Fistulagrams

Hi Fellow kidney Patients, I would like to hear from anybody who has had a fistulagram. My renal consultant Dr Fluck said something that concerned me regarding risks associated with having a fistulagram. He told me that there is a risk that I may need a blood transfusion! I have had numerous fistulagrams done with angioplasty balloon intervention. However, I have never had a doctor point out this potential risk before! Has anybody ever heard of this associated risk factor before? I would have presumed to need a blood transfusion one would need to lose a lot of blood. On the occasions I have had one the doctor holds pressure on the access site or puts in stiches to stop the bleeding and I have never lost that amount of blood to need a blood transfusion! Please can anyone reassure me that this would be a extremely rare occurrence. If there are any doctors reading this post I would appreciate your opinions.

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  • Hi Sparky1

    I too have had a number of fistulograms. I dont think your consultant is wrong. His job is to tell you every risks associated with the procedure, no matter how small it may be. That does not necessarily means it will happen, it is just to prepare you if it does. you have had fistilograms in the past with no complications right!!!!!!

    Well no need to worry this time.

    I hope that helps.

  • Hi Coaching, thanks for your response to my concerns about Dr Fluck's comments regarding blood transfusion possibility. I know it does not mean it will happen, whether it was necessary to concern me is debateable. In any event all risk should be included in the patient information leaflet, as it is that information upon which read you then have a choice to sign or not. Needing a blood transfusion is a major event and if there is a slight possibility it should be officially included in the patient information leaflet. I presume the patient information leaflet is the same across the country in the NHS. So either the NHS do not consider it a risk or a negligent mistake which is different!

  • Hi Sparky1,

    I totally understand your concerns better now. Every little risks should be included in the leaflet including Human errors. the best thing to do is always ask for the worst that could happen and insist to know. I always do and now they tell me everything.

    Have a good day.

  • Hi SPARKY1

    I've never had to have a fistulogram so I looked on a website which helps me when I need to check up on things medical:

    rcr.ac.uk/…ients/worddocs this site says this,

    What are the risks of a fistulogram?

    Fistulograms are very safe procedures but there are some risks and complications that can occur. Very occasionally, a small bruise can appear at the site of needle puncture. Less commonly, ongoing bleeding in this area leads to a short inpatient stay (once or twice in every hundred). Very rarely damage to the fistula can occur that may require further treatment by the interventional radiologist or a small operation. The risk of infection is very low.

    Dr Fluck is one of my consultants and I know he always wants his patients to be given all the relevant information and this can sometimes frighten the life out of you, but try not to worry and I hope this helps.

    Good luck Kibibi90

  • Hi Kibibi90, thanks for your response and information on my concerns regarding Dr Fluck's information to me. You are right it did freak the life out of me, but I hope that wasn't his intentions!! I asked my HHD nurse about what Dr Fluck said and he laughed! Strange response to my concerns but he did say it could happen if an artery was severed then obviously I would lose a lot of blood. What concerned me is how they would stop the bleeding, as immediate pressure would need to be applied or the patient would bleed to death. The surgeon would somehow need to staunch the blood which would be gushing out, it would need to be sutured, but that would be difficult with blood gushing out profusely from a major artery! I fear the patient would die or bleed to death. If Dr Fluck said there is a risk of death when having a fistulagram that may be more accurate. However such important information should be included in the patient information leaflet before they sign for the procedure. In fact all documented risks should be included on the patient information leaflet.

  • Hi SPARKY1

    I quite agree about the PI leaflet it's worth mentioning the subject to the powers that be (Dr Fluck). My partner is an ODP and he suggested maybe getting a group of patient and clinicians together to develop a info' sheet that comes from the two perspectives of the technical side and the personnel experience. Perhaps the NKPA could facilitate, has anyone else got any thoughts?

    Kibibi90

  • Hi Kibibi, Thanks for you input regarding the PI leaflet. I do think it is very important that serious risks associated with having a fistulagram should be on the PI leaflet. I cannot understand why such a risk is not on the leaflet unless it is not a genuine risk. After all as I said to 'coaching' it would probably be more regarded as a negligent mistake which is not a normal risk. Can you imagine any doctor saying before a kidney transplant there is a risk we may make a negligent mistake when operating and you could bleed to death? However, if there is a real risk it may be worth contacting the NKPA as all patients should be made aware of the life threatening possibility with having fistulagrams. I shall make enquiries with relevant authorities as to whether this has ever happened though in the UK.

  • Dr. FLUCK??? LOL. I WAS GOING TO SAY SOMETHING SMART BUT REFRAINED. THIS IS NOT THE FORUM FOR SUCH OFFENSIVE LANGUAGE..HOWEVER Dr.FLUCK is a very funny, unusual name.

  • Quite right, it is an unusual name Fluck! I believe it is of German origin! I will soon publish a report about this person, which is not to favourable.

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