Fistula Location Question

[HelloKidney]

Hello -

After doing vein mapping, my doc says my veins look fairly comparable on both arms for a fistula. I am not sure where the best place is to put a fistula, doc said I can do it on upper arm or middle arm (between elbow & wrist) or by the wrist. I do plan on self cannulation & am somewhat ambidextrous.

My question: If you already have a fistula on your arm, where is it placed, do you like where it is placed, or if you could change it, where would you have yours placed?

Thanks!

Denise

[MooseMom]

I am right handed, so my fistula is in my left arm.  The anastomosis (the point where the vein and the artery are joined) is right below the crease of my elbow, so the access will be above the crease.  I am still, though barely, pre-dialysis; I've had my fistula for just over two years and have not yet used it, so I can't really tell you if I am happy with the placement.  That is just where the vascular surgeon said would be the best place, and all of the medical people I've seen in the past two years tell me it's a really fab fistula, so I guess he was right.  If it works, I will be happy.

[Cordelia]

They highly recommend you not have it put in your dominant arm. Reason being is because you can only lift up to a certain amount of weight in your fistula arm post surgery. 

I am very glad they did not put mine in my dominant arm, which is my right arm. My fistula is on my left.

They recommend having it put in at the wrist.  If it doesn't work at the wrist, then they can go higher. From my understanding, it is best to have it put in at the wrist. I like mine there and really, it is hardly noticeable.

[noahvale]

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[Mr. B 123]

I am left handed so mine is in my right arm.  Same location as MooseMom above the elbow with the connection just below the elbow.  When I had the vein mapping done the doc said I had 2 brachia arteries all the way from my shoulder to my wrist so they decided to put it in the upper arm.  Guess I am a freak of nature?  Always like to be different.

[Rerun]

If they do a loop you need to ask the surgeon if you are a blue thumb or a red thumb.  I just got in a tangled mess because I didn't know what I was and they ran me backwards for 4 times and my labs were really bad.  So, if it is straight you don't need to know.  But, I guess loops you will need to know.  Mine is a graft.  I don't know if they loop fistulas.

[HelloKidney]

MooseMom - Wow that is great that you have been able to stave off dialysis for 2 years! Congrats on your top notch fistula, from what I hear, they are priceless! Thanks for the explanation of anastomosis, I was thinking that the access was done at the anastomosis.

Cordelia/Noahvale - Do you know why they recommend starting at the bottom and moving up? Are new veins joined together for each time you move up?

Does anyone know why some fistulas are visible and others are not? My mom was on dialysis for 15yrs and hers sticks up above her arm about 2" and it about 5" long.

Noahvale - Thanks for the links! I have not found much info on this on my own. I am planning on buttonhole, my brother did this for a year and recommended it. 

Mr. B 123 - That is funny that you mention the dupe set of arteries, as my rad tech told me I had them as well!
 
Rerun - Thanks for the heads up, I will remember to ask them about it. It sounded painful. Is that like hooking the the cold water to the hot faucet and the hot water to the cold faucet?

[malaka]

One more thing to consider.  I'm now on hemodialysis.  Fistula is above left wrist.  I'm right handed.  On dialysis, you essentially can't move to dialysis access arm for 3 + hours during dialysis. How good are you with your non-dominant hand versus your dominant hand?  I'm "very" right handed, so I can operate my Kindle with my right hand alone.  And put on and take off my reading glasses. 
 
In summary, I'm glad mine is where it is.  Sitting there unable to accomplish thiese minor tasks would drive me crazy!

[Mr. B 123]

HelloKidney,  so you got the same thing going on with 2 arteries, they said it is not real common, but they see it sometimes.  The doctor told me I should not have a problem with steal syndrome due to improved blood flow with 2 arteries to the hand.  At least one good thing while dealing with kidney issues.  Hope all goes well for you.

[Rain]

I am left handed and my fistula is place on my upper left arm.   It was the best place for it.  If I had a choice I would have done lower arm since it's easier to hid. 

I self needle and have no problems with needling with my right hand even though I"m left handed. 

[Sue]

I'm relieved to read your post Rain, I am right handed and my fistula is in my right wrist, I have been concerned that when the time comes I wont be able to self needle,I've been trying to use my left hand to do other things just to get a bit used to using it lol

[Rain]

Sue next dialysis run ask the nurse if you could self needle.  And see how it feels.  It felt weird at first but after 2-3 treatments it was easy. 

[mamagemini]

Mine is is my dominant arm because all the veins in my other arm were useless...too tiny. It is in the crease of my elbow and have been told the veins are deep. So when I start on Wednesday it will be intersting to watch them try and get it in. That and my arm is all mottled from the fistulagram over a week ago.

[Sue]

Rain I am pre-dialysis - still hanging in there lol, gfr stable at 12 for now !  I am hoping to do home dialysis when I have to start tho, I am linked to a home dialysis unit and will start training when the time comes.

Good luck for Wednesday mama'