A little help please

[anemraz]

My mother (70+) has been on dialysis for almost 4 years. We started with a catheter until fistula matured. Unfortunately, fistula was a complication for her because her veins are deep. It was torture for her to go through dialysis because it was hard to cannulate her. 5 months later, her fistula was dead, she thanked heavens and returned to a cath. Unfortunately, she is now have repeated, unexplained right IJV cath failures (stenosis and tunnel issues ruled out, her body is producing excessive fibrin sheath) and we've been advised to try for a fistula again. My mom is terrified because she remembers the pain she used to go through. Is AV graft a better option for her? Is it easier to cannulate than a fistula? Her veins have a complicated structure so while a fistula is possible, we haven't been given any guarantees and she's scared of being pricked multiple times just because her veins are hard to find.

[Sapphire187]

I recently had my fistula fail and was given the option to do a graft in my left arm or try a fistula in the right arm. The surgeon said the graft runs just under the skin, so I assume it is easier to cannulate and probably less painful. I am not on dialysis yet, so can’t confirm that from experience. I would at least ask about a graft. I was told grafts don’t last as long as fistulas, so you have to weigh the pros and cons for yourself.

[anemraz in reply to Sapphire187]

I know people push for fistulas but my mom's numerous catheters each lasted longer than her fistula. One size certainly doesn't fit all. On Monday she is undergoing cath replacement and balloon angioplasty to remove fibrin sheath. Following this we are going to go for an AV graft.

[horsie63 in reply to anemraz]

My fistula never worked so I now have an AVGraft and it worked right after it was installed. My issue is I have very tiny veins but I've not had any issues with the graft. I wish he'd done it first.

[anemraz in reply to horsie63]

That's what we are hoping for. Graft after this cath replacement and then getting rid of cath

[FelineFandom146]

Hello: So sorry to hear about your mother's condition and the pain she has had to endure. This is why so many try to avoid or delay dialysis but transplants aren't always there when we need them. I have not yet begun dialysis instead trying to delay with diet & nutrition and Vegan VLPD. However, according to most Nephrologists, the fistula is the way to go with less complications, but if someone can't do it, they can't do it. If she can't endure a fistula, I don't understand their repeated push to do it. Why not try the AV graft? It is supposedly prone to more complications, but if she's already endure two forms with complications, why not give this one a try? As someone else said, one size does not fit all. It is your mother's life and body and she is enduring all this and it should be left up to her along with you and her Nephrologist. Perhaps, this is a time for a second opinion. I wish you both well in this painful journey. There are others on this site who have lots experience with Dialysis. Try reaching out again here......

[anemraz in reply to FelineFandom146]

Thank you. I live in Pakistan and unfortunately, some doctors have their own minds here. They learn something from the U.S. and then try to shove it down our throats.

[FelineFandom146]

You're very welcome. Know that you're not alone. Some doctors in the U.S. can be the same way. They forget they are only human. Take care of yourself and your mother. Wishing you the best from the U.S.