Life Span of a Fistula

[AlasdairUK]

Hi all,

I would like to know if you have dialysis more than three times a week, do you reduce your life span of a fistula with the extra sticks?

Thanks
Alasdair

[BigSky]

Everyone is different.

I have heard of people who have had the same fistula for over 15 years and have heard of others who have gone through several of them.

[Rerun]

That is why the "Button hole" technique is promoted.  You go in the same hole everyday.  There is a whole thread dedicated to it.

http://ihatedialysis.com/forum/index.php?topic=965.0;topicseen

[Zach]

Everyone is different.

I have heard of people who have had the same fistula for over 15 years and have heard of others who have gone through several of them.

I've had my fistula for over 15 years.  It helps if you self cannulate.       

[angieskidney]

Ya all fistulas are different. Mine has collapsed twice and I only have had it since May of this year. But with all the scar tissue in my arms it makes a difference.

[Zach]

Hi all,

I would like to know if you have dialysis more than three times a week, do you reduce your life span of a fistula with the extra sticks?

Thanks
Alasdair

If you are rotating the sites (which is moving up and down the vein), then there's probably no shorter life span of the AV fistula.  But as Rerun said, the "Button-hole" technique might be a good move.

[AlasdairUK]

Thanks for the replies,

I have asked my unit about button hole and they have not even heard of it. I was trying to explain the blunt needles and I may well have been talking to a wall. I'm trying to arrange a visit with the renal doctors to talk about it. This is not as easy as you would think I do evening shifts they only have doctors on call. I need to take a day off work to do it which is frustrating, but well worth it in the end.

Yes, I do rotate my needle sights.

thanks

[angieskidney]

They can't really rotate my needle sites and now my fistula is getting hard to stick (you have to really push to get it to go through the skin). I don't want the life of my fistula shortened because there is no room for a spot to be taught buttonhole. Any advice on what I can do to make sure my Fistula lasts? I have only had it since the very end of May this year.

[glitter]

my husband just started using his fistula on last Friday-they say its a new kind and it has the nurses all frustrated-they said it is only half-mature.The first day the couldn't use it (wed)and they turned his whole upper arm purple, then Friday they did use it,but it hurt-then today they used one needle in the fistula,and one in the cath. in his neck-he says it hurts alot more then he thought it would,the poor man was so discouraged today-its like every new hurdle that comes up is so  hard-and he can't get a break.This one really surprised him-he was looking forward to this so he could get the cath. out. How long until it doesn't hurt so much? I have read everything you all wrote about the button hole,his nurses won't even consider it.

[angieskidney]

my husband just started using his fistula on last Friday-they say its a new kind and it has the nurses all frustrated-they said it is only half-mature.The first day the couldn't use it (wed)and they turned his whole upper arm purple, then Friday they did use it,but it hurt-then today they used one needle in the fistula,and one in the cath. in his neck-he says it hurts alot more then he thought it would,the poor man was so discouraged today-its like every new hurdle that comes up is so  hard-and he can't get a break.This one really surprised him-he was looking forward to this so he could get the cath. out. How long until it doesn't hurt so much? I have read everything you all wrote about the button hole,his nurses won't even consider it.

Could he get Emla cream at the drug store? That is what I use as I hate pain and having it on for an hour prior to cannulation, with syran wrap on the arm to prevent it from evaporating, works well!

It gets better with time. My arm was constantly brusing for the first whole month or so.

See?

(My arm is a lot better now ... it has only gotten a "gooseegg" once in the last 3 weeks and I am finally getting my permcatheter out of my chest next week).

I say, give it time! It WILL get better. If it doesn't they might have to do a fistulogram (I had to have 2 so far already).

[Epoman]

my husband just started using his fistula on last Friday-they say its a new kind and it has the nurses all frustrated-they said it is only half-mature.The first day the couldn't use it (wed)and they turned his whole upper arm purple, then Friday they did use it,but it hurt-then today they used one needle in the fistula,and one in the cath. in his neck-he says it hurts alot more then he thought it would,the poor man was so discouraged today-its like every new hurdle that comes up is so  hard-and he can't get a break.This one really surprised him-he was looking forward to this so he could get the cath. out. How long until it doesn't hurt so much? I have read everything you all wrote about the button hole,his nurses won't even consider it.

Could he get Emla cream at the drug store? That is what I use as I hate pain and having it on for an hour prior to cannulation, with syran wrap on the arm to prevent it from evaporating, works well!

It gets better with time. My arm was constantly brusing for the first whole month or so.

See?

(My arm is a lot better now ... it has only gotten a "gooseegg" once in the last 3 weeks and I am finally getting my permcatheter out of my chest next week).

I say, give it time! It WILL get better. If it doesn't they might have to do a fistulogram (I had to have 2 so far already).

Keep that chest line in for as long as you can Angie, you want to be sure your fistula is working good without any problems for a few weeks at least. Did you know that you can develop a "stenosis" in the place where the cath is placed and you may not be able to have a chest cath anymore? I have a stenosis on my left side. So please do not remove that cath until your fistula is giving you no problems.

