Fistula In Place --- Now What ???

[ToddB0130]

What is the next step after your fistula surgery ??  I guess I need to know if I'm missing something.  Literally ---  I told this story elsewhere.   I had my fistula surgery three months ago (next week). Since then I have had issues seeing the vascular surgeon who did the surgery (once,  I showed up .......and they'd set the appointment at a location I didn't even know existed.  The second time I showed up and they said "Oh,  we tried to call you ...the doctor ended up having surgeries and all appointments today have to be rescheduled)

I walked out and am now looking for a new vascular surgeon (and practice) to do 'whatever comes next' .......... I see my nephro at the end of the month and already called him for a reco for a new vascular surgeon.

My question is --- the thrill is still there and I am exercising it with the stress ball .........is there anything else I've 'missed' at this point (since I don't yet have to use it) ??  When do they bring it up for use, etc ?  I'm hoping to remain pre-D through the upcoming winter (AT LEAST) and expect to have a new vascular surgeon by mid February.  Is there something more a vascular surgeon would be doing at this point besides saying "Looks good. Sounds good.  Keep up the exercise."

[willowtreewren]

Todd,

Carl had his fistula for about a year before he had to use it. His was already right at the surface when they created it. He had one check-up about 3 weeks to a month after the initial surgery, but then never saw the VS again.

He had one slight stenosis after he had been using the fistula for about a year and a half and needed an angiogram (very minor and we were able to use the fistula for dialysis the same evening).

I don't think you are missing anything. Carl was really lucky. He got the best VS in the area (without knowing it until afterward). Even now, a year post TX, there is a wonderful strong thrill in his fistula. When he got the TX, he was told that if the fistula died, they would not try to revive it. It's nice to know that he still has that back up in case his TX fails.

Aleta

[Hazmat35]

So far it sounds like you are on track.  I would have your Nephro get you another Surgeon however, so you can have an ultrasound done on your fistula.  They will look at it, and make sure that there is the correct flow through the veins where they did the cutting and make sure that there is no blockage.  Sometimes (like mine), the vein tends will narrow and they have to go back in and do an angioplasty.  Which, is a very simple procedure and very common among people with Fistulas.  They just go back in, and widen the vein with a "balloon" and stretch it.  VERY COMMON, don't worrry. 

But in the mean time, keep checking the thrill.  If that changes, and becomes a THUMP THUMP, then you've go problems.  But if it is a steady steam, you should be good (but I'm NO DOCTOR). 

But, keep squeezing the HELL out of that ball and excersing it.  Hopefully, you will NEVER have to have "D". 

[lmunchkin]

 
But in the mean time, keep checking the thrill.  If that changes, and becomes a THUMP THUMP, then you've go problems.  But if it is a steady steam, you should be good (but I'm NO DOCTOR). 

But, keep squeezing the HELL out of that ball and excersing it.  Hopefully, you will NEVER have to have "D". 

I totally agree.  Just keep doing what you are doing.

lmunchkin
 

[sullidog]

Yes, keep doing what you are doing, the surgeon should also be doing an ultrasound as part of the followup

[chook]

Okay, now I have a fistula question for Hazmat: what happens when there's a THUMP THUMP? I'm all good and have the fistula as a backup. It has a strong thrill but there is definitely a thump too. Mine has come to the surface and is very obvious, particularly as it moves (beats) as well.
 
To Todd, I agree with everyone else, keep doing what you're doing. I had my first fistula done and no follow up but when I needed it, it wasn't any good so had to have a second created. The first didn't ever have the strong thrill thing going. The second one is all good and worked well for the whole 8 weeks I needed it. Good luck with yours.

[Hazmat35]

A THUMP THUMP could possibley mean that there is a blockage or a narrowing of the vien/artery.  If you feel that, then I would recommend seeing your surgeon. 

[sullidog]

also when you listen to it it will sound like a water hammer.

[chook]

Thanks for the info, will check up on it
And back to Todd, hope I get told the same as you: sounds good, looks good!

[Mr. B 123]

I  saw the vascular surgeon only one time after the operation, and since then the neph. checks it every 3 months when I go in for blood work/check up.  My vein is right at the surface and is ready to go.  I have read that sometime they need to bring the vein to the surface to be able to use it.

I check my thrill every morning to make sure everything is good. I also bought a $15.00 stereoscope to listen for the swoosh about 2 times a week. A doctor friend of mine let me listen to the swoosh using his stethoscope so I know what to listen for.  Guess I am ready when I need to use it.  Better to have it and not need it, than to need it and not have it.  Spent a week in the hospital last year because I didn't have the fistula in place.

Hope all goes well.

[sullidog]

yep those cheap stephoscopes come in handy:) Yes the 3 month checkup is great because some nephs/surgeons don't check it at all and when there's an issue then that's when they care.

[malaka]

Don't stop exercising it.  I was told mine was "ready" so I quit squeezing the rubber ball. Then, of course, in session #2, it clotted.  Had to see the vascular surgeon asap, clot had dissolved by then.  But I was then told to keep squeezing the ball. 

[Hazmat35]

When I first starting D, my Fistula was really deep, and they hard a hard time to to get to it a first.  Then I starting exercising in MORE, and brought it up to the surface, and then there were no issues.  So keep exercisiing it, just to be safe.  It can't hurt anything, just make it better.   Plus it works the extra muscules in your arm, fingers and wrist and keeps athrits away.