Guest guest Posted October 26, 2004 Report Share Posted October 26, 2004 Hi A fistula usually takes about 4 months to mature, nominally, assuming that the operation was successful, that your veins are good, and that you have properly exercised the fistula starting about 10 days after the surgery. At 4 months, mine would have been usable, I think, but it was much more usable at the six month mark, which is when I happened to start dialysis. At 4 months, it wasn't really big enough to be visible, but at 6 months it was. Even so, the fistula still needs some more " maturing " from actual use once you start using it on dialysis. To exercise mine prior to starting dialysis, I used a little one pound hand dumbell and did repeated arm curls, plus, the cycling I did on my drop bar road racing bicycle helped as well. I exercised it many times each day. If the fistula vein is still too small, the nurses may have trouble getting a needle into it successfully. If the fistulagram was Ok, I would guess that yours still needs a bit of regular, active exercising. It won't grow in size otherwise. Exercising your arm increases the blood pressure in the fistula vein, and it helps to enlarge it over time. The idea of a fistula is that since it's a vein that is now under the same pressure as an artery is (contrary to popular misconception, our veins are not really under pressure, like our arteries are), it will stretch out and become a big pool of blood for the dialysis needle to go in. But it does need some help from active exercising. I used the little dumbel, but some people use a rubber squeeze ball or anything that you can squeeze repeatedly. Once they start needling it, it will continue to mature because the pressure in it will cause it to further enlarge and the walls will stiffen. When you first start, even if the fistula is fully mature, it may hurt for a week or two during dialysis. It may spasm, or it may " steal " blood from your hand and your hand or fingers will feel numb. This is common, and it's just a hump you will get over, and then it doesn't hurt at all. The bruising you got is from blood infiltration outside of the fistula. It means that because your fistula is currently not developed enough (and this means it's too small), the needle probably punctured through it and let blood infiltrate in the surrounding tissues. It looks bad, but it's harmless. They told me my fistula was well-developed when the surgeon checked it a few weeks after the surgery, and then again on my first day at dialysis. But, it was nothing compared to what it is now and what it became after a couple of months of use. So, the answer to your question about whether it can take longer than 4 months to mature is a definite YES. In the meantime, it's not the most comfortable thing to have a chest cath, but it's perfectly adequate to use for dialysis. By the way, if you decide to switch to PD, it may not be worth it. Usually, it can take a while before they actually put the catheter in, and when they do, it has to heal for a couple of weeks (and in some people, it takes longer). Then you need another week for training. So, it might be just as well to remain on hemo with a chest catheter while your fistula continues to mature - but that's just my opinion, and that's assuming you experience no problems with PD. Some people do, you know. Pierre Fistula Maturation > > > I would like to ask Pierre, or anyone with any knowledge of fistula > maturation, this question: > > I recently had to be put on hemodialysis, but when they tried to use > my 'new' fistula it bruised my arm up horribly. I looked like someone > had attacked me with a baseball bat! They had to put in a jugular > catheter to let it heal up. They also wanted to know why nobody in the > dialysis unit could seem to hit it with their needles, so they did a > 'fistulagram'. > > I have had this fistula since June of this year, and it is in my upper > arm. They looked at it during their fistulagram and said it is 'just > fine' but that it hasn't matured yet. It has been 4 months now since > they put it in. They say it can take a much longer time to mature, but > I am not so sure. I think if it hasn't matured by now then it will > never mature. > > I am considering getting a peritonial access temporarily so I can have > some time to get all of my medical benefits in place before I get > another fistula, or see if this one matures. > > Anyone have any knowledge of fistulas maturing after more than 4 > months? > > Aldrich > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 26, 2004 Report Share Posted October 26, 2004 Thanks very much for the detailed answer. I was considering doing that thing with the weights, but the surgeon that put the fistula in told me that an upper arm fistula doesn't respond to excercise. I keep getting mixed up information from different sources. I would tend to think it would help develop it though myself. Why he would say that I do not know. Aldrich > Hi > > A fistula usually takes about 4 months to mature, nominally, assuming that > the operation was successful, that your veins are good, and that you have > properly exercised the fistula starting about 10 days after the surgery. At > 4 months, mine would have been usable, I think, but it was much more usable > at the six month mark, which is when I happened to start dialysis. At 4 > months, it wasn't really big enough to be visible, but at 6 months it was. > Even so, the fistula still needs some more " maturing " from actual use once > you start using it on dialysis. To exercise mine prior to starting dialysis, > I used a little one pound hand dumbell and did repeated arm curls, plus, the > cycling I did on my drop bar road racing bicycle helped