Fistula Bumps...

[rsudock]

Good morning friends,
 I have been noticing that folks at my unit have these huge bumps/lumps on their fistulas. It scares me...is my fistula going to look like that? My buttonholes are not really taking to the blunt needles and I still continue to use sharps...does this affect the fistula balloning out like that?
Anything you can do to stop or reduce that? How do you get rid of it once it happens?
xo,
R

[Phil]

I was worried about the same thing when I started.....and from what I understand, basically, the longer you're on HD the more likely you are to get aneurysms (bumps). This is because eventually the skin weakens around the needling areas and due to the high blood pressure, balloons out. It also dipends on the structure of your veins, so some people will get larger bumps than other people.

I have heard that the buttonhole technique can reduce the risk of aneurysms, but there is no way (that I know) to reverse them once created. I'm not sure, but if & when a fistula stops working, then I think the aneursyms 'deflate'....but not sure on this last part.

At the end of the day I'm not as worried as I was....my fistula is what keeps me alive.

[KICKSTART]

Oh ive seen some whoppers ! and thought ewww, so you are not alone on that one. Everyone i asked about them (no one minded) seemed to say the same thing and that was they had had them for many years and a lot of it was scar tissue as the fistula with use over the years toughens up ! So you might have to wait a while before you need worry about that 

[Gandalf]

I have been dialysing for less than a year, and already have a lumpish bumpish arm - but I have scrawny arms so maybe it makes it worse.  Seems its pretty much par for the course, although I certainly find it less disfiguring than the permcath was.......

[Brightsky69]

I was  always worried about that. That was one reason I wanted to do PD. One of my nurses was telling me about a patient that hated the idea of a PD catheter because she wanted still look good in a bikini. I was thinking does she know what a fistula can do to the arm?

[Poppylicious]

The 'bumps' were one of the main reasons Blokey didn't want a fistula.  He's been using his fistula for a couple of months now (and I've just realised we don't have all the hoo-haa we used to have when he was using the line in his chest) and came home on Wednesday to announce that his arm was starting to get 'bumpy'.  He seemed a little sad, but I said that I'd rather he had a 'bumpy' arm than not be here and that I promise not to love him any less because of it.

 

[tyefly]

High blood speeds..... could that be the cause of those large bumps.....   

[grannysgirl]

  I was anti-fistula too because of the huge bumps. I did inquire as to why and was given a couple of answers from both techs and a doc. I was told " if you are cannulized at the same spot all the time that this happens". These bumps can be removed with plastic surgery! " One fellow patient told me that we can have them removed anytime we get tired of looking at them. I have hard bumps up dand own my arm so who knows what the real answer is.

[talker]

Once I was happy, but I'm not forlorn,
to see my fistula partially tattered but not torn,
so over hill, over dale,
rushes my blood, under full sail,
against the mounds, I don't rail,
as it keeps this body on life's trail.
If I were to add 'Burma Shave' how many would ,get it!'

[Michael Murphy]

Repeated use of the same spots weakens the blood vessel walls and aneurisms form.  The methods that I have heard  work are button holes and then there is what is known as the ladder approach.  The ladder is a new spot every session and spreads the load over more of the fistula.  The Down side is that frequent sticks at the same spot reduces the pain of the insertion so every time they move its going to hurt, second every time a new spot is used there is a chance of infiltration.  If I am not paying attention at the start of dialysis there is a good chance I will be stuck in my small bumps.  But if I insist they will move either up the arm or down and I am happier.  The other thing I have noticed is some patients do not like the pain and will complain if they are stuck in a new place.

[Simon Dog]

While not generally promoted, it is possible to learn to create/use buttonholes for selt canulation even if you are an in-center patient.

[Cowdog]

I'm an in-center patient and create/use buttonholes for self cannulation.