New Fistula

[Restorer]

I had my fistula put in this morning. It's in the crook of my left elbow with the basilic vein on the inside of my upper arm. My wrist veins were too small, so the surgeon was going to connect the artery to my cephalic vein of the outside of my arm, but during surgery he decided that was too small also. I have one short (maybe 1.5 inches) incision in the inside of my elbow.

The anesthesiologist asked me what kind of sedation I wanted, whether I wanted to be completely out, or kind of aware, or mostly aware. I said I wanted to be mostly aware, but I don't remember the surgery at all, so I'm pretty sure I slept through the whole thing with not much sedative. Maybe it was the sleep deprivation from the last two days! 

It seems most people here have describe their trill as like buzzing or vibrating or purring. I don't really feel that. It feels like water rushing through a hose (is that the bruit?). I figure it'll change as my fistula matures.

[willowtreewren]

Congratulations!

 

[amanda100wilson]

Will you be self cannulating?  Mine was there, right under the scar after the second surgery to bring it to the surface and I insisted on a further surgery to move it across to the middle of the bicep so that it was accessible for self cannulation.  I thought that this was part of what he was going to do on the original transposition, but the extra surgery was well worth it because I am able to self-cannulate which was always my intention.

[sullidog]

Hope it works well for you! I like how they say you will be aware but you are always a sleep, I think different levels of anathesea work differently for people.

[Riki]

I have mine in the same place. I never had the best veins either.  My surgeon was amazing.  Now, almost 2 years after we started needling it, I now have 3 sites, and the fistula is still maturing. My higher site on my upper arm is getting bigger, and is slowly moving into my armpit. *L*

[mcclane]

congrats !

your fistula sounds like it is in the same area as mine.  took about 2-ish months to mature enough for needling, but took over 7 months for it to fully mature (where i don't have to fish around with the needle to get the flash)

[Restorer]

I guess the nurse here at dialysis (just one, since it's Saturday) is impressed with my fistula. He said it looks 2 weeks old, not 24 hours old, probably because of the lack of bruising and swelling. 

I remembered after I posted that the surgeon said he'd probably have to do a second surgery to bring the vein closer to the surface later, and at the same time he'd move it across my bicep to a spot that's easier to stick.

I've been trying to balance pain from the fistula with nausea from the Norco. It takes a lot of food and a lot of rest. Last night I woke up and the entire vein was throbbing and in pain. I had to get up to take a Norco, and then I lied in bed squirming for an hour until it kicked in.

Parts of my forearm are partially numb. I thought it was just leftover anesthetic, but it's still around so it's probably my arm being asleep thanks to the change in blood flow. It's just a couple patches on the skin anyway.

[big777bill]

 I just had my fistula surgery on Nov. 17. My forearm has some numb areas too. I think that it is caused from the surgeon cutting through nerves to get to the artery and vein. I have to go Feb. 16 to have it moved closer to the surface. So far I haven't had  much pain associated with the fistula but I did get an infection post-op. That put me in the hospital for a week and then came home with a picc line for antibiotics. I finished the antibiotics on Christmas day. The infection wasn't in the fistula but in another cut the surgeon made in my inner elbow area. He checked that area out first and decided that the veins there weren't big enough for the fistula so he put it in the inside area of my left bicep. I hope everything goes well for you when you have the next surgery. Luckily I don't have to use my fistula yet. My egfr is 17 with creatinine @ 3.8.  God Bless

[Riki]

I never had my fistula moved.  Is that a common thing to do?  One of my sites is a little deep, but it's not hard to get to.  The possibility of moving it was never brought up.  Before I started coming here, I didn't know anyone ever did that.  I'd be afraid that doing anything to it would hurt is, and make it useless.

[Restorer]

I never had my fistula moved.  Is that a common thing to do?  One of my sites is a little deep, but it's not hard to get to.  The possibility of moving it was never brought up.  Before I started coming here, I didn't know anyone ever did that.  I'd be afraid that doing anything to it would hurt is, and make it useless.

The nurse and tech today both asked me if I was with Kaiser, because apparently they do that a lot (I'm not). For me, the surgeon wants to have it moved just because getting stuck in the inner upper arm is harder. That vein was the third choice, and it might be a little deeper than ideal.

[amanda100wilson]

The surgeon had to go down to the bone to get mine and then wondered why I needed to be kept in overnight for pain - tells me I have a low pain threshold.  Duh, I'd like to see how he'd cope with that.  He told me this the other week when I was incredible and increasing pain from having my well grown-in pd cath removed.  Got to the point that I couldn'teven brush against my skin near there without pain.  He eventually aspirated a small collection of blood which I am convinced was causing compression of a nerve between it and scar tissue.