as well. I exercised > it many times each day. > > If the fistula vein is still too small, the nurses may have trouble getting > a needle into it successfully. If the fistulagram was Ok, I would guess that > yours still needs a bit of regular, active exercising. It won't grow in size > otherwise. Exercising your arm increases the blood pressure in the fistula > vein, and it helps to enlarge it over time. The idea of a fistula is that > since it's a vein that is now under the same pressure as an artery is > (contrary to popular misconception, our veins are not really under pressure, > like our arteries are), it will stretch out and become a big pool of blood > for the dialysis needle to go in. But it does need some help from active > exercising. I used the little dumbel, but some people use a rubber squeeze > ball or anything that you can squeeze repeatedly. > > Once they start needling it, it will continue to mature because the pressure > in it will cause it to further enlarge and the walls will stiffen. When you > first start, even if the fistula is fully mature, it may hurt for a week or > two during dialysis. It may spasm, or it may " steal " blood from your hand > and your hand or fingers will feel numb. This is common, and it's just a > hump you will get over, and then it doesn't hurt at all. > > The bruising you got is from blood infiltration outside of the fistula. It > means that because your fistula is currently not developed enough (and this > means it's too small), the needle probably punctured through it and let > blood infiltrate in the surrounding tissues. It looks bad, but it's > harmless. > > They told me my fistula was well-developed when the surgeon checked it a few > weeks after the surgery, and then again on my first day at dialysis. But, it > was nothing compared to what it is now and what it became after a couple of > months of use. > > So, the answer to your question about whether it can take longer than 4 > months to mature is a definite YES. In the meantime, it's not the most > comfortable thing to have a chest cath, but it's perfectly adequate to use > for dialysis. > > By the way, if you decide to switch to PD, it may not be worth it. Usually, > it can take a while before they actually put the catheter in, and when they > do, it has to heal for a couple of weeks (and in some people, it takes > longer). Then you need another week for training. So, it might be just as > well to remain on hemo with a chest catheter while your fistula continues to > mature - but that's just my opinion, and that's assuming you experience no > problems with PD. Some people do, you know. > > Pierre > > > Fistula Maturation > > > > > > > > I would like to ask Pierre, or anyone with any knowledge of fistula > > maturation, this question: > > > > I recently had to be put on hemodialysis, but when they tried to use > > my 'new' fistula it bruised my arm up horribly. I looked like someone > > had attacked me with a baseball bat! They had to put in a jugular > > catheter to let it heal up. They also wanted to know why nobody in the > > dialysis unit could seem to hit it with their needles, so they did a > > 'fistulagram'. > > > > I have had this fistula since June of this year, and it is in my upper > > arm. They looked at it during their fistulagram and said it is 'just > > fine' but that it hasn't matured yet. It has been 4 months now since > > they put it in. They say it can take a much longer time to mature, but > > I am not so sure. I think if it hasn't matured by now then it will > > never mature. > > > > I am considering getting a peritonial access temporarily so I can have > > some time to get all of my medical benefits in place before I get > > another fistula, or see if this one matures. > > > > Anyone have any knowledge of fistulas maturing after more than 4 > > months? > > > > Aldrich > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 26, 2004 Report Share Posted October 26, 2004 Thanks very much for the detailed answer. I was considering doing that thing with the weights, but the surgeon that put the fistula in told me that an upper arm fistula doesn't respond to excercise. I keep getting mixed up information from different sources. I would tend to think it would help develop it though myself. Why he would say that I do not know. Aldrich > Hi > > A fistula usually takes about 4 months to mature, nominally, assuming that > the operation was successful, that your veins are good, and that you have > properly exercised the fistula starting about 10 days after the surgery. At > 4 months, mine would have been usable, I think, but it was much more usable > at the six month mark, which is when I happened to start dialysis. At 4 > months, it wasn't really big enough to be visible, but at 6 months it was. > Even so, the fistula still needs some more " maturing " from actual use once > you start using it on dialysis. To exercise mine prior to starting dialysis, > I used a little one pound hand dumbell and did repeated arm curls, plus, the > cycling I did on my drop bar road racing bicycle helped as well. I exercised > it many times each day. > > If the fistula vein is still too small, the nurses may have trouble getting > a needle into it successfully. If the fistulagram was Ok, I would guess that > yours still needs a bit of regular, active exercising. It won't grow in size > otherwise. Exercising your arm increases the blood pressure in the fistula > vein, and it helps to enlarge it over time. The idea of a fistula is that > since it's a vein that is now under the same pressure as an artery is > (contrary to popular misconception, our veins are not really under pressure, > like our arteries are), it will stretch out and become a big