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  1. #1
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    Unhappy New Fistula and swelling?

    Hi all,

    My grandfather started emergency dialysis two weeks ago when his numbers dropped unexpectedly low. Since he hadn't been scheduled to start before, he is getting it through a catheter in the chest.

    A week ago, he had surgery to have a fistula made in the arm. Friday morning, a week after the surgery, his whole arm and hand started to get swollen. It is still swollen now and he says there is a dull constant pain. The arm is not overly red, the temperature between the two arms are the same and he has a strong pulse in his wrist so I don't think the blood flow has slowed down.

    Did anyone else have such problems soon after getting the fistula? Anyone know if it is normal for the hand/arm to be swollen? Anything we are supposed to do besides elevation to help the swelling to subside?

    Being as it is the weekend, his doctor is unreachable until Monday morning. Any advice would be appreciated.

    Thanks.

  2. #2
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    Re: New Fistula and swelling?

    My arm swelled my DR told me to see the surgeon. He took me in immediately. So my suggestion is to go to DR. DO NOT SELF DIAGNOSE. I am not trying to scare you it may be benign but it is something that the surgeon should decide.

  3. #3
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    Re: New Fistula and swelling?

    I am a total newbie - in fact this is my first post.

    Get him to the dr's first thing monday morning.

    DH had a fistula put in, he had some pain, it went away.. and then it got worse. Lots of pain. and it got more and more swollen. DH waited and waited... turned out he had a blood clot... the size of a tennis ball. (this was over a 3 week period)


    Just - get him to the doctor's asap.

  4. #4
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    Re: New Fistula and swelling?

    I would advise the same. This is something a dr. needs to see. Sometimes the fistula arm swells for a benign reason, but other times it is the sign of something serious like a clot. Only a dr. can tell you the difference and he/she would probably have to see it.
    To the stars through difficulty!

  5. #5
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    Re: New Fistula and swelling?

    Many things can cause swelling in a fistula. I used to get swelling a lot in mine but that was from the staff infiltrating my arm. Boy did that hurt and I got bruised. After a few weeks I got bruises (escaped blood under the skin) and swelling less and less and that made me happy. They said because my fistula was maturing and getting easier to cannulate (stick). But there are other things to look for to clue you in that there might be a real problem. Is the machine beeping a lot. Do they keep having to readjust? I had trouble with narrowing and needed the surgeon to go back in twice. I used my fistula for dialysis from mid 2006 to Nov 2007. Before that I used a PermCath from my chest as my first fistula had failed.

    MInd you I am only a patient and not a medical expert but am only speaking from my own experience with my own fistula. I was told that mine is not normal however as mine rolled a lot (that even made it impossible for them to ever establish buttonholes with).

    It is always good to discuss your worries with the dialysis team as people can't really give you advice based on black and white text on a computer screen and not knowing you or ever seeing your fistula first hand. Heck even the surgeon can't really and has to do certain procedures at times to be sure there are no problems.
    Angie
    Kidney Korner Dialysis Ethics Forum Kidney Pix Awareness Shirts KidneySpace Donor Search
    I will be walking a Kidney Walk in Ontario Canada Sept 18th 2011

    • Peritoneal Dialysis = 4 yrs
    • Hemo Dialysis (in center) = 2 yrs
    • 2 kidney transplants = 1990 - 2001 & 2007 to present

  6. #6
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    Re: New Fistula and swelling?

    Quote Originally Posted by angieskidney View Post
    Many things can cause swelling in a fistula. I used to get swelling a lot in mine but that was from the staff infiltrating my arm. Boy did that hurt and I got bruised. After a few weeks I got bruises (escaped blood under the skin) and swelling less and less and that made me happy. They said because my fistula was maturing and getting easier to cannulate (stick). But there are other things to look for to clue you in that there might be a real problem. Is the machine beeping a lot. Do they keep having to readjust? I had trouble with narrowing and needed the surgeon to go back in twice. I used my fistula for dialysis from mid 2006 to Nov 2007. Before that I used a PermCath from my chest as my first fistula had failed.

    MInd you I am only a patient and not a medical expert but am only speaking from my own experience with my own fistula. I was told that mine is not normal however as mine rolled a lot (that even made it impossible for them to ever establish buttonholes with).

    It is always good to discuss your worries with the dialysis team as people can't really give you advice based on black and white text on a computer screen and not knowing you or ever seeing your fistula first hand. Heck even the surgeon can't really and has to do certain procedures at times to be sure there are no problems.
    Hi Angie,
    You mentioned that you used PermCath from your chest before. Once the fistula healed on your arm and ready to use, do they remove the one on your chest and closed it up. Will they do another surgery to take the catheter out? I would like to know. Thanks!

  7. #7
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    Re: New Fistula and swelling?

    I am not Angie, but yes, once your fistula is reliably working (usually within a month) you go in for an outpatient surgery to remove the catheter. They don't even completely put you out.
    To the stars through difficulty!

  8. #8
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    Cool Re: New Fistula and swelling?

    Quote Originally Posted by benito View Post
    Hi Angie,
    You mentioned that you used PermCath from your chest before. Once the fistula healed on your arm and ready to use, do they remove the one on your chest and closed it up. Will they do another surgery to take the catheter out? I would like to know. Thanks!
    It was really quite easy to remove and I was so nervous once I heard they would take it out while I was awake. They numbed the area and sniped something (I could not tell what they were doing as I had to keep my chin out of their way lol) and I didn't even feel them pull it out (I had imagined it would be like when they pull the tube I had before out of my nose .. didn't like that feeling .. but that was years ago and I forget what that was for now ..). It was a lot easier to remove than I thought it would be and that was with some growth that made a part of the cath not want to come out .. but they got it out anyway.

    They waited til my Fistula was working and good to go (able to be cannulated) before they took out the PermCath.
    Angie
    Kidney Korner Dialysis Ethics Forum Kidney Pix Awareness Shirts KidneySpace Donor Search
    I will be walking a Kidney Walk in Ontario Canada Sept 18th 2011

    • Peritoneal Dialysis = 4 yrs
    • Hemo Dialysis (in center) = 2 yrs
    • 2 kidney transplants = 1990 - 2001 & 2007 to present

  9. #9
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    Smile Re: New Fistula and swelling?

    Quote Originally Posted by chefnancy View Post
    I am not Angie, but yes, once your fistula is reliably working (usually within a month) you go in for an outpatient surgery to remove the catheter. They don't even completely put you out.
    Wow! Dialysis protocol is so different everywhere in this country and all over the world for that matter. I was reading the post, and I could recall when I had my first subclavian, that when my AV Graft matured for utilization, an RN would remove the catherer insertion right at the unit, right before hemo treatment was to begin, but I haven't been on hemo for 10 yrs, so maybe it has changed that much since then. Just remember I am speaking from my own experience. I could remember the catherer being placed by the surgeon, but it was removed by the unit RN. I would like to know if there are pts. that are still having their catherer removed right at the unit. Oh, I forgot they would do this in an isolation room., of course the Rn and I would wear a mask during this procedure, and they would do my hemo treatment in that room for a week, and then I would be moved to the opened part of the unit. I guess this was a safety precaution.

    Glo

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