Fistula prep

[Betsysue2002]

What kind of things do people have to do to prepare for a fistula ? It's not time for me but i wonder.

[Hidden]

First, there are different types of fistulas and since you didn't say anything specific I'm sending you a link to an NKF page on that very topic. Select the type you are thinking about and click on that link and get your answers.

kidney.org/sites/default/fi...

[Betsysue2002 in reply to Hidden]

Hi mr kidney 😺 Im still only stage 3 ! But from what ive read maybe i can get arm "ready" for fistula and if i can start now with some squeezing exercises i figure why not.

A fellow in my kidney group said he had to get a tube in his chest till his arm was ready. Id like to by-pass that if possible.

Im trying to eat better and swap off food but wont know how that is going to my feb appt.

If my gfr drops 13 points like it had in nov i'll be down to 27.

All this is in my head ... i think too much without information ... but what else have i got to do ??? So i'll try the site and see what it says.

Thank you again.

[Hidden in reply to Betsysue2002]

If you have a physical therapy place near where you live to stop by there. They have a lot of equipment that you can look at and then find something similar online. I basically used a spring loaded hand device that allowed me to move up in strength resistance from 1.5 lbs. to 9.0 lbs. It helped me a few years ago when I had a senior moment, lost my balance and crushed my shoulder. They told me surgery would be the last resort. I did six weeks of PT and then bought the hand squeezers and now have 100% range of motion in my shoulders and full use of all fingers and both hands.

[Betsysue2002 in reply to Hidden]

How neat is that ! The recovery i mean ... not the accident.

Thanks for the suggestion !

[Dixidude39 in reply to Hidden]

Mr. K, that's a great link ... 5 pages of fistula info! Just printed for my file.

[raybacci]

You don"t have to do anything. Somewhere in your arm the surgeon will attach a vein to an artry, Then you may need another procedure to fix vein flow. These are out patient procedures- Good luck- I"ll pray for you.

[Betsysue2002 in reply to raybacci]

Thank you 😺 I dont understand tho why i read about having to wait for your arm to be "ready" for a fistula.

[KidneyCoach NKF Ambassador in reply to Betsysue2002]

They connect a vein to an artery. This connection is not normal for the body. The pressure of the flow from the artery going to the vein is abnormal but needed to do dialysis. A large vein with thick walls and ability to have large volume going through it is needed for the dialysis needles. Two large needles 14-17 gauge are used for dialysis. One needle allows blood to come out of the body into the artificial kidney (dialyzer) where the blood is cleaned and then to another needle where the blood is returned to the body. This can only be accomplished when the fistula is "matured" (i.e., ready to be used). Maturation means simply that the venous side of the fistula (where the blood is returned) is comparable in wall thickness and size (diameter) to handle the large pressure and blood flow as the arterial side. It matures or is supposed to mature on its own. Nothing else can really help it other than perhaps weight training prior to a surgery and squeezing a ball or similar after. Sometimes it just never matures properly. It happens. Some people have great veins but the surgery still fails. Since it is an unnatural thing for the body oftentimes the body will try to "correct" this problem by narrowing the vein down until it clots or is completely closed off. This is called stenosis or thrombosis. Stenosis in this situation is simply the body saying "no, this is not normal" and it narrows the vessel. Some may need "angioplasty" where they place a small tube in the vessel where the narrowing is and open a little balloon in there to open it back up, then remove the balloon/tube. Sometimes the narrowing happens over a long period of time other times it is very quick and unable to be repaired. There is nothing one can do to prepare for a fistula so that it matures well. Protect your arms as much as possible. Hope this helps you understand. Blessings #kindredkidneys

[Hidden]

The fistula is noticeably larger and some people are self-conscious about the appearance and depending on the location, some wear long sleeves to hide the bump. There are technical terms for the fistula to "grow" to be able to handle the dialysis. If you would like to go online and look it up you'll find a lot of information. The best reason for you to do this will be to understand the procedure but more importantly to have a base understanding of the process and know what questions you need to ask the nephrologist to completely decide what will be best for you. Example, if you are right-handed you would want the fistula in your left arm. Just one basic example but there are many others for you to find.

I spent some time yesterday looking for the information I used to help me recover from my "senior moment" and found the website page that I used for the hand/arm exercises. I've included the link below to make your search easier. Hope it helps

protherapysupplies.com/Shop...

[Betsysue2002 in reply to Hidden]

Great ! Thank you so much ! Hopefully i "caught" the problem before things get serious and can moderate my diet ... if thats all it takes ... but just in case i need some things what youve told me is really helpful !

[Betsysue2002 in reply to Hidden]

Hi. Ive ordered a hand/finger exerciser. I appreciate the information because it should help any carpel hand/arm tunnel probs too.

[Hidden]

Not to continue to overwhelm you with information but... davita.com has many excellent recipes to help you with the diet moderation. Try to keep in mind that you can't eliminate any of the items that effect CKD, but you can cut down considerably. Before doing anything speak to your nephrologist and take your lab values with you to an appointment with a Renal Dietitian. Remember that while you will have a restricted diet before CKD turns to ESRD when you have to choose dialysis or some other option you will again have to change your diet. Even water (for drinking and what's in foods) must be watched. Keep up a steady exercise routine and maintain any other health issues you may have. It's a balancing act but you'll find lots of support here in addition to what you get from your family and friends.

[Betsysue2002 in reply to Hidden]

Thank you.

Im hoping that with a few more doc appts i can get things going smoothly.

I have an appt now to see a new new kidney doc. The new first one was nice but he has mainly hospitalist experience and im not sure if much kidney experience.

The new one has apparently 7 years experience and is one of the docs at one of the local dialysis centers.

As far as renal dietitians go we dont have any unless there is one affiliated with the dialysis center so ive been on my own except for davita and other online information.

I eat at the local senior center which does not have special menus and at restaurants.

I'll find out next month how my menu choices are.

[Bet117 NKF Ambassador in reply to Hidden]

Agreed!