[glitter]

 

[Zach]

my husband just started using his fistula on last Friday-they say its a new kind and it has the nurses all frustrated-they said it is only half-mature.The first day the couldn't use it (wed)and they turned his whole upper arm purple, then Friday they did use it,but it hurt-then today they used one needle in the fistula,and one in the cath. in his neck-he says it hurts alot more then he thought it would,the poor man was so discouraged today-its like every new hurdle that comes up is so  hard-and he can't get a break.This one really surprised him-he was looking forward to this so he could get the cath. out. How long until it doesn't hurt so much? I have read everything you all wrote about the button hole,his nurses won't even consider it.

Is he continuing to exercise it?  The longer he does, the stronger (blood flow) it becomes.

[angieskidney]

my husband just started using his fistula on last Friday-they say its a new kind and it has the nurses all frustrated-they said it is only half-mature.The first day the couldn't use it (wed)and they turned his whole upper arm purple, then Friday they did use it,but it hurt-then today they used one needle in the fistula,and one in the cath. in his neck-he says it hurts alot more then he thought it would,the poor man was so discouraged today-its like every new hurdle that comes up is so  hard-and he can't get a break.This one really surprised him-he was looking forward to this so he could get the cath. out. How long until it doesn't hurt so much? I have read everything you all wrote about the button hole,his nurses won't even consider it.

Could he get Emla cream at the drug store? That is what I use as I hate pain and having it on for an hour prior to cannulation, with syran wrap on the arm to prevent it from evaporating, works well!

It gets better with time. My arm was constantly brusing for the first whole month or so.

See?

(My arm is a lot better now ... it has only gotten a "gooseegg" once in the last 3 weeks and I am finally getting my permcatheter out of my chest next week).

I say, give it time! It WILL get better. If it doesn't they might have to do a fistulogram (I had to have 2 so far already).

Keep that chest line in for as long as you can Angie, you want to be sure your fistula is working good without any problems for a few weeks at least. Did you know that you can develop a "stenosis" in the place where the cath is placed and you may not be able to have a chest cath anymore? I have a stenosis on my left side. So please do not remove that cath until your fistula is giving you no problems.

I told the Neph but he said that I have had it in now for 3 weeks no problems (of course that was before they had to use the cath again last Friday). He said 3 weeks is long enough as they usually only wait 2 weeks. Still .. sometimes I feel like they don't take me seriously and that all my words go in one ear and out the other ...

The catheter is scheduled to come out next Tuesday...

[Stacy Without An E]

I had my fistula installed in July of 2005 by a really jerky doctor, but he did know what he was doing.  Doctors, nurses and the like are amazed that it's still operational 11 years later.  I go three days a week for three hours at a time, so it does get regular use.  I have had to have it cleaned three times since I started up again back in 2004, but it's better than a complete replacement.  My doctor wants to replace it in my upper arm, but after my horrid experience with the attempt at a PD catheter that never worked (he was a quack) I'm not really in the mood to have more huge co-pays in my life.

If you get a qualified doctor who had placed many of these in people's arms, it could last indefinately with proper care and regular cleanings.

Stacy Without An E

stacywithoutane.blogspot.com/

First Transplant: 1983
Second Transplant: 1996
Third Transplant: ANY DAY NOW

[glitter]

Is he continuing to exercise it?  The longer he does, the stronger (blood flow) it becomes.

yes,he is exercising it,they have been using only one needle all week now.He says he is just blown away by how painful it is.
At least I showed him those pics you posted angieskidney,and read him what everyone wrote,so he has a bit of hope that it will get better over time. Its funny when(not ha ha) when you ask what to expect from the Dr. they only talk about the procedure,they never really mention the pain or side-effects which just serves to make the effects more scary because you don't know what is normal.

[angieskidney]

Is he continuing to exercise it?  The longer he does, the stronger (blood flow) it becomes.

yes,he is exercising it,they have been using only one needle all week now.He says he is just blown away by how painful it is.
At least I showed him those pics you posted angieskidney,and read him what everyone wrote,so he has a bit of hope that it will get better over time. Its funny when(not ha ha) when you ask what to expect from the Dr. they only talk about the procedure,they never really mention the pain or side-effects which just serves to make the effects more scary because you don't know what is normal.

Ya exactly!! That is why we as patients must speak up so new patients are not left in the dark! We all know how scary it is for the first time!!

For the pain all I can suggest is going to the drug store, buying Emla cream, using very litte as it is expensive, and wrapping the arm in Cyran Wrap to make it last and not evaporate! Some dialysis units offer a numbing needle (don't know what it is called since my unit does not). Ask about it!

Also when they started with me they used just one needle at first (17 gauge which is smaller than the 15gauge) and then 2 17ga and then they went to 2 15gauge (smaller numbers mean bigger needles!). What is he at now? I heard some do 16 gauge as well.