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  • laken1981
    started a topic Hand Pain/Fistula arm

    Hand Pain/Fistula arm

    Not sure if this is where I should post this, but has anyone had pain in the hand your fistula is in? I have 2 fistulas, one in the wrist, didn't take, 2nd in bicep...above the elbow...I realize the hand will get cold etc. but this week the left ring finger has completely gone numb, and throughout the day there is a severe pain in the tips of my fingers, like you smashed it and the blood is flowing into it... my neph said we'd watch it... and that if it got worse back to the vascular surgeon... anyone had a similar experience?

  • kcramer
    replied
    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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  • atomicapple
    replied
    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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  • stumpr54
    replied
    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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  • rebel789
    replied
    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; 07-22-2013, 11:19 PM. Reason: more info

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  • mrs brown
    replied
    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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  • stumpr54
    replied
    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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  • M3Riddler
    replied
    Originally posted by laken1981 View Post
    Not sure if this is where I should post this, but has anyone had pain in the hand your fistula is in? I have 2 fistulas, one in the wrist, didn't take, 2nd in bicep...above the elbow...I realize the hand will get cold etc. but this week the left ring finger has completely gone numb, and throughout the day there is a severe pain in the tips of my fingers, like you smashed it and the blood is flowing into it... my neph said we'd watch it... and that if it got worse back to the vascular surgeon... anyone had a similar experience?
    Sounds like it may be steal syndrome

    This is where the fistula "steals" the blood supply and it doesnt get to all necessary parts - fingers etc... There are procedures that can help this dependong on the severity. When do you get the numbness ? Is is only during dialysis ? If so, you could be running at too high of a blood flow. If other times, then more likely steal syndrome. They should be able to measure your flow in the fistula to help determine...

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  • lsamen
    replied
    If I am correct they call it "Steal hand" syndrome because they "stole" the vein to a certain area. I had a "fistula" in my left wrist that did not take. The veins are to small. They then gave me an "AV Graph" that works awesome. Over 1 year ago I had pain one morning in my arm. My daughter insisted we leave for the E.R. immediately. When all 3 of my doctors showed up I knew it was bad. They had to place a "Tunnel Catheter" in my chest and do a "angioblast" to clean out a clot. Never, EVER, carry ANYTHING in your access arm. No purse, no groceries, no dialysis bag with blanket. Guard it with your life, it IS LITERALLY your lifeline! Stay healthy mentally and look at life "through the eyes of a child." Remember to find beauty in all you see and trust that GOD has us all on watch! Love Lynda, write anytime, I am here for YOU! God Bless, Lynda

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  • Hoofpkr
    replied
    Yesterday, I went to surgeon and he ballooned the artery ro clear away some webbing that was blocking the blood flow. It is not ba painful procedure and relatively quick. I am able to ndo home dialysis today in the fistula, but chose bto wait one more day. When I began Home-Hemo just 27 months ago therte werebonly 3,000 do this kind of dialysis. The number is growing every day. My support team is the best and so diligent, none better banywhere!
    Hope then pain goes away. May the good Lord Jesus give you the strength and wisdom to get whatever is needed done.
    Hoofpkr

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  • scubygear
    replied
    Infiltrations can be cause by a few things. Movement of the arm can, will and has caused infiltrations. Movement of the arm can displace the needle from it's location and it can either puncture through the fistula or pulled out of the fistula causing the infiltration. But...cannulation technique definitely has caused infiltrations as well. How long has your mum had her AVF? Newly established AVFs will sometimes have a tendency of infiltration if not cannulated by one of the "expert cannulators" at first. Expert cannulators are in the clinic to help facilitate correct cannulating technique on any AVF/AVG and especially newly acquired accesses. Do the infiltrations happen often? I would advice to seek out the expert cannulator of the clinic and speak with the Vascular Access Manager and ask what might have happened and if there are things either the staff or your mum can do to further prevent painful occurences such as infiltrations.

    PS - also make sure the sights are rotated in a ladder format. If you have any further questions don't hesitate to ask and also here's a great site to learn from: http://www.fistulafirst.org/

    Hope this helps

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  • jbeauzil
    replied
    My mother had inflitration last week and they told her is because she keep moving her arm, I think it was bad cannulation.

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  • scubygear
    replied
    Originally posted by Delores1935 View Post
    Hi, I had the Graft Fistula put in on Aug 16,2012 and on August 17th i was rushed into the hospital with what they call a steal hand syndrome. They went in on August 18th and disconnected it. The Drs said if i did not have that done i would of lost my arm from elbow down. I was told my veins are very small and week so i cannot go with a fistula. Right now am on a catherter port in my chest. I have only been on dialysis since May 2012. Since i cannot go with a Fistula they gave me 2 choices Go with what they call a Hero or go to Home dialysis. I do not feel i am ready to do at home but not sure of the hero either. Am looking for some information or hear from someone that is doing these. Thank You Delores
    Hey there Delores sorry to hear about having so much trouble with your AVF (Arterial Venous Fistula), with my experience a vascular specialist could've possibly helped more than a surgeon only because surgeons are quick to cut in order to fix the problem vs. trying to really figure out what can be done to save the AVF and your arm. Steal syndrome normally means there is are "collateral" vessels that have formed and stealing the blood from your AVF causing pain and immaturity in your fistula. I've had plenty of patients have weak vasculature in general and their fistulas were able to be saved; BUT everyone is different so your case may be different. HHD (Home HemoDialysis) normally requires a working AVF so PD might be your best bet. I will say I personally would much rather have Peritoneal Dialysis vs. Hemo at home. Easier on you and your support system by far.

    HeRo grafts are a LAST RESORT only from my understanding. Here are some info on what they are and how they work:

    http://www.veithsymposium.org/pdf/vei/2090.pdf

    I was trying to look for something on the fistulafirst.org site but unfortunately wasn't able to find any. That pdf was the most thorough description I could find.

    I hope this helps!

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  • Delores1935
    replied
    Hi, I had the Graft Fistula put in on Aug 16,2012 and on August 17th i was rushed into the hospital with what they call a steal hand syndrome. They went in on August 18th and disconnected it. The Drs said if i did not have that done i would of lost my arm from elbow down. I was told my veins are very small and week so i cannot go with a fistula. Right now am on a catherter port in my chest. I have only been on dialysis since May 2012. Since i cannot go with a Fistula they gave me 2 choices Go with what they call a Hero or go to Home dialysis. I do not feel i am ready to do at home but not sure of the hero either. Am looking for some information or hear from someone that is doing these. Thank You Delores

    Leave a comment:


  • wswann
    replied
    Re: Hand Pain/Fistula arm

    THANKS for the reply, that was a lot of good information. I was having a tremendous amount of pain down my arm and in my hand while having Diallysis and was just suffering through it. Then I did what we all should do, I told my nurse at the unit about it. She told me to hold my arm closer to my side and it made a world of difference Such a simple thing, but I thought I had to keep my arm streched out on the table. The one thing I have learned in this whole world of Dialysis is to ask a lot of questions and if it does not feel right, ask more. I have gained a lot of information from reading hear, don't post as much I should. Thanks again for the information.

    Bill

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