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  • fistula - needle hole still bleeds a bit the day after

    I do the 4 Ė 7:30 shift of HD at the center and am in my first month (with a two year old fistula). Iím finding some mornings after dialysis when I go to remove the bandages that the scab on the needle hole is lifted off with the bandage and the hole starts to bleed a bit. Sometimes itís just a sheen on the hole so I use a band aide, other times it is oozing out enough that I want to put a replacement bandage on my arm. This is not strong bleeding that makes me worried for my life, just more of an irritation and worry about sanitation. After dialysis I hold the bandage with my fingers, fairly strongly, and the bandages are generally tight. Some blood does seep into the bandage, but no more than a dime sized dot and never enough to show on the top of or the sides.

    Should the nurses or I be doing something different to prevent the scab from attaching to the bandage? (Thanks)

  • #2
    My tech nurses told me to keep the bandages on for 24 hours. I do about 18 hours. I also have the 4:15-8:00 shift. If I take it off before 18 hours, a spot of blood might come out of one area not both. Hope this helps.

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    • #3
      I go for 6 pm until 9:45 pm (sometimes they call me in early if possible). My nurses actually tell me to take them off the next morning, even a few hours after finishing if I"m still up. Though I normally wait until at least noon the next day to be sure. I've occassionally had one of the holes start to bleed. What I do is get a gauze pad and press down as I would at dialysis after finishing and that gets it to stop and then I put a band aid on.

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      • #4
        Thanks, I bought a bunch of Band-Aids and plan to keep taking them off in the AM. I don't like the idea of keeping the bandages on longer since they press down on my fistula - I worry about the pressure..

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        • #5
          Originally posted by iolaire View Post
          Thanks, I bought a bunch of Band-Aids and plan to keep taking them off in the AM. I don't like the idea of keeping the bandages on longer since they press down on my fistula - I worry about the pressure..
          Good idea and also I was told keeping them on too long increases the chance of infection as well.

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          • #6
            On a regular basis I get bleeding from my fistula the day after treatment. I was told it might help to shower with the bandage on before removing them. It makes more of a mess to me. I shower and put on a band-aid. Sure this does not help other than to say it seems normal.

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            • #7
              Originally posted by MadMarcus View Post
              On a regular basis I get bleeding from my fistula the day after treatment. I was told it might help to shower with the bandage on before removing them. It makes more of a mess to me. I shower and put on a band-aid. Sure this does not help other than to say it seems normal.
              That might be worth trying, maybe it would loosen the scab on the bandage side so it pulls of the bandage rather than the wound. I'll give that a try (but I use a bath rather than a shower). Personally I'd prefer to keep the scabs since I think it will heal better with them.

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              • #8
                HI all, i've been on PD for just about a year now, and i'm cramping more than ever, and pretty painful cramps at that. I have a cyst on my left ovary and next month i go to have them (both ovaries) removed, they think that may be a reason that i still cramp. But i'm seriously considering going to fistula at home hemo. Terrified of the needles, but i can't do 13 hours a day of dialysis ( 9 on machine - 1 four hour dwell before machine.) and besides that my healthcarere will be running soon and i need to go back to work. I work at UPS, a pretty physical job, however in the last year that i've been outta work, i've gained weight, lost alot of my muscles and am very weak. My questions are: is there anyone out there with a physically demanding job? Can i lift substancle weight with that in my arm? Does anyone workout? Will this make my arm "useless" as i've heard? I'm in a dilemmea here...any thoughts or opinions and experience are welcomed and needed...thank you!!!

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                • #9
                  Originally posted by freverone View Post
                  HI all, i've been on PD for just about a year now, and i'm cramping more than ever, and pretty painful cramps at that. I have a cyst on my left ovary and next month i go to have them (both ovaries) removed, they think that may be a reason that i still cramp. But i'm seriously considering going to fistula at home hemo. Terrified of the needles, but i can't do 13 hours a day of dialysis ( 9 on machine - 1 four hour dwell before machine.) and besides that my healthcarere will be running soon and i need to go back to work. I work at UPS, a pretty physical job, however in the last year that i've been outta work, i've gained weight, lost alot of my muscles and am very weak. My questions are: is there anyone out there with a physically demanding job? Can i lift substancle weight with that in my arm? Does anyone workout? Will this make my arm "useless" as i've heard? I'm in a dilemmea here...any thoughts or opinions and experience are welcomed and needed...thank you!!!


