when to expect a fistula

[Brian]

Hi, I'm VERY new here and have a question.  Over the last couple months my gfr has gone from 24 to 16.  I feel terrible all the time.  Constant nausea, always tired, and only manage to sleep a couple hours a night and I've had diarrhea for about a month and a half!  I get my blood drawn to check my creatnine this coming week and see the doctor in a week and a half.  The gfr of 16 was last month's numbers.  I'm afraid from the way I feel that my kidney function is crashing.  Are these normal symptoms from someone still in stage 4?  Should I expect a conversation with my doctor about a fistula at the next visit?  I'm pretty nervous, and I like my neph, but I've had about two years of those "Your kidneys are shutting down nicely, see you in three months" appointments, and I just feel like things have progressed a lot and would like to try to emotionally prepare myself if it's time for the doctor to start discussing the big D with me.
Thanks for any help!

[MooseMom]

Yes, these symptoms are normal and yes, it is time to get your fistula.

[Michael Murphy]

The sooner you get your fistula the better off you will be.  I had mine installed about 30 months before I started dialysis so when I finally started Dialysis it was fully matured.  If you wait too long they will start you on dialysis with a chest cath.  It's better to be able to start with a fistula then a catch.

[Mr. B 123]

Brian,
I have had the same conservations with my neph, see you in 3 months.  But after a stay in the hospital he said it was time to get a fistula, he put it this way, "Better to have it and not need it, than to need it and not have it.  The fistula operation wasn't so bad, I have had worse.  Good luck.

[Michael Murphy]

Brian getting the fistula is just the smart thing to do.  It's a minor procedure and if the worse happens it makes dialysis a lot easier.  I know a couple of people who have had one for several years and have not started dialysis.  However most people who don't have it installed early either start with a chest cath or have difficulties with a immature fistula.  The difference is you can't get a cath wet so no swimming and no showers.  Get the fistula, if you don't need it ever so much the better but if you start dialysis it's  better if its mature and usable.