My fistula is buzzing to beat the band

[skyedogrocks]

Glad it is buzzing along!!!  Rob's lower arm fistula is starting to die, but his upper arm fistula/graft is buzzing HARD! 

[mtaylorbrown]

Folks

     It was nice to hear all of you taking this in strides.

     I just got my fistula on my left wrist, it is only about 1.5" long. It almost looks like a suicide attempt.

     Nobody told me about maturing or the buzzing. What is this about pumping exercises? Is there something I should be doing to help it mature? (whatever that means)

     I've had it for about 11 days and it was very painful. I have numb areas, sensitive areas, and tingly areas.

     I told a guy at a client site yesterday that I had a blue-tooth upgrade implanted in my wrist. He didn't believe me, he isn't a moron. That is until I rushed over and told him my phone was ringing and placed his hand on my wrist. His eyes lit up and he said, "You did get an upgrade." Then I had to tell him something closer to the truth.

     Will the sensitivity, pain, numbness, and tingling go away?

     Grats on your successful fistula, by the way.

Regards,
Matthew

[flip]

When I first got my fistula, they gave me a small foam kidney and said to squeeze it 500 times a day. I'm sure a rubber ball will work just as well. I started using mine when it was 6 weeks old. Like yours, mine is in the wrist with a 1 1/2" scar that is barely noticeable. As for the numbness and tingling, most will go away in time.

[monrein]

Matthew, can I assume that it is buzzing?  Hope so because if it isn't you need to see your doc ASAP.  Fistulas can take up to four months to mature, or as little as six weeks depending on the person.  In the case of a forearm fistula it is recommended to squeeze a rubber ball or those wrist exerciser thingies (note the advanced technical jargon) to help the vein get big and fat and mature and ready for the needles.  I was told that this is not necessary for an upper arm fistula like I have but I certainly did the exercises a lot for my forearm fistula many years ago.  I do some light weights at the gym and was told that was good.  Some people exercise the fistula with a light tourniquet but personally I would avoid that for fear of cutting off blood supply and my neph blanched when I asked him about that particular detail.

The tingling should go away but if it's really worrisome you could ask your doc.  Steal syndrome can be an issue but I think it's too early to be thinking that.

Hope this helps and if you do a search of IHD you'll find more fistula info too.  You could also do a Google search of AV fistula for dialysis and see what you find there.  

Best of luck Matthew and I'm sure many others will chip in with more info on this subject.

[del]

Hubby used one of those stress balls to exercise his.  Actually he used one so much that it burst!!  What a mess. I was ready to  He was told to use the tourniquet but only for a few secs.  His fistula developed very quickly and very well. It was done in April 2000 and still buzzing to beat the band!!  No problems at all.  He is really careful not to lift anything really heavy with the fistula arm. he also never wears his watch or anything tight on that arm.  He hit the fistula with the hammer last year when we were putting flooring in the basement.  Made me sick to my stomach when he did it because I thought he had it ruined.  Didn't cause any damage at all.  Matthew make sure it is buzzing and working properly. If it isn't the docs need to know now.

[mtaylorbrown]

Folks

     Good stuff about the exercising, the turni would worry me a bit. I didn't know about the lifting restrictions. My surgeon and neph said nothing of these topics. I was only told to expect a thrill, after they explained what that was I remembered it from my mother's experiences years ago.

     If by buzzing, you mean the thrill, yes it is giving off a powerful noise and flow. It is moving up my arm, very strange. It almost sounds like grains of sand are passing through my vein(s). It freaks my wife completely out. I always go to sleep with some noise on in the bedroom, now I just have to have my wrist near my face. (I have a loud ring in one ear) It helps lull me to sleep.

 
Matthew

[talon999]

I think a "buzzing" fistula is good news. All the nurses seem to like mine. It actually vibrates my pillow at night. Kinda sings me to sleep.

Mark

[dkerr]

Hmmm  I can feel mine but don't hear anything.

[monrein]

If you can't hear the bruit (the swish swish pumping sound it makes) you should call your nurse or doctor to check it out.  You ought to be able to feel the thrill and hear the bruit.

[Ang]

Hmmm  I can feel mine but don't hear anything.

if  you  are  able  put  your  ear  close  to  the  fistula  should  hear  it   loud  and  clear,  if  not  start  hollering  at  someone.

[lruffner]

Ok, I probably have a very stupid question, but why do fistulas buzz and what makes it buzz?

Secondly, I have head that some people get a PD access and a fistula done, just in case one doesn't work or you can't tolerate one or the other. Is it a good idea to ask for both? Can they both be "undone" if not needed?

[monrein]

My understanding is as follows.  An AV fistula is when an artery is surgically attached to a vein so that the vein has arterial blood rushing through it, instead of the more passive flow of the blood in a vein.  The "buzz" or thrill is the feel of the arterial blood rushing in, while the bruit is the sound of the arterial blood rushing in to the vein.