                  I worked at UPS for over seven years before becoming an RN, and I remember how hard the work was. I had been on disability a few times with two pregnancies and a couple of surgeries. If you have used the entire 26 weeks of short-term disability, I would recommend returning to work, but only on light duty, with no heavy lifting. Does your hub have a smalls area? That's probably where they will put you for the time being. I had this happen several years ago, so I'm not sure if insurance still works this way, but I'm sure it will, especially if you're a union member. I came back from short term disability from maternity leave, and I was working for about a month, when I rolled my ankle and broke some bones in my foot. I was granted another six months, or 26 weeks of short-term disability because according to the contract, if you return to work for at least two weeks, and you are still unable to perform duties at 100%, you are given another 26 weeks of leave, but only with a doctor's note stating that you are unable to perform all duties at 100% due to illness or injury. Good luck, and I hope this helps!

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                  • #10
                    Hello freverone,

                    I work a desk job but I also travel and hump luggage through airports while on business travel, perform demanding auto repair with handtools on weekends not during the winter and otherwise have no limitations with the use of my non-dominant right fistula arm. I've been fairy ambidextrous most of my life and try not to play favorites with shoulders, arms, hands and fingers so as to balance out the wear and tear. After you have a fistula placed you are advised to get a hand/wrist strengthening exercise ball to help develop the fistula.

                    I've had a serviceable right forearm fistula since October 2012 and four button hole access sites I've been using for HHD since early September and other sites used since starting HHD (via training) in July of 2012. The only precautions I am aware of are pressure (tight fitting clothing, strap of heavy bag across the fistula) on the fistula that may restrict flow and certainly sharp objects which if they cut the fistula, you can expect to bleed out in a matter of minutes. I have been told my my HHD team that I must apply pressure to the anastomosis (vein and artery union) at the wrist to stop bleeding that would be anywhere in the fistula between that point and the elbow or shoulder. A tourniquet applied between the cut fistula and the heart won't do squat to prevent bleeding to death.

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                    • #11
                      Originally posted by freverone View Post
                      My questions are: is there anyone out there with a physically demanding job? Can i lift substancle weight with that in my arm? Does anyone workout? Will this make my arm "useless" as i've heard? I'm in a dilemmea here...any thoughts or opinions and experience are welcomed and needed...thank you!!!
                      I have an office job so I don't have direct experience but... The paperwork says never lift more than 10 pounds with your fistula arm, so don't carry in groceries etc.. But that being said I'm sure relatively healthy/able people (like me) all carry much more than that. i.e. I carried in and out of the house a 60 pound smoker over the weekend. Likely I'm risking my fistula in some way, but it has not physically impacted my mobility/arm in any fashion.

                      Make sure you understand your HD session timing before you make the jump. If I want to be close to my house and stay with my doctors all the shifts are during working hours. Once I factor in the commute I'm leaving at 2:30 on M/W/F.

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                      • #12
                        I am quite new to hemodialysis, and don't have a lot of advice for you, but I did want to offer you support. I have been told to never lift more than 3 pounds with my fistula arm......fistula is 3 months old.....I am now completing 3 weeks of HD. Try to be gentle with yourself....this can be a brutal process, especially when you're getting poked with 15g needles, much comfort is needed!!! God bless.

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                        • #13
                          Hi TutuOBrien, I was told I could lift up to 20 pounds because I had three grandbabies in 2013 and would be watching one at least once a week. The doctor told me I could lift the babies until they were 20 pounds and use mostly my right arm. I had to learn to fed the opposite of what I was use to and it felt funny for a few weeks. My sons still place her in my arm the wrong way and has to re adjust. Now that they are at 20 pounds my sons or husband lifts them up to me. I can still carry them around in my right arm with left arm support.
                          I have been on HD for 4 months with a difficult deep fistula. I should have a transposition soon. Just waiting for the vascular doctor to ok what the kidney doctor thinks needs to be done. So far, he has had me wait. I am thankful for Christian friends and support.

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                          • #14
                            thay told me i couldent go back to work couldent left more than 50 lbs or i would hurt my fisula i have to start all over agian

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                            • #15
                              Unless I've missed it, no one has mentioned using Bactroban on the needle site once bleeding has stopped. This is not only a "Best Practice", but also lubricates the contact point and the scab will not pull off when the bandage is removed. Good luck!

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