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  • #16
    I'm no stranger to infiltrations. During my HHD training with a 9 month old forearm fistula, I experienced 5 infiltrations in the venous portion of the fistula in two weeks. This was with the clinic's expert cannulators. After the fifth infiltrate I was sent to a fistua specialist who "scoped" the fistula and found an 80% stenosis in the vicinity of the anastomosis. The vascular MD "blew out" the stenosis, which led to the development of an array of new fistula branches on top and the back side of my forearm. My clinic started successfully cannulating the new venous portion of the fistula and if a few weeks we were able to go to 15 ga blunts in the two buttonholes they had developed. Cannulating a new fistula even with buttonholes and blunt needles had its challenges (up to 20 minutes in a land, air and sea search for the fistula flap) as the venous portion of the fistula developed. I have had to make sudden changes in needle angle over the first several months, but mercifully the cannulation angles for both buttonholes to access the respective fistula flaps have been stable for the past few months and will remain so as the "new" portion of the fistula is now almost 6 months old and fully mature. Blunt dialysis needles and buttonholes are the way to go for HHD. After alcohol sponging my buttonholes (after the Except has flashed), I get both my needles in, taped, flushed and connected to the arterial and venous lines on the NxStage System 1 and the machine running in 4 minutes and on my way to completing a 2 hr 45 minute, 30 liter treatment. After I'm connected and running, I'll cover both cannulation sites and pull down my sleeve and then route the lines up along my arm and secure with elastic velco bands and then across my chest back to the machine. I can do practically anything I want with my fistula arm with everything secure and virtually unlimited freedom of movement without any fear of infiltrations owed to the blunt needles.

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    • #17
      my hubby has been having pains and numbness in his hand during dialysis the last 2 weeks he has had an ultra sound and and fiistulagram and everything looks perfect they dont think it steal syndrome and basically have no explanation for the pain . he has been on dialysis for 2 years and just started with issues the last 2 weeks

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      • #18
        is there anything we can do, exercise or anything to help the hand and finger pain and numbness? I don't want to lose my graft and go to the heart. I am on my second operation for blood stealing but it is still pretty bad.
        Last edited by rebel789; 07-23-2013, 12:19 AM. Reason: more info

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        • #19
          It sounds like nerve involvement in these cases of numbness/pain in the hand and fingers. There are nerves/nerve bundles that may run in close proximity to the fistula or graft and the coursing of blood through vessel/graft could very well disturb nearby nerves. When you consider that a fistula develops like a muscle with use, that development could affect nearby nerves at some point in the future or not at all. Re-routing the fistula away from the affected nerve(s) may be possible as well as the nerve(s). In any case it is delicate surgery that could involve complications and/or make the condition worse. Using a different portion of the fistula may be worth consideration.

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          • #20
            I have pain in both hands 24/7. The pain began when I had a procedure done to correct what my Drs. were calling "Steals disease". be careful with any procedure on your fistula. The risk of nerve damage is very high.

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            • #21
              The help for that pain is heat. I just put a heating device in my hand and it eases the pain. I usually have it during dialysis if the needle is close to the edge and the heat stops it. During the day, I rub the area below the elbow that cramps with pain and if it doesn't help I put a heating pad on it and it goes away within 5 minutes. I hope this helps you too. I have a good tech who has worked on my arm from the beginning, four months ago, because of a deep fistula with many issues and problems. I just had the fistula transposition and pray when they start the needles again, the problems will stop. In the transposition they took out a lot of scar tissue which also pressed on nerves and was pushing the fistula deeper.

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