[lmunchkin]

Riki, J's has never had his moved either, but his is right at the surface.  He has, however, had to have them go in and tie off the offshoots that develope with new fistulas.  I think as long as you have no problems cannulating it should be ok!  As long as the "butterfly" is still felt.

lmunchkin
 

[Riki]

Riki, J's has never had his moved either, but his is right at the surface.  He has, however, had to have them go in and tie off the offshoots that develope with new fistulas.  I think as long as you have no problems cannulating it should be ok!  As long as the "butterfly" is still felt.

lmunchkin
 

I know that lower down, the "butterfly" as you called it, is stronger than higher up.  But the higher up spot is still developing, after the fistula being there for 2 years.  My needling began in the crook of the arm, but as the fistula developed, that spot didn't need to be used as much, and now it's only used to give one of the other 2 sites I have a break

[lmunchkin]

Forgive me if you ever mentioned it before, but I take it you do not do bottonholes.  You may have said in prevous posts.  I would try buttonholes, but the ladder method has been working great, so why change? 

But back on point, he has never had his fistula moved, cause it developed very well on surface.

lmunchkin
 

[Riki]

No. they only do buttonholes on people who are going to be putting their own needles in. My eye sight just isn't good enough for that.

My bottom sites are deeper than the top site, and I'm told that they are easier to feel than to see.  My upper site, however, I can see it myself, so to whoever is putting my needles in on any particular day, it must look huge.

[sullidog]

I also had that numming feeling, that will take a good month or so but will eventually go away.

[lmunchkin]

I wish I could post a picture of J's.  It looks like a rope about 5 to 6" between his wrist and elbow.  He is definately easy to cannulate, "Thank God".

lmunchkin

[Mr. B 123]

Got my fistula in June in the same place (just in my right arm), pain was no problem but still have numb feeling in my arm just above my wrist.  Doctor said it was normal when he does the operation and has to move the nerves around.  Not a problem but feels funny. 

Good luck with yours!

[Riki]

I wish I could post a picture of J's.  It looks like a rope about 5 to 6" between his wrist and elbow.  He is definately easy to cannulate, "Thank God".

lmunchkin

Mine isn't close enough to the skin to see, except for the top site.  You can see the 2 pseudoaneurysms on the bottom sites really well, though. *LOL*

[MooseMom]

I wish I had thought more about self-cannulation when I had my fistula created.  I didn't think to discuss it with the vascular surgeon, and he didn't think to ask me.  I've had it for almost two years, and it has been only in the past year or so that I had seriously considered home hemo, so I hope I didn't screw things up.

[Riki]

I wish I had thought more about self-cannulation when I had my fistula created.  I didn't think to discuss it with the vascular surgeon, and he didn't think to ask me.  I've had it for almost two years, and it has been only in the past year or so that I had seriously considered home hemo, so I hope I didn't screw things up.

I think as long as you can see where it is, self-cannulation won't be much of a problem.  Some people are able t needle down (needle pointing towards the hand instead of the shoulder) which would probably make it easier to put your own needles in as well.

Home hemo hasn't really been an option here until the last year or so.  I only know of one person it was offered to, but he said no.  I don't see it as an option for me, 1, because my mother refuses to put needles in me *L* and 2, I'm prone to complication, so I'd rather be somewhere with nurses around in case something happened, than to have my mom need to call 911

[MooseMom]

Riki, home hemo certainly isn't for everyone, and if you feel safer doing D in a clinic, then that's what you should do.  I'm sure that if I had your vision difficulties, I'd want to be in a clinic, also.

[Riki]

My BP drops way too fast, too.  It doesn't even have to go that low, it just drops fast, and I go out. *L*  I wouldn't want to do that in front of my mom.  That was a fear I had when I was in NYC, that my BP would drop and I'd pass out in front of my mom and my best friend, and scare the crap out of both of them

[ToddB0130]

With a fistula,  how long does it take to create buttonholes ??  And then the really dumb sounding question ..... if you're pre-D,  would the center you've selected ever start button-holes before you actually needed to start using them (I *know* that sounds dumb .... why develop button holes if you don't yet need D ?? .... but I'm just wondering,  thinking it might be easier to not only have the fistula ready for use, but also the button holes too)

[Desert Dancer]

With a fistula,  how long does it take to create buttonholes ??  And then the really dumb sounding question ..... if you're pre-D,  would the center you've selected ever start button-holes before you actually needed to start using them (I *know* that sounds dumb .... why develop button holes if you don't yet need D ?? .... but I'm just wondering,  thinking it might be easier to not only have the fistula ready for use, but also the button holes too)

I think with my original buttonholes we did 10 or 12 sharp sticks before we switched to blunts. With my second set I sharp stuck for a whole month - about 15 times - just to be certain they were established. It was probably overkill.

If you were to start buttonholes you'd have to commit to sticking them on a regular basis to keep them open. This leads to two questions: 1) do you really want to cannulate if you don't have to, and 2) do you really want to risk infection if you don't have to?

I dialyze every other night and mine STILL completely heal up from time to time and have to be sharp stuck. You can't just create them and then forget about them, thinking you'll go back in a year and use them. They won't be there! I used my original buttonholes from October 2010 to February 2011; they've LONG since been tiny scars and even those are fading.