Fistula??

[woodsman]

I had my fistula placed on nov 9th. Now i can feel it vibrating but  i don't see any vein(s) growing yet. Should i be seeing something growing??. How could they place needles if they cannot see where to put them???


...............

[YLGuy]

They do it by feel.  They will gently push nad usually can feel it below your skin.  Some are deeper and harder to find unfortunately.

[MooseMom]

I didn't start to see any veins growing until maybe 5 months after the procedure.  Before that time, I saw the vascular surgeon a couple of times because I was paranoid and needed reassurance that all was well.  He said that everything was fine.  I think you may just have to give your veins a bit more time before "growing".  Even thought my vein growth seems really obvious to me, I am not sure it would be apparent to anyone else.

I assume that if they couldn't see where to put the needles, they could FEEL where they should go.  Not sure about this, though.

[woodsman]

That part about them being able to "feel" where to place the needles is not reassuring i'll say that.   

[Pam]

They had to feel where to place my needles for the first few weeks. Then I started button holes.My fistulas is much more predominate than it was at the start. Button holes are the way to go! There is no question then where the needles are going.
Pam

[Stoday]

Shortly after I got my fistula I could raise it by grasping my elbow and blocking the vein. I'm told that that is very naughty, so I'm not suggesting anyone should do so too.

Don't worry — it will become very visible 6 months after you start using it!

[RichardMEL]

Don't sweat it. Remember most(*) of the techs/nurses have been needling for years and they will be able to do it easily I bet. Don't forget to do your strength exercises with the ball(or whatever they gave you to use) which will help mature the fistula and make it easier for them.


(*) obviously there are newbies everywhere, but with new patients usually experienced staff are used for just this sort of situation - well that's what I've noticed anyway.

[MooseMom]

I've already approached my clinic with this question.  I was told that all of the techs are "master cannulators" who specialize in using new fistulae.  I hope that's not just bs.

[YLGuy]

Some people truly have "the touch".  I am sorry but I have a hard time swallowing that all the techs have it.  I would bet that some are better than others but they do not want you all always asking for a certain tech to cannulate.  I could be wrong and your center is the exception.

[RichardMEL]

Like any human process some will be better than others. That's life. Think about simple blood draws (of which I have had a heap over the past 3 weeks) - some are very good and cause almost no pain, others..... well I won't post a picture of my right arm!!!  I do think though in most places when a new patient starts to use their fistula for the first time there is definitely an effort to get the more experienced folks to stick them.

[MooseMom]

Some people truly have "the touch".  I am sorry but I have a hard time swallowing that all the techs have it.  I would bet that some are better than others but they do not want you all always asking for a certain tech to cannulate.  I could be wrong and your center is the exception.

The clinic that I assume I will be going to/training at is quite small and is not run by any of the big dialysis providers.  Maybe all of the techs/nurses go to a class that gives them a certification that deems them to be "master cannulators"...I don't know.  But even then, I'm sure you are right that some are going to be better than others because cannulating is a skill that is closer to art than to mere luck.  Believe me, I know there's a difference between having a piece of paper that says "master cannulator" on it and having "the touch".

My point is that every clinic should have at least one person who is better than others at using virgin fistulae successfully.

[kellyt]

It takes a few months for the fistula to mature.  Mine never got big, but mine was a little deep.  I had a dialysis tech just feel it to be sure they could "hit" it if I had to start dialysis and she assured me they would be able to.  If not, I would have had to go back in and have the surgeon move the vein closer to the surface.  Luckily it never got big and ugly cause I never had to use it.

Work that exercise ball!

[Bruno]

They don't do it by 'touch'. They scan it a couple of times to locate where they need to cannulate and over the months following it will continue to develope so that in the end you'll even notice it youself.
Trust me.

[Stoday]

I never had a scan. All by touch & feel. 

[kellyt]

They don't do it by 'touch'. They scan it a couple of times to locate where they need to cannulate and over the months following it will continue to develope so that in the end you'll even notice it youself.
Trust me.

