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angellady07
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« on: August 14, 2007, 03:53:26 PM »

I have a question regarding my graft. I understand that its normal for the graft to be visible. My concern is I have a large lump protruding out from the side of my arm. The lump extends to the underside of my arm. I showed the vascular surgeon and his quote was " I prefer function over beauty". Well, I don't know how well my graft will function since the same doc stated the graft will be ready in a year. I'm awaiting an appointment with another vascular surgeon. Any opinions on this issue? Thanks.
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angela515
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« Reply #1 on: August 16, 2007, 08:25:23 PM »

Uhm... I don't have an answer... but I have a question... Why won't your graft be ready for a year?
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Adam_W
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« Reply #2 on: August 16, 2007, 09:32:34 PM »

It should never take a year for a graft to be ready to use. I was using mine a month after it was put in. I don't know if I would trust that particular surgeon. As for the lump, I've never had anything or seen anything like that, so I can't comment on it, although I'd like to hear as well if anyone else has, so I can know what to look out for. I don't believe a lump like that is normal, but I also know that not every access is created equal.

Adam
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-Diagnosed with ESRD (born with one kidney, hypertension killed it) Jan 21st, 2007
-Started dialysis four days later in hospital (Baxter 1550-I think, then Gambro Phoenix)
-Started in-centre dialysis Feb 6th 2007 (Fres. 2008H)
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-PD catheter removed Dec 2, 2008-PD just wouldn't work, so I'm back on NxStage
-Kidney function improved enough to go off dialysis, Feb. 2011!!!!!
-Back on dialysis (still NxStage) July 2011 :(
-In-centre self-care dialysis March 2012 (Fresenius 2008K)
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thegrammalady
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« Reply #3 on: August 16, 2007, 09:55:57 PM »

i know that many fistulas are large and lumpy. i saw one guy that had lumps the size of eggs. don't know about a graft though, but a year does sound a bit strange. a second opinion never hurts.
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angellady07
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« Reply #4 on: August 17, 2007, 12:24:40 AM »

Thanks for the replies. I know a year sounds strange. My graft starts at the bend of the inside of my arm and extends where my second incision ends underneath my arm pit. The lump as I said extends from the side of my arm to underneath my arm above my incision. I hope I'm explaining it well enough. It's been extremely painful the last few days. I was tempted to call the surgeon who performed the graft however, I remember his quote " I  prefer function over beauty". I don't really care about the appearance as long as I know I can count on it when I need to. I hope the pain eases soon and my second opinion has good news. Thanks again, I always find great support here.
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okarol
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« Reply #5 on: August 17, 2007, 12:29:20 AM »

Whenever there is pain I would call and check in just to make sure everything is ok.
I am curious, why a graft instead of a fistula?
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angellady07
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« Reply #6 on: August 17, 2007, 12:33:33 AM »

My surgeon told me that  fistula surgery would be too complicated. My veins are too small.
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sophiasmom
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« Reply #7 on: August 17, 2007, 12:58:56 AM »

Hi AngelLady,

Usually the lumps you are talking about happen in line with the incison, not on the side of your arm.
They usually do not get that big until after you have had dialysis for a while with all the needle sticks and
scar tissue.  I would definetely seek a second opinion form another vascular surgeon to make sure all is well.
Your doctor didn't seem very compassionate either with that quote of his.   :thumbdown;

Maybe another surgeon could do a fistula on you if your graft doesn't work out.

Best wishes,
Chris
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angela515
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« Reply #8 on: August 17, 2007, 11:05:34 AM »

My surgeon told me that  fistula surgery would be too complicated. My veins are too small.

That's the same reason I have 3 un-usable grafts in both my arms... My viens are wayyyy too small to make a fistula, and for month's on hemo I was using a perma-cath, until finally they told me I could have an access put in my thighs, which at that point and how I hated hemo so much, I looked for alternatives and found PD. SO I know now that when I do go back on dialysis in the future, it's either PD (If that's still an option for me at that point in time) or an access in my thighs, b/c I won't live with a perma-cath for the rest of my life.
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angellady07
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« Reply #9 on: August 20, 2007, 03:26:56 PM »

I just wanted to post an update. I'm still waiting for a second opinion. In desperation I made a follow up with the original vascular surgeon. His office scheduled an ultrasound to check for a clot early next week. The surgeon said " I hope it's not a clot they are a pain in the a**  to treat. You have to be monitored very closely." I reminded him that right now my arm is a pain.I called my nephrologist. They are supposed to have a conference regarding my case. Meanwhile, I'm still in a lot of pain and have no answers.Thanks for tolerating my rant.
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