I've never done PD so I can't really say much about the second part of your question.  Someone else asked a similar question but I couldn't find the thread.

[Wallyz]

A fistula cannot be undone.  Many, perhaps most, PD patients end up having to go on Hemo at some point, and so many doctors recommend doing both surgeries so that you do not have to be hospitalized if and when you have an infected PD catheter and need hemo in an emergency situation.

[monrein]

Good point about the "undoing" not being an option.  My first fistula (left forearm, five years of use prior to first transplant) was like a small snake but when it clotted off, a year or so post-transplant, it changed to a long flat scar that's quite unobtrusive unless you look really closely.

[willieandwinnie]

monrein, is that bruising on your upper arm? I infiltrated Len just once in 5 years of home hemo and I cried and felt bad for days.  Len has a graft in his upper arm and the vascular surgeon said he would not take it out unless problems were linked to it.

[monrein]

Yep that is bruising.  My fistula is deep and somewhat twisty at the top.  We are still trying to develop it and get it bigger.  We sometimes have to dig around and sometimes we go right into some clots thereby requiring more than one needle per spot.  The vein also rolls.  I'm just lucky that I don't find it too painful as I distract myself by watching and giving my opinion about what they should be doing.  I have a very high tolerance of pain I've been told and my nurses apologize endlessly for hurting me and they get rattled if they have trouble getting in.  I don't like when they get rattled or seem to lose confidence.  I want them to feel the vein, decide their approach and go for it with confidence.  Readjust if necessary.  If I can maintain my calm, so can they and I do my best to reassure them while they're digging around.  Keeps me distracted talking them through.  I also insist that they travel up and down the fistula regularly even into the uncharted spots because that will help to develop it evenly and avoid aneurysms in the long run.

I did the same with my first fistula but it was easier by far because it was in the forearm and so closer to the surface.

[willieandwinnie]

monrein, your a brave women. Len's graft is real deep in certain spots and would always try to roll on me. I had to grab in pretty tightly with my thumb and index finger toward the bottom of the graft to keep it still. Somedays it was very frustrating to say the least. 

[monrein]

You can stick me any time.  LOL.  (What fun for you).  I like your assertive sounding approach.

[lruffner]

A fistula cannot be undone. Many, perhaps most, PD patients end up having to go on Hemo at some point, and so many doctors recommend doing both surgeries so that you do not have to be hospitalized if and when you have an infected PD catheter and need hemo in an emergency situation.

Thanks for the info. Now another stupid question....if they connect a vein and artery together somewhere, is blood being cut off to something that it used to supply?

Scary pic Monrein

[monrein]

Yes.  There are two large arteries and two major veins that supply the arm.  When one of each is lost to a fistula here remains one of each to supply the arm and hand.  If you do a search of fistula on IHD you'll find a video of the surgery.

Sorry you found the picture scary.  I am quite fond of the life-prolonging function of my fistula so I find it quite lovely, although I'm not too keen on the bruising.  However I bruise easily and often anyway from prolonged prednisone use so my tolerance and acceptance of these disfigurements may be higher than average.  Wrinkles are the very least of my concerns about aging.  LOL

[lruffner]

Thanks monrein and I didn't mean that your picture was scary, as in ugly or not meaningful, but just from someone who is getting ready to enter that world....the whole thought of all of it.  I have zero pain tolerance and a huge baby when it comes to stuff like that.

I hope I didn't offend. 

[monrein]

  Not at all.  No offense found or taken.  I always worry about frightening people who are new to this but believe that you'll know the full awfulness soon enough so knowledge is power and shared experiences can be so helpful as you try to decide what is right for you. 

I have, of course, had to work at changing how I think about all this stuff and I too was very scared at first.  The first time I needled myself, I did it, was successful and promptly threw up on the other side of my chair.  That was a surprise.  The next time I asked for a bucket but it never happened again.  I am tough but we are all tough who deal with ESRD.  Courage takes many forms and your questioning the hows and whys of everything at this stage in it for you is the first huge leap of courage. 

Please don't worry about offending me.  If ever I do feel offended I'll let you know but my assumption here is that we don't seek to offend each other.  All except for the politics thread.   

[del]

Hubby's fistula is very close to the surface and easy to needle. In 2 years I have not infilltrated at all  but it could happen.  He was infilltrated several times in center (probably 3 or 4 times in 6 years).  The fistula does look a bit gross but its a life line that has to be looked after!!!  Hubby hit his with the hammer a year ago but it didn't cause any damage.  Scared the crap out of both of us though!!!  No problem feeling or hearing his "buzz".

[boxman55]

It's the only "buzz" I can count on everyday. Use to be when I was younger ahh well never mind...Boxman

[G-Ma]

Bragging rights....My arterial site buzzes so hard we can feel it without touching the skin...hope that doesn't mean another problem up top....grrrr....