Confused about fistulas can someone help plz

[peaches94]

I have been doing research on fistulas the last few days and i must say i am so confused. I go back to my neph on Tuesday and at my last apt she said that if my creatinine has reached 3 then she is sending me for vein mapping. I don't want to go in blind so i havebeen trying to find out all i can about diff accesses. I haven't really learned much that makes since so i figured my good friends here would be the best source for information. I have saw pitcures on the net of what some fistulas look like after words and i must admit it scared me to death. Do all of them end up looking like someone blew your vein up like a balloon? I can handle the scarring but what i saw I'm not so sure. Button holes good or bad? Can someone please help me understand what to expect. 

[okarol]

Jenna had an upper left arm fistula. It lasted 3 years, until the day of her transplant, then clotted. They take a high pressure artery and reroute it into a vein, and the pressure makes the vein expand. Jenna's was not too bad but everyone is different. Her next fistula will have to come from a vein that is deeply submerged and will require more surgical manipulation. We are hoping we find a donor before that, but her creatinine is now at 4.05.

[Sydnee]

My aunt Judy never has used her fistula, it doesn't look bad (she got a kidney from a sister before she needed to start)  My aunt Betty scarred very badly. My hubby Ed has a Very large vein going up his arm. They only used his fistula for 4 months before we switched to PD. The interesting thing about Ed is the vein in the other arm also enlarged when the arm with the fistula in it enlarged. We figure his body is trying to keep it's symmetry.  drs don't know why either.
 Point is each person seems to be different.

[MightyMike]

Vein mapping is just a ultrasound to measure the size of your veins for where to place the fistula.  If everything is ok then they usually try to create the fistula in the opposite of your dominate hand meaning if your right handed then they will use left arm and vise versa.  Best place if your worried about appearance would be upper arm between elbo and shoulder again if the vein is good.  If your veins are shallow it doesnt take long for the procedure I think about 30 minutes but if you have deep veins like me, mine took 3 hours to do outpatient so you go home that day.  When it's done you should feel a buzzing sensation that's called the thrill and if you put your ear up to it you will hear a pulse that's called the bruit.  It can take anywhere from 4 weeks to a year to mature depending on the quality of your veins, age, and how much you exercise it.  Exercising requires using a stress ball of sorts to help it mature.  Your arm will be sore for a week or two but the doctor should give you some 5mg percocets to get you by.  You will probably have to go see the doctor a couple times afterwards just so he can check progress.  The incision is usually is held by internal stitches that dissolve and externally butterfly stitches that fall off after a while from taking showers.  You probably wont see it get much bigger till your on dialysis for a while.  Buttonholes are better to establish when you start dialysis rather then the ladder technique because it can prolong the life of the fistula by creating less scar tissue.   Hope this helps good luck and best wishes.

[peaches94]

Thanks you guys that helped a lot. Im guessing that the fistula is the best way to go as far as acesses go if anyone thinks diff plz feel free to tell me why you think otherwise. I am just learning and the more info i have the better equiped ill be to make a decission. Thanks again.

[M3Riddler]

I have been doing research on fistulas the last few days and i must say i am so confused. I go back to my neph on Tuesday and at my last apt she said that if my creatinine has reached 3 then she is sending me for vein mapping. I don't want to go in blind so i havebeen trying to find out all i can about diff accesses. I haven't really learned much that makes since so i figured my good friends here would be the best source for information. I have saw pitcures on the net of what some fistulas look like after words and i must admit it scared me to death. Do all of them end up looking like someone blew your vein up like a balloon? I can handle the scarring but what i saw I'm not so sure. Button holes good or bad? Can someone please help me understand what to expect. 

Peaches... the following link to the

 Fistula First website will teach you anything and everything there is to know about them.
FistulaFirst.org

Remember, using your own vein/artery is the best way to go. Many US surgeons like to go the synthetic route because it is much easier for them sergically.  Another thing to remember is, never be afraid to ask for and receive a second opinion from a surgeon with affiliations to another institution.   
finally, different surgeons have different comfort levels in the size of the vein/artery they work with.  Some will not work a natural vein smaller than 4 millimeters while others will go down to 2 or 2.5.  Yes, it is true the larger the vein/arter, the better the outcome. Perhaps this is why many work with larger.
Please view the website as it will give you many answers to what you are looking for. Remember, never be afraid to question your docs or surgeons about anything... An informed patient is not afraid to ask for information.

///M3R

[cattlekid]

I fought getting a fistula for a long time because I despised the way they looked.  When I finally got mine, I had the nurse establish the buttonholes and I've been using the same set of buttonholes for almost a year now.  Other than the two small buttonholes and the scars from the actual surgery, my arm is still in good condition.  To me, buttonholes are a must, especially if you are going to do self-cannulation, which I highly recommend.