb. 2009
First failed kidney transplant removed Apr.  2009
Second trx doing great so far...all lab values in normal ranges
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« Reply #8 on: June 18, 2010, 05:11:34 PM »

I FEEL FAB now that the toxins are clearing out. 
I hope you don't mind my asking, Des, but how long was it before you started feeling fab? I'm told that I won't feel good again as soon as I start, it will take a bit of time.

The very first time I had dialysis, 3 hemo sessions in 3 days in the hospital, I had a really bad case of "dirty fishbowl syndrome" for a week after, and I felt disconnected from my own body, kinda dizzy-without-really-being-dizzy, and my feet swelled up and went partially numb. Even so, I still felt good enough to do more things than I would've normally done - cooking and such. It's different for everyone, though.
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- Matt - wasabiflux.org
- Dialysis Calculators

3/2007Kidney failure diagnosed5/2010In-center hemodialysis
8/2008Peritoneal catheter placed1/2012Upper arm fistula created
9/2008Peritoneal catheter replaced3/2012Started using fistula
9/2008Began CAPD4/2012Buttonholes created
3/2009Switched to CCPD w/ Newton IQ cycler            4/2012HD catheter removed
7/2009Switched to Liberty cycler            4/2018Transplanted at UCLA!
FindingNeverland
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« Reply #9 on: June 18, 2010, 05:19:14 PM »

I got my fistula at the end of March and just started using it a couple weeks ago, which would be about 7/8 weeks out from the surgery. I had trouble the first two times and wound up just using my catheter. They say that it's very strong but it's also small, of course I am a very small person to begin with (4'10 85 pnds). By the third try they finally got it. I've gone four times with my fistula so far, twice using two needles and dialysis has been going well for me. I had to take a break this past week because they infiltrated but I blame it on the tech who did it and will not let that person do it again, I don't think they were used to cannulating someone like me as the more experienced nurse who initially stuck me. Like they say though, everyone is different.
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sullidog
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« Reply #10 on: June 19, 2010, 07:35:38 PM »

The policy for our center is they will start with 17 gage, if you have a catheter they put one needle in the access and use one port on your catheter until fully developed. I was told they really don't know how it's going to go until it's actually done.
Troy
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May 13, 2009, went to urgent care with shortness of breath
May 19, 2009, went to doctor for severe nausea
May 20, 2009, admited to hospital for kidney failure
May 20, 2009, started dialysis with a groin cath
May 25, 2009, permacath was placed
august 24, 2009, was suppose to have access placement but instead was admited to hospital for low potassium
august 25, 2009, access placement
January 16, 2010 thrombectomy was done on access
MooseMom
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« Reply #11 on: June 19, 2010, 07:40:05 PM »

I was told they really don't know how it's going to go until it's actually done.
Troy

I figured this was the answer.
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"Eggs are so inadequate, don't you think?  I mean, they ought to be able to become anything, but instead you always get a chicken.  Or a duck.  Or whatever they're programmed to be.  You never get anything interesting, like regret, or the middle of last week."
Des
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« Reply #12 on: June 20, 2010, 10:46:08 PM »

I FEEL FAB now that the toxins are clearing out. 
I hope you don't mind my asking, Des, but how long was it before you started feeling fab? I'm told that I won't feel good again as soon as I start, it will take a bit of time.

Just after the first 3 weeks I felt a surge of energy and people said that I wasn't so swolen and pale anymore. I have had some tired days in between but they are few in comparison to the "before" dialysis.   If it wasn't for the time away from family I would have said: I love dialysis. heheheheh
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Please note: I am no expert. Advise given is not medical advise but from my own experience or research. Or just a feeling...

South Africa
PKD
Jan 2010 Nephrectomy (left kidney)
Jan 2010 Fistula
Started April 2010 Hemo Dialysis(hate every second of it)
Nov 2012 Placed on disalibity (loving it)
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