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Author Topic: rr's thread poses me this question  (Read 2356 times)
sullidog
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« on: March 20, 2012, 05:41:12 PM »

why is fistula creation outpatient and graft surgery inpatient? I hear it's because graft's are tunneled, but I mean I've had no problems when I've had a graft put in that would require me to stay, I leave the next day feeling the same when I had the surgery, hmmm...
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May 13, 2009, went to urgent care with shortness of breath
May 19, 2009, went to doctor for severe nausea
May 20, 2009, admited to hospital for kidney failure
May 20, 2009, started dialysis with a groin cath
May 25, 2009, permacath was placed
august 24, 2009, was suppose to have access placement but instead was admited to hospital for low potassium
august 25, 2009, access placement
January 16, 2010 thrombectomy was done on access
lmunchkin
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"There Is No Place Like Home!"

« Reply #1 on: March 20, 2012, 05:52:12 PM »

I may be wrong on this Sully, so don't quote me.  I think the reason is a graft surgery requires a foreign object inserted under your skin.  They probably keep you over night for observation.  Your body recognizes that something is foreign in the body and may want to attack it, therefore, they want to provide the proper medicine to stop that.  A graft is somewhat similar to a PD Catheter, in some respects, in that the body see's it as a foreign object.  Thus susseptable (?) to infections too.  They may want to just observe you so that this does not happen.

Whereas a fistula is your natural veins being tied together.  Nothing artificial is inserted, it is your body's natural veins!

Like I say, dear, I could be wrong on this, but I bet that Iam close!!!!!   :):) lol

God Bless,
lmunchkin :kickstart;
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11/2004 Hubby diag. ESRD, Diabeties, Vascular Disease & High BP
12/2004 to 6/2009 Home PD
6/2009 Peritonitis , PD Cath removed
7/2009 Hemo Dialysis In-Center
2/2010 BKA rt leg & lt foot (all toes) amputated
6/2010 to present.  NxStage at home
sullidog
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« Reply #2 on: March 21, 2012, 06:53:06 PM »

good answer! I bet you're right
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May 13, 2009, went to urgent care with shortness of breath
May 19, 2009, went to doctor for severe nausea
May 20, 2009, admited to hospital for kidney failure
May 20, 2009, started dialysis with a groin cath
May 25, 2009, permacath was placed
august 24, 2009, was suppose to have access placement but instead was admited to hospital for low potassium
august 25, 2009, access placement
January 16, 2010 thrombectomy was done on access
jbeany
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« Reply #3 on: March 21, 2012, 07:40:40 PM »

Ummm - but my graft surgeries were all outpatient.  So it's apparently just your doc's policy, not a universal standard.
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"Asbestos Gelos"  (As-bes-tos yay-lohs) Greek. Literally, "fireproof laughter".  A term used by Homer for invincible laughter in the face of death and mortality.

lmunchkin
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« Reply #4 on: March 21, 2012, 08:15:41 PM »

It may just be like you say, jbeany, depends on the doc.  I know when J. had his PD cath put in, they kept him overnight.  He also has trouble with infections due to his diabeties.  I agree, it depends on the doctor and probably is not a given. But the reasons to keep someone over night with graft vs fistula, IMHO, would be the foreign object vs natural.

God Bless,
lmunchkin
 :kickstart;
Logged

11/2004 Hubby diag. ESRD, Diabeties, Vascular Disease & High BP
12/2004 to 6/2009 Home PD
6/2009 Peritonitis , PD Cath removed
7/2009 Hemo Dialysis In-Center
2/2010 BKA rt leg & lt foot (all toes) amputated
6/2010 to present.  NxStage at home
Lillupie
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« Reply #5 on: March 21, 2012, 09:04:20 PM »

Probably your doctors. Im going to argue Imunchkin's response, because the PD cathater is a foreign object, I do agree with, but since starting dialysis the one surgery that did not require me an overnight stay was getting the PD catheter inserted. That wasnt overnight.

