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  • Fistula vs Graft

    My husband was scheduled for his fistula the first wk. of Feb. then last night the surgeon called to say he and the Neph conferred after going over the mapping that DH's veins were way too deep to do the fistula. Rather than lifting them and risking bad access now they want to do a graft instead. We aren't very pleased about the graft but respect the surgeon and the neph's opinion. Anyone else have deep vein problems? Anyone with a Graft? We are concerned how long it will last and what happens if it has to be replaced? Questions we should have asked last night altho there are no better answers than those who have been there before. Thanks!
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  • #2
    Re: Fistula vs Graft

    I am not an expert in this area but can they put a fistula in another arm or are his veins deep in both arms? I wish I could help you more with this but I'm sure someone will have the right answer for you

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    • #3
      Re: Fistula vs Graft

      Yep, he has very deep veins in both arms. He is a very large man, also has a pacemaker & diabetes. Our Dr. said not too worry he will always be able to be on dialysis one way or another. Just hoping for a smooth transition. I think we are a few months away from dialysis but we both like to be pro-active. Thanks for your response!
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      • #4
        Re: Fistula vs Graft

        I do not have a graft, but I know several people who do and who are very satisfied with them. Another approach you might consider is peritoneal dialysis in which a catheter is placed in the abdomen, fluid is instilled into the abdomen and the peritoneum is used as a filter. This system works very well for lots of people and many people use a "cycler" machine which automatically fills and drains the abdomen on a schedule while you sleep. It leaves your days free for work or whatever and is easier on the body than hemodialysis.
        To the stars through difficulty!

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        • #5
          Re: Fistula vs Graft

          Unfortunately, he is not a candidate of peritoneal dialysis either. He is a large man with his weight around the middle. The nurse said his diabetes doesn't make him a good CPD candidate either. Hemodialysis was the only choice given to him. They didn't even discuss transplant We were hoping to make this road to dialysis as smooth as possible but guess there are a few bumps along the way. Thanks for your response though it was a great thought. This site is great to get info.
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          • #6
            Re: Fistula vs Graft

            Hmmm, I was told that weight around the middle would not affect doing PD. Perhaps doctors have differing opinions on this.
            My Writings

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            • #7
              Re: Fistula vs Graft

              Maybe it is the diabetes in addidtion to the weight around the middle. He does have a LOT of weight around his middle. Also something was mentioned about a residue left after dialysis affecting diabetes. By far, we are no experts just what we have recently learned from his Drs. We would love for him to do Peritoneal. This will give me something more research. Thanks for the response.
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              • #8
                Re: Fistula vs Graft

                Hi,

                I speak only from my own experience. It was found from my mapping that not only were my veins fairly deep but also very small. I did speak to my surgeon and really wanted to try the fistula first. They doubted that it would be functional but were very surprised when it not only came upward but is still pumping along beautifully. There is a portion that is very useable but it does dive at each end. We tried several times to use the deep parts but that usually led to an infiltration. The useable portion is large enough making the needling very easy for the 2.5 years it was used. As I said, this is my experience and I really haven't spoken to anyone wth deep veins. If your surgeon is steadfast in his resolve to do a graft he must think it is the only way to go.
                "Within every adversity lies a slumbering possibility"
                Linda
                Tx: 7/28/2005
                St. Louis University Hospital

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                • #9
                  Re: Fistula vs Graft

                  Is that what they call "lifting"? At first they thought it might be possible because my husband really wanted the fistula but then after they surgeon and neph had a conference they decided against it. But it sure sounds like it worked well for you. Glad to hear it.
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                  • #10
                    Re: Fistula vs Graft

                    micknjudy,

                    I believe the Good Lord was looking after me when the fistula was done because as I said it is still going strong. It's not that I would not have accepted a graft but being a little bull-headed I insisted where I maybe should not have. I am one of those people who definitely listen to my doctors but feel that I sometimes "hear" my body a little better. Fortunately I was right but I could have very well been wrong. I've been dealing with kidney disease for 30 years and you will find that to make educated decisions concerning your husband's treatment is a very important issue. You have chosen one of the best places I know to get that education and as always, I encourage you both to arm yourselves with info because you are called upon many times for input. We will keep you in our thoughts and prayers!
                    "Within every adversity lies a slumbering possibility"
                    Linda
                    Tx: 7/28/2005
                    St. Louis University Hospital

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                    • #11
                      Re: Fistula vs Graft

                      Thanks, Linda!

                      We really would like the Fistula too but unfortunately with his pending dialysis my husband has just kind of buried his head in the sand and takes things as they come. Totally unlike any other situation. I am sure the Drs. think I am the Wicked Witch of the West with my 100 questions about his care. Fortunately, I do like & respect both Drs.

                      I'm so glad it worked out well for you and if it were me I might push for it too but he just seems resigned to "whatever".
                      There...now I feel better - LOL
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                      • #12
                        Re: Fistula vs Graft

                        micknjudy,

                        Never think you are the "wicked witch"! Questions need to be asked and if the patient is willing to "take things as they are" you, as the caregiver will need to find those answers and make sure you understand the whys and whatfors that need to be answered. I was fortunately able to make myself very verbally understood and wanted answers when I had the questions. I was very fortunate that my neph was a great guy and was more than willing to take the time for my sometimes (what I considered) silly questions. There are no silly questions I found out. Every questions you have demands an answer and never give up until you recieve it. Due to my tenacious nature the unit asked me to be the patient advocate and I still do it today even though I've had a transplant. People tend to give in rather than dig a little deeper for the answers. Never allow yourself to be ignored.

                        Please forgive me for stressing this point so adamantly. All I really meant to say was "thank you"!
                        "Within every adversity lies a slumbering possibility"
                        Linda
                        Tx: 7/28/2005
                        St. Louis University Hospital

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