Well, they "touched" mine and said "We can hit that no problem".  And when I say "touched" I mean they pressed around for a bit and could really feel the vein.  They didn't just poke it with their finger.    I could even feel the large vein/fistula, but you could not visually see it just by looking at my arm.  Come to think of it I was sent back to the surgeon for him to look at it and he even "touched" it and said they shouldn't have a problem hitting it, but if they couldn't he would be more than happy to move the vein closer.

I can only give my experience.

[RichardMEL]

I've seen both. I was just felt up and they got in no problem. I think they do the scan if they can't obviously get it, or some do it to be sure anyway. I wouldn't be alarmed if they don't pull out the scanner and go at it manually - it might be easy for them to access.

[woodsman]

Well back to the neph on wed for another visit, hopefully it will be good news and D will be pushed off.. I really hate waiting to go and see this guy it really interferes with my life so much having to worry 10 days before i go..

[M3Riddler]

I've already approached my clinic with this question.  I was told that all of the techs are "master cannulators" who specialize in using new fistulae.  I hope that's not just bs.

Moosemom,

That could not be further from the truth. If this were so, then there would be no infiltrations. Some are great at it, but others shouldnt be aloud near your fistula.

[MooseMom]

I've already approached my clinic with this question.  I was told that all of the techs are "master cannulators" who specialize in using new fistulae.  I hope that's not just bs.

Moosemom,

That could not be further from the truth. If this were so, then there would be no infiltrations. Some are great at it, but others shouldnt be aloud near your fistula.

I misspoke.  Not everyone at the clinic are "master cannulators", but apparently some are.  But I understand that this label means absolutely nothing.  I just wish that the ones that shouldn't be allowed near you would wear a neon sign to that effect.  I don't want to learn from (bad) experience.  Hopefully I can learn to self-cannulate without having to need anyone else do it for me, but I do worry about being too ill to learn at the beginning.

[boswife]

hi moosemom, i dont think you'll be to ill to learn to do yourself.  Your so on top of things that i think you'll be doing just fine when the time comes.  I will add that when my hubbys buttonholes were established, they were done by a very compitant guy.  Then, i fought to have only him do them until i could take over and nope, didnt happen that way.  Now, 'I' a person who never stuck anyone before had the issue that all of those techs created...and Now was going to do a new buttonhole on him.  SO FAR, i am soooooooooo glad that im the one doing it.  I am creating my own angle etc and no one else is poking around messing with it.  We shall see, but i think things are working out well.  And... I saw you 'over there' ;-) and actually responded about 'fistulas etc'  but i must have hit the wrong button cause i just went back over to add something to it and didnt find it    Anyway, your going to do great.. You'll prob be a pro before you ever stick.. 

[MooseMom]

Well back to the neph on wed for another visit, hopefully it will be good news and D will be pushed off.. I really hate waiting to go and see this guy it really interferes with my life so much having to worry 10 days before i go..

Oh, I'll be thinking of you; OMG I hate those appts.  I have one early Jan, and I'm already getting nervous and I haven't even had my bloods taken yet.   That feeling of dread is palpable.  I feel the dread just thinking about the dread!!!  It's dreadful!!!  ACK!

Anyway, I don't want to iintrude, but I'd really like to hear about your appt if you feel like talking about it.  I'm also eager to hear how your fistula is maturing.  I hope the neph is happy with it.

[woodsman]

Well all went well at the doc's and i don't have to go back until the end of march!!! woohooo a 3 month reprieve!!!!!  . All my numbers were unchanged and he just added some pill for calcium depletion??. My fistula is still  not visabable but doc says it is maturing and may take time but it is working, (vibrates well).

MM i have come to the point that worring does nothing but deprive me of my life so i'm  not going to allow it to worry me any longer, if it happens then it happens. Worring about it just makes things worse so i'm letting it all go and moving ahead.....   

[MooseMom]

Woodsman, that's outstanding news!  Even better is your determination not to let worrying stink up your life.  I admire that attitude!
 

[kellyt]

    Congratulations!