I hate my access!

[sullidog]

I'm getting real fed up with this graft! It only runs at 450 whenever it feels like it and I'm always have to be recanulated a lott because when they try to get it to run at 450 I get infiltrated and it hurts like a b**!. It's always my venus that's running high so that can only mean one thing,  that same section is probably narrowing again! They already tried a balloon, and then a stent, I don't know what else they are able to try. My center doesn't do flow tests, not sure why but they don't. My bruit has quieted to a base like swish no and sometimes it will be very week and pick back up again. Today I had the FA nurse feel it it was fine, but I do notice it weekening then it picks back up again the weird thing is it's mainly when I take a hot shower but I've also noticed it from just sitting around. I don't know if they can do much else with this graft but go in there and do a fistula gram for the third time, and then the cycle will repeat, it will run good for a few treatments then it will narrow off again, there's gotta be something that can be done. I've had more then one surgeon work on it and each surgeon while doing the procedure differently they always come up with the same result, narrowing! My failed graft would do the same thing.
I am fed up!
Any advise you can offer me would be greatly welcomed!
Troy

[hexoffender]

I have a fistula, so your mileage may vary. But, when I first began using the fistula I also had problems with narrowing. After several stents to open up areas of my are that did nothing, one of the vascular surgeons figured out that the problem wasn't stenosis. The problem was a tertiary vessel was routing blood away from the fistula. He used a 'coil', which is really just a piece of wire, to wrap around the vessel and re-route the flow back to the fistula. The solution is to find a better vascular surgeon.

[Rerun]

Your body knows that a lot of blood is going to that arm and it is not nautral so it tries to shut if off.  Just keep opening it.  My body has finally accepted it.  (I HOPE) 

Call your vascular surgeon.  Some places have intervention specialists that just do fistulas and grafts..... find one.

[Ken Shelmerdine]

When your bruin becomes very low are you testing your BP. It could be low blood pressure. If you are passing a lot of fluid you may be having some fluid taken off unnessarilly and this can cause low BP and flatten a fistula and maybe a graft. Remember most patients don't pee much so the excess fluid they come to clinic with is causing the blood to pound through their veins making the fistula stand up and widen out.

I have come to an agreemnet at my clinic that on the morning of dialysis I drink a lot of fluid otherwise at my dry weight my fistula is flat and difficult to needle. I go in about .4 of a kilo over dry weight which later I pass normally either near or at the end of dialysis and I then go below my dry weight without the need for any UF removal. Maybe this won't apply to you  as I'm just using a fistula as an analagy and perhaps grafts don't work in that way. Just my 2 penn'orth.

[sullidog]

I still pea enough so that I don't gain so nothing is pulled off, just the minimal they need to clean the blood which in our center it's .3
Yep bp is fine. I got a huge lump now where they've played and played with the needle, the playing with the needle actually hurts worse then the needle going into the skin in my oppinion.
There was a tech in our center that would get it to run fine every time, but she quit,
My neph comes tomorrow and he seems to know a lot about accesses, so I will talk to him as well.
Right now it seems to be buzzing nice and strong.