Removing my fistula and inserting a Graft

The following are recent posts to my Paddling on Dialysis for Kidney Health Facebook Page.

January 16, 2011

Goodbye my snake

Tomorrow I say goodbye to my fistula, what Jake and Antonia affectionately call my snake. We have had a great ten year run. It is the access that keeps me alive and keeps me paddling...

I struggle posting this type of post. For many it is too much information. However, occasionally I hear from someone who has happened on something I write, rarely mind you, but it happens, and they tell me thank you for posting. So it is with that thought- that perhaps what I write may help someone else dealing with kidney disease or crisis, that I post too much information. Thanks for reading.

For more information on what a fistula is see http://kidney.niddk.nih.gov/kudiseases/pubs/vascularaccess/

Jaunary 17, 2011

I'm posting this because I have had some questions. Always Fistula First!. A fistula is the best access to avoid infection and blood clots. No one likes needles but you eventually grow to tolerate them. After numerous sticks scar tissue develops and it becomes less painful. Of course the best to combat pain is to develop button holes, a technique that allows you to pick off a scab and place the needles through a tunnel similar to how pierced ears work (without the scab of course). My first fistulagram was after eight years of use of the fistula and my first angio was last week. My skin became very tight and was not longer able to make button holes, then it became difficult for the skin to heal. But, it wasn't until my fistulagram last week that it was determined that the walls were too thin and that there was a real risk of rupture. Please keep the questions coming.

(these are Xrays of my fistula showing the 

large pseudoaneurysms that eventually were incised 

after the vectra graft was placed)

Does this mean that you will need a new fistula made...

Eventually. But I'd like to gain as much time as I can from the graft. Because it will be more difficult sticking my right arm with my left hand after a new fistula is placed there. Also, once the right arm is used up we have to move to a leg and that doesn't sound at all appealing. But waking up with Andria at my side and coming home to big but cautious hugs from Jacob and Antonia make it all worthwhile.

So fistulas can go wrong? Do you mean the vessel part or the actual fistula tubing? In the hospital they told me they were for life which clearly isant the case! So where do they go when your arms and legs are all used up? 

:-(

They can go wrong but they are the least likely to, especially if the are being followed by a good vascular surgeon. Some people have used their fistulas for over 35 years. Every patient is different. Remember a fistula is you - nothing artificial. The blood vessel is the fistula. The artery is rerouted to a vein. The vein which is a low pressure system back to the heart enlarges when it receives the high pressure from the artery. This is how it gets large enough to use as an access. I absolutely love to swim and canoe and kayak as do my children which are 6 and 11. The fistula allows me to continue to do these things. Also, I love the fact that I don't have anything hanging on like a catheter. Home Dialysis Central has a great tutorial about establishing button holes athttp://www.homedialysis.org/learn/buttonhole/

February 7, 2011

After a couple of weeks of recovery I had the thirty staples removed from arm. As the pain of the surgery and and the swelling both subsided, I started to poke my new graft.  I am now happy to report that Dialysis Dad and graft are both doing fine.