A question on fistulas

[jodaer]

I'm scheduled to get my fistula at the end of August. I know it is painful and you can't use your arm for a bit. But, how easy/hard is it to get dressed, i.e. bra, undies and pants? Also using the bathroom? I live alone and trying to figure it all out. Thanks.

[barbara55109]

I only had mild pain for a few days. I think they sent me home with like 6 pain pills, enough for a day and a half. I didn't really have any trouble getting dressed. I couldn't shower for a few days I think.

[jodaer in reply to barbara55109]

Thanks. I was just concerned with the small things. Glad yours went so good.

[barbara55109 in reply to jodaer]

I was worried too. When I had my one week check up I was worried, but surgeon said it looked great. I feel so lucky I haven't had to use it. My eGFR went up, against all "conventional wisdom" of my doctors.

[jodaer in reply to barbara55109]

How much did it go up? My neph said people who get it early seems to take longer to have to go on dialysis. She said studies were done but I didn't ask for details.

[barbara55109 in reply to jodaer]

I'm an outlier. My CKD is from dehydration. Major changes helped me rise from 7 to 31. I drink non stop, am on anti diarrhea meds and lost 50 pounds. The combo helped me get it up above the dialysis line.

[jodaer in reply to barbara55109]

That's great. I hope it stays up there.

[Sapphire187]

I just had my fistula surgery done 15 days ago. They connected my basilic vein to my brachial artery in my upper left arm. The incision is in the crease of my elbow. Once the fistula matures, they will have to do another surgery to move the basilic vein up (transposition). You are not to shower for the first two days. I had no trouble getting dressed. You just have to try to be careful moving the arm. The incision itself wasn’t bad. It healed nicely within a few days. They did not give me anything for the pain. The nerve block they gave me was supposed to last 18 to 24 hours, where you can’t feel or move your arm. Mine was wearing off when I woke up in recovery and completely worn off 3 hours later for a total of 7 hours. That being said, I am still experiencing some swelling, pain, numbness and tingling in my forearm from my elbow to my wrist. It is finally not too bad today. It has been constant pain since the surgery. They said it is because my arm has to adjust to the new circulation. I’ve been taking Tylenol for the pain. You will also want to make sure you don’t lay on your arm, lift more than 10 lbs or push or pull anything heavy.

[jodaer]

Thanks.

[Bassetmommer NKF Ambassador]

Hey Jodaer, Depending on where they put the fistula will matter. If it is the upper arm, It will be sore and puffy for a while, and it maybe hard to bend your arm. Lower, arm, much easier. You cannot lift or carry stuff for a week or two. Figure a month for carrier heavy things. Think of things like how you get out of bed. What arm do you use? We actually took our bed off the frame so I could just swing out and hit the floor and stand up without using an arm. Look at how you get out of a chair. What arm do you brace yourself with? We had to put another railing on the stairs because it was on the fistula arm side. You can't put weight on it for maybe a week. Go slow. Get a rubber ball to squeeze to build it up but wait the first week before you start with that. The pain was minimal actually. Don't look for the trill for a bit. You will be swollen. But then, maybe a month you will feel it and see it. You can use the arm for all your dressing and so forth, except maybe putting on your bra. We are of the era for being hippies! We had a party to go to two days after my surgery and I was fine. Tired mostly. They knocked me out for several hours. The surgery was postponed after we got there at 12 and I didn't get into surgery until after 3pm. Then they were only going to do a two-hour surgery, but they did four hours and I was done. Otherwise, I would have had to come back. My arm was numb going into the next morning My husband had to put my very long hair up in a rubber band, and couldn't do it so my hair was lopsided for a day. Other than that, it was easy. You doing home hemo or in center? Don't rush it if you can. I waited only four months and it as not enough. I had some real problems with placing needles. That's another story.

[jodaer]

Thanks. I'm nor sure where they will put it. I haven't talked to the doctor yet. I don't think it will be as long as yours did. They said about 4 hours start to finish. I do have to stand up from a chair and not use my arm before I can leave. I haven't decided if I'm going to do dialysis, but I do want to be ready. I had labs, for other stuff, done Monday and my eGFR was 25. I will do it in center if I do. There's no way I could do all that at home by myself. I know others do but I don't have the room nor the energy. I think I'll practice not using it. I hold my phone and kindle in that hand. I hope i can still do that.

[Bassetmommer NKF Ambassador in reply to jodaer]

Jeepers, 25..... wow do not rush it. They won't even consider you until you are below 20. You could talk with the surgeon and see what is involved on that end. Sometimes just having it ready puts off dialysis. I read that in several places. You will know when to start. I was down to a GFR of 7 and felt fine. Sort of got talked into starting. I wish I had waited a few more months.

[MariaB27]

Hi I'm 80 had local anesthetist and was worried, it was fine nothing like I imagined. If I had had a nerve block I would of had a problem as I need two hands to change my urostomy bag. Had no problems at all x

[jodaer]

Thanks for the input

[AmosBurton]

I don’t recall much pain at all. Mine was in the crook of my arm and didn’t hurt when straightening it. I actually used my hand when getting dressed in recovery.

[unknownunknown]

My husband is 21 GFR and they're just talking about doing a fistula versus home dialysis. Always better to prolong the inevitable if possible.