Stayin’ alive

A kidney dialysis/transplant diary

Fistula use 1 and 1

I arrived at dialysis Thursday prepared for the first attempt to use my fistula: Skin numbing cream applied and plastic wrap protecting it from being rubbed off by clothing; Dead Woman Walking T-shirt on to make it easier to get to the fistula; St. Fiacre medal around my neck (I’m not Catholic, but when you find a saint who is patron for both fistulas and knitters, you wear it, right?).

I was shown how to wash the fistula area with antibacterial soap, my temp and blood pressure were taken, and I was ready for the sharp end of the needle.

Nurse Sue was soon at my side with her “template” of the path of my fistula. They used a 15 gauge needle and it truthfully hurt very little, only when the needle actually pricked through the skin. Sue couldn’t get it started though, so she told Lori to give it a try. Luckily, the needle didn’t have to be reinserted.

Lori got it started by simply “going a little deeper.” So, with one line to my left arm and one line to the catheter in my right jugular, I sat for 41/2 hours hardly moving. I discontinued my coumadin Tuesday evening, so the machine was turning off more than usual and by the end of my treatment my dialyzer was heavily streaked, but all in all the first use was deemed a success. WooWho!

Jackie, one of the techs, tried to prepare me for the idea that I may not be able to knit with this access. I know she just doesn’t want to see me get my hopes up high to have them dashed, but let’s just try it and see if it works. Maybe not the first week or month, but who knows, maybe 3 months down the path my arm will be settled enough that I can knit small-movement things. I certainly hope so.

I wish I could say I was back to my dry weight, but I’m not. I’m trying hard today to keep my liquid intake well below the 48 ounces because this extra fluid in my legs, though somewhat better, is still annoying and painful, so much so that I finally filled the pain pill prescription I was given about a month ago. It seems to be helping. I’m more aware of that toward the end of the 6-hour dosage course when the pain killer effects are wearing off.

The Dead Woman Walking T-shirt went over well at the dialysis unit, with both patients and many of the staff. I’m sure some may have thought it inappropriate, but like I said when I ordered it, it makes me smile a crooked smile and that’s good enough for me.

Saturday’s cannulation attempt didn’t go as well. The arm was properly numbed — though I just realized that I forgot to wash the access — so the needle going in didn’t hurt. The scab came off easily and Lori thought she got it first time, comma but…

My vessels are tricky. They roll, they hide, they skitter away as if they have some kind of radar telling them when a needle comes close. After a couple of pulls, Lori was able to get the blood flowing into the body of the syringe, but before she even tried to return the blood, the needle site infiltrated, in a nice big lump. It’s still lumpy and sore today and there’s a 50-cent sized bruise surrounding the needle site. The thrill is still there, but it’s more difficult to find in the infiltrated area.

It’s not unusual to be unable to use the fistula during the first few tries, according to the nurses, so I’m not disheartened by the second try being aborted. I have this urge to wrap my upper arm in an Ace bandage, though, to put some gentle pressure on the infiltrated site, but I’m resisting the urge.

The fistual being used has added a few more don’ts to my life like “don’t sleep on your left side and don’t sleep with your left arm under the pillow.” I tend to fall asleep on my side, but usually it’s the right side. I did wake a couple of times in the night and started to roll to my left side when I remembered, “DON’T!”

I’m going over to Davita.com to see if I can get some quick menu ides. Adieu!

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February 3, 2008 - Posted by | diabetes, dialysis, fistula, health, kidney, renal diet, renal recipes, transplant, weight loss

5 Comments »

  1. Why are they using a 15 gauge needle on a new fistula?! They should be using a smaller gauge needle, 16 or 17. No wonder it infiltrated. Ask for a smaller needle. I’m also really surprised they went the whole session on a new fistula. Ask to have the most experienced nurse there cannulate your new fistula.

    Comment by hymes | February 19, 2008 | Reply

  2. Thanks for the advice … I’ll ask those questions at today’s (2/19) treatment. We’re supposed to try using the fistula again. I have no idea why they chose a 15-gauge needle. It’s all new to me.

    Comment by iowakitkat | February 19, 2008 | Reply

  3. http://health.groups.yahoo.com/group/dialysis-support/

    Is a very large listserv on Yahoo of folks on dialysis, one for over 35 years! Many people who do home dialysis as well as in center and a source of great information, I learned anything I know from that listserv, although I must say even my first dialysis center took better care of my first new fistula than you are getting and that’s where I first learned about smaller guage needles.

    You have to get a Yahoo ID to join but that’s pretty easy. Good luck to you.

    Comment by hymes | February 19, 2008 | Reply

  4. Thanks … I’ll check it out

    Comment by iowakitkat | February 19, 2008 | Reply

  5. I just had the mapping of my arms and neck for a fistula. I have an appointment on monday, I’m scared to death to have this done, I had a graft 2 years ago it got a nasty infection. Is having a fistula better than a tunnel cath? an comments will be helpful. Thank you!

    Comment by dawne | July 3, 2008 | Reply


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