Lisa
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Check out my Facebook profile for CKD "Help Lisa Spread Awareness for Kidney Disease"

It is my utmost dream and desire to reach out to other kidney patients for them to know that they are not alone in this, also to reach out to those who one day have to go on dialysis though my book i am writing!

dx with lupus nephritis 5/99'
daughter born 11/2005
stage IV CKD 11/2005-6/2007
8/2007- PD cathater inserted
9/2007- revision of PD Cathater
10/2007 started PD
lmunchkin
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"There Is No Place Like Home!"

« Reply #6 on: March 21, 2012, 09:22:39 PM »

Oh Lisa, no one is arguing here.  The question Sully posed is why would they keep someone overnight for a graft surgery and not the fistula.  I answered that possibly because of the foreign object vs the natural veins.  You may not have had to be in over night when they put your PD catheter in, but My husband was kept over night when he had his. I never questioned it, in fact, I felt savier them keeping him overnight.  I do however feel, looking back, that they were concerned about infections with him. He is susiptable to infections.  He has lost some limbs due to infections, so I don't think it was by accident, they kept him overnight!  And I did not say that it was the law and mandatory either, I was trying to explain the whys to Sullys question, with out reference or data or proof.

Im not here to argue dear, with anyone., Im just trying to shed light! Sorry if I came across like that.

God Bless,
lmunchkin
 :kickstart;
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11/2004 Hubby diag. ESRD, Diabeties, Vascular Disease & High BP
12/2004 to 6/2009 Home PD
6/2009 Peritonitis , PD Cath removed
7/2009 Hemo Dialysis In-Center
2/2010 BKA rt leg & lt foot (all toes) amputated
6/2010 to present.  NxStage at home
Lillupie
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wedding 12-10-11

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« Reply #7 on: March 22, 2012, 06:23:21 AM »

Oh Lisa, no one is arguing here.  The question Sully posed is why would they keep someone overnight for a graft surgery and not the fistula.  I answered that possibly because of the foreign object vs the natural veins.  You may not have had to be in over night when they put your PD catheter in, but My husband was kept over night when he had his. I never questioned it, in fact, I felt savier them keeping him overnight.  I do however feel, looking back, that they were concerned about infections with him. He is susiptable to infections.  He has lost some limbs due to infections, so I don't think it was by accident, they kept him overnight!  And I did not say that it was the law and mandatory either, I was trying to explain the whys to Sullys question, with out reference or data or proof.

Im not here to argue dear, with anyone., Im just trying to shed light! Sorry if I came across like that.

God Bless,
lmunchkin
 :kickstart;

oh Im so sorry sweetness. I should not of said it that way. Just with me and my hernia surgeries, the PD cath was the only one I had that did not require an overnight stay.

Lisa
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Check out my Facebook profile for CKD "Help Lisa Spread Awareness for Kidney Disease"

It is my utmost dream and desire to reach out to other kidney patients for them to know that they are not alone in this, also to reach out to those who one day have to go on dialysis though my book i am writing!

dx with lupus nephritis 5/99'
daughter born 11/2005
stage IV CKD 11/2005-6/2007
8/2007- PD cathater inserted
9/2007- revision of PD Cathater
10/2007 started PD
lmunchkin
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"There Is No Place Like Home!"

« Reply #8 on: March 22, 2012, 06:02:51 PM »

Its okay! Sometimes I dont come across very well either. I just think that they (medical establishment) may sometimes have a good reason to keep some overnight, because of some other medical issues.  I know that is true with J. I was just trying to ease Sully's mind about the why it was that way.

Still love you Lisa!!! That shall always be.

God Bless,
lmunchkin
 :kickstart;
Logged

11/2004 Hubby diag. ESRD, Diabeties, Vascular Disease & High BP
12/2004 to 6/2009 Home PD
6/2009 Peritonitis , PD Cath removed
7/2009 Hemo Dialysis In-Center
2/2010 BKA rt leg & lt foot (all toes) amputated
6/2010 to present.  NxStage at home
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