Fistula yesterday

[Beachgirl32]

ok had fistula yesterday not sure it working cause not feeling anything . I did have a nerve block and said it could last until today don’t know if that natter. Plus surgeon told don I need another surgery in three weeks never told me that . I look it up about having second surgery a

Nd found this

Two-stage fistula surgery for the arm is a procedure to create a brachiobasilic arteriovenous fistula (BB-AVF) for hemodialysis access. The procedure involves two stages, with the second stage performed about 6–12 weeks after the first:

• Stage 1 
A transverse incision is made, the brachial artery and basilic vein are dissected, and an end-to-side anastomosis is created. The fistula is then allowed to mature. 



• Stage 2 
A longitudinal incision is made, the arterialized basilic vein is dissected, and a new end-to-end anastomosis is created. 

 
The two-stage procedure allows the basilic vein to become more arterialized and easier to mobilize, which may reduce the risk of devascularization. However, the two-stage procedure requires two surgeries and delays access to hemodialysis

so don’t know if this I really didn’t get much info on discharge yesterday but I know the nurse said I will start feeling the thrill but I don’t so wondering if it work . Will talk to dialysis nurse today . Any tips for caring for it do you always feel the thrill right away .im just feeling pain in the fistula today it doesn’t last long I didn’t receive any paperwork about fistula itself

[Bassetmommer]

Ok, breath..... you won't feel the trill for a while. There is swelling and it takes a bit for that to calm down so you can feel it. And when you do, it is really weird. But do not go pressing on it and messing with it for at least a week. Start slowly with the hand squeeze on the ball after a week. Let your arm heal. You will have less issues.

They told me that I was supposed to have two surgeries, but he did it in one. So its a good thing. Let your fistual grow and heal before you start dialysis. The longer the better. I started too soon, 3.5 months and it was hard to work with. Now, almost a year later, I have less issues and it works great. (Not that I think much of anything about dialysis is really great)

[Beachgirl32 in reply to Bassetmommer]

Ok you may me feel better. I’m already doing dialysis I did pd a year and half until I got fungal infection then they put chest port in so I’m going dialysis through that . Thank you so much for replying

[Sapphire187 in reply to Bassetmommer]

Bassetmommer, correct me if I’m wrong, but the two surgeries were if you got a brachio-basilic fistula and they ended up doing a brachio-cephalic fistula which doesn’t require two surgeries.

[Bassetmommer in reply to Sapphire187]

Yes I had a left brachiocephalic fistula.

[Sapphire187]

I had surgery for a brachio-basilic fistula in July. I was told it would be two surgeries too. The first surgery creates the anastomosis and after the fistula matures, the second surgery is the transposition (move the basilic vein up and closer to the surface). When I went back for my 6-week post-op appointment they did an ultrasound and told me the fistula failed. When I was discharged they didn’t tell me anything much either. When I called on day 7, they said don’t worry if you can’t feel the thrill right now. I regret listening to that advice. I wonder if they could have saved my fistula if they would have had me come in so they could have checked it. If I were you, if you don’t already have a stethoscope, get one so you can at least listen for the bruit. Squeeze the foam ball to help your fistula mature. I started doing that the day after my surgery because that is what my discharge papers said. I still had numbness, pain and tingling on day 33. I’m sure everyone heals differently though. Make sure you are careful with your fistula arm and don’t lift anything over 10 pounds with it or push or pull anything heavy. Don’t put anything tight on that arm. No Blood pressures, needles or IV’s in that arm. If you have any doubts about anything, I would call them and ask. Best of luck to you.

[Beachgirl32 in reply to Sapphire187]

Thank you the dialysis nurse listen to it yesterday she didn’t hear anything she said may not hear anything until the second surgery I don’t know if that is right. I am calling vascular office tomorrow.

[Beachgirl32]

ok I call vascular office this morning she told me I should be feeling the thrill I said I’m not. Saturday at dialysis the nurse did not hear it. The nurse at vascular said if dialysis nurse doesn’t hear tomorrow for them to send in a request to vascular office for surgery appointment. Now yall on here who have experience tell me it can take awhile a person at my church who husband had one it took awhile . So people who actually experience said sometimes it takes a while but the nurse said I really should feel it so I’m so confused

[horsie63]

That's pretty much what I experienced. I did have a very weak thrill and they tried a fistulagram at about 4 months in but said the veins weren't strong in my arm. So I got a graft and that has worked from day one. They put that in on Apr 1, should have done that to begin with but you know how doctors are...always right until proven wrong.

With the fistula I kept my arm elevated and used the squeezee ball but it did not help. They already knew I had tiny veins (along with my tiny body) so I wasn't shocked when it never worked despite doing all I was supposed to.

[Beachgirl32 in reply to horsie63]

Thanks yeah the surgeon even had the nerve to tell me if it doesn’t work it not his fault cause he is working with my body parts it depends on what they want to do he said. Talking about my veins .

He knew I had tiny veins so don’t know why he didn’t do a graft . Just wondering how many surgeries I’m going to have to have .

[horsie63]

Hopefully not as many as I've had..lol. I hate the question when I see a new doc "How many surgeries have you had?". Too many to count. Another favorite is the medication one...I currently take 8 different ones and I've heard that when I get a transplant that will at least double if not more.

[Beachgirl32]

kidney doc came by dialysis today he said fistula is definitely not working. He will talk to vascular surgeon he said they would have to put in graft I don’t know why they didn’t do it first time I told him how they have to get specialist and they even get ultrasound to get to my vein but he was like I’m an expert with small vein sometimes they just don’t listen to you .

[horsie63]

How are you feeling today? Are you getting a graft?

[Beachgirl32 in reply to horsie63]

My arm is still sore kidney doc calling vascular to let him know it not working . I go for ultra sound Oct 9 see surgeon October 15 so we will see what he said

[horsie63]

Let me know if they plan on an AVGraft and I can tell you about mine.

[Beachgirl32]

I thought that was the only kind of graft there was are there differnt ones?

[horsie63 in reply to Beachgirl32]

They are either straight or looped. Mine is looped cause my upper arm is small. Mine is also heparin bonded. Not sure if that helps or not, guess time will tell. I had mine put in Apr 1 and used it on May 3rd. The thrill was strong just after surgery...had to wait till it was fully healed. Took the chest catheter out a month later. Now I take baths, shower and could go swimming if I wanted.

[Beachgirl32]

I was wondering how long after the chest catheter come out be great to go to the pool again.

Went to heart doctor today he put me on two meds one to bring my blood pressure up at dialysis I only take it at dialysis Midodrinne and metoprolol 25 mg once a day of course no idea why I have low ejections fraction He said sometimes it because of dialysis

[horsie63]

Do you do any kind of exercise? I started walking every day now and I'm hoping mine stays in the good range. I do have a treadmill at home so don't have to worry about the weather. They have stationary bike's too if you like to ride. Swimming is good low impact when you can get in the water again.