TIE OFF AV FISTULA IN GROIN

[huldafolk]

Hi; Just wanting to know if anyone has ever had an AV fistula tied off in the upper leg/groin area.?  I have had it in place for over 7 years. It has never been used for D , but rather was placed to increase blood flow through my IVC to prevent further blood clotting (Past constriction of IVC due to huge polycystic kidneys that were removed).  It has caused a back flow/congestion of venous flow in my leg causing ulcers and pain and engorgement of the leg.  The vascular surg. is going to tie it off on Jan 18,2011 in order to assist with the leg issues. but mainly because of future kidney transplant. He feels that the venous pressures in the area would be too great for the kidney graft to withstand. They have left me on Plavix and ASA ,but have taken me down off the coumadin for the procedure( I had a RCA heart stent placed 10 weeks ago). The anesthetist said that on review of my chart ,that I remain at risk for a heart attack due to the instrumentation of the heart vasculature 10 weeks ago, although the risk is lower now than it would be if the surg. was being done in the fist 4 to 6 weeks after the stent placement.

[huldafolk]

Just an update,  had the surg. and all went well for the start and immediate post op.  About 24 hours after the surg. I began to experience extreme leg pain from groin down to foot.  I could not get my leg into a comfortable position that would alleviate the pain.  It was so intense that I could not even touch the skin of my leg without causing pain . This lasted for about another 24 hours, then has subsided except for the area around the biggest/thickest vessel that was present down the inside of my leg.  It seemed to be pain related to the sudden closing off of the large vessels that formed over 7 years that I had the groin fistula in place.  I don't think even the vascular surgeon was expecting that I would have such extreme pain, as they wanted to stop my IV pain meds well before I was ready to have it stopped. I just switched over to oral hrdromorph which was barely adequate for the first and second post op day at home.  At least this is one step closer to the elusive transplant, and I won't have that kind of pain to deal with post transplant.  NOT DEAD YET!!!!

[rsudock]

sorry you were in so much pain but glad surgery went well!

xo,
R

[Kay]

Sounds like you have had a lot to deal with over the years. Hope the pain has subsided now and that longed for transplant is on its way to you! Keep smiling

[karrye]

Congratulations on making it through the pain and the surgery.  You have a transplant in the future and this was one needed, if painful, step in a new and bright direction!

[huldafolk]

Further update;  I have reduced my dry weight 1.5 kg since the fistula was tied off.  The legs appear very similar in size and volume.  I have had a sudden increase in blood pressures since the surg.  I am running at ~ 165/100 p 87 . I have a constant headache requiring increasing amounts of T3 and hydromorph.  I feel that the symptoms that I am having at dialysis treatments is an indication that the dry weight goal is too low.  There is no way that I can take off more fluid to get lower pressures, as the headache and full body sweats are making me have to stop treatments early .  I have to wonder if anything vascular has changed that has resulted in the increased blood pressures.  Post treatment prior to surg. I was ~ 125/70 ~ if not lower and crashing.  Any ideas??  I have neph and Vascular surg. in on the situation . Waiting for their replys.