pool of blood > for the dialysis needle to go in. But it does need some help from active > exercising. I used the little dumbel, but some people use a rubber squeeze > ball or anything that you can squeeze repeatedly. > > Once they start needling it, it will continue to mature because the pressure > in it will cause it to further enlarge and the walls will stiffen. When you > first start, even if the fistula is fully mature, it may hurt for a week or > two during dialysis. It may spasm, or it may " steal " blood from your hand > and your hand or fingers will feel numb. This is common, and it's just a > hump you will get over, and then it doesn't hurt at all. > > The bruising you got is from blood infiltration outside of the fistula. It > means that because your fistula is currently not developed enough (and this > means it's too small), the needle probably punctured through it and let > blood infiltrate in the surrounding tissues. It looks bad, but it's > harmless. > > They told me my fistula was well-developed when the surgeon checked it a few > weeks after the surgery, and then again on my first day at dialysis. But, it > was nothing compared to what it is now and what it became after a couple of > months of use. > > So, the answer to your question about whether it can take longer than 4 > months to mature is a definite YES. In the meantime, it's not the most > comfortable thing to have a chest cath, but it's perfectly adequate to use > for dialysis. > > By the way, if you decide to switch to PD, it may not be worth it. Usually, > it can take a while before they actually put the catheter in, and when they > do, it has to heal for a couple of weeks (and in some people, it takes > longer). Then you need another week for training. So, it might be just as > well to remain on hemo with a chest catheter while your fistula continues to > mature - but that's just my opinion, and that's assuming you experience no > problems with PD. Some people do, you know. > > Pierre > > > Fistula Maturation > > > > > > > > I would like to ask Pierre, or anyone with any knowledge of fistula > > maturation, this question: > > > > I recently had to be put on hemodialysis, but when they tried to use > > my 'new' fistula it bruised my arm up horribly. I looked like someone > > had attacked me with a baseball bat! They had to put in a jugular > > catheter to let it heal up. They also wanted to know why nobody in the > > dialysis unit could seem to hit it with their needles, so they did a > > 'fistulagram'. > > > > I have had this fistula since June of this year, and it is in my upper > > arm. They looked at it during their fistulagram and said it is 'just > > fine' but that it hasn't matured yet. It has been 4 months now since > > they put it in. They say it can take a much longer time to mature, but > > I am not so sure. I think if it hasn't matured by now then it will > > never mature. > > > > I am considering getting a peritonial access temporarily so I can have > > some time to get all of my medical benefits in place before I get > > another fistula, or see if this one matures. > > > > Anyone have any knowledge of fistulas maturing after more than 4 > > months? > > > > Aldrich > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 26, 2004 Report Share Posted October 26, 2004 Mine is an upper arm fistula too. I was told to exercise it, and it certainly seems to have worked for me. My fistula is so strong I get compliments on it from the nurses all the time :-) Pierre Re: Fistula Maturation > > > Thanks very much for the detailed answer. I was considering doing > that thing with the weights, but the surgeon that put the fistula in > told me that an upper arm fistula doesn't respond to excercise. I > keep getting mixed up information from different sources. I would > tend to think it would help develop it though myself. Why he would > say that I do not know. > > Aldrich > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 27, 2004 Report Share Posted October 27, 2004 Hi , I am so sorry you have declined to the point where you needed to start dialysis. Are you being worked up for a transplant? I'm sorry your fistula needs more developing. Pierre always warns to get the fistula in early, and I guess your experience unfortunately is an example of just how important it is. My heart goes out to you. I do hope dialysis helps you to feel better. In a message dated 10/26/2004 7:05:50 AM Pacific Daylight Time, single_dallas_dude43@... writes: > > > I would like to ask Pierre, or anyone with any knowledge of fistula > maturation, this question: > > I recently had to be put on hemodialysis, but when they tried to use > my 'new' fistula it bruised my arm up horribly. I looked like someone > had attacked me with a baseball bat! They had to put in a jugular > catheter to let it heal up. They also wanted to know why nobody in the > dialysis unit could seem to hit it with their needles, so they did a > 'fistulagram'. > > I have had this fistula since June of this year, and it is in my upper > arm. They looked at it during their fistulagram and said it is 'just > fine' but that it hasn't matured yet. It has been 4 months now since > they put it in. They say it can take a much longer time to mature, but > I am not so sure. I think if it hasn't matured by now then it will > never mature. > > I am considering getting a peritonial access temporarily so I can have > some time to get all of my medical benefits in place before I get > another fistula, or see if this one matures. > > Anyone have any knowledge of fistulas maturing after more than 4 > months? > > Aldrich > Quote Link to comment Share on other sites More sharing options...
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