Kidney Failure - Need advice quickly

Author

Need advice quickly

tangal

2004-10-03, 10:21 pm

My husband's AV graft clotted precipitously after a very difficult dialysis
session, where several clinicians failed to perform effective needle
sticks and it was necessary to change machines, etc. At the end of the
session, the bruit and thrill were still present, however upon arrival
home, the site began to bleed again and we could no longer palpate the
thrill. We went immediately to the surgeon's office and he said the two
options were to inject a chemical to dissolve the clot or use a balloon to
open it. The doctor "prefers" the surgery and of course we need to make
the decision immediately so my husband can resume dialysis on Saturday
morning. I am concerned that his experience in dialysis contributed to
the clotting and want to make sure that we do what we can to prevent
problems like that in the future. Anyone aware if that kind of problem in
the treatment can cause the clotting. Also, any experience with either of
the procedures I mentioned? Thanks

Spot

2004-10-03, 10:21 pm

A declot is a pretty simple procedure to have done. I've been through a
half dozen or more.

A clot can form for any number of reasons, low blood pressure, too much
fluid removal or thick blood. I'm in agreement with the doctor on surgery
as being the best option. I wouldn't want a loose clot floating around in
me and using the chemical you can end up with exactly that and you can die
from a blood clot if it hits the heart. It's better to have the graft
opened up where the doctor can basically flush it out of the tubing without
it hitting the blood stream. This also gives the doctor a chance to see if
maybe something needs fixed that could be causing it to clot.

You end up with a graft that works, stitches and some minor bruising. It's
a whole lot less painful than when they first them inserted............

Celeste

"tangal" <lizzio50@nospam.aol.com> wrote in message
news:a941706666fb6f450818d730d74fb478@localhost.talkaboutsupport.com...
> My husband's AV graft clotted precipitously after a very difficult
dialysis
> session, where several clinicians failed to perform effective needle
> sticks and it was necessary to change machines, etc. At the end of the
> session, the bruit and thrill were still present, however upon arrival
> home, the site began to bleed again and we could no longer palpate the
> thrill. We went immediately to the surgeon's office and he said the two
> options were to inject a chemical to dissolve the clot or use a balloon to
> open it. The doctor "prefers" the surgery and of course we need to make
> the decision immediately so my husband can resume dialysis on Saturday
> morning. I am concerned that his experience in dialysis contributed to
> the clotting and want to make sure that we do what we can to prevent
> problems like that in the future. Anyone aware if that kind of problem in
> the treatment can cause the clotting. Also, any experience with either of
> the procedures I mentioned? Thanks
>

Larry Krzewinski

2004-10-03, 10:21 pm

On Thu, 08 Jul 2004 17:10:51 -0400, "tangal" <lizzio50@nospam.aol.com>
wrote:

>My husband's AV graft clotted precipitously after a very difficult dialysis
>session, where several clinicians failed to perform effective needle
>sticks and it was necessary to change machines, etc. At the end of the
>session, the bruit and thrill were still present, however upon arrival
>home, the site began to bleed again and we could no longer palpate the
>thrill. We went immediately to the surgeon's office and he said the two
>options were to inject a chemical to dissolve the clot or use a balloon to
>open it. The doctor "prefers" the surgery and of course we need to make
>the decision immediately so my husband can resume dialysis on Saturday
>morning. I am concerned that his experience in dialysis contributed to
>the clotting and want to make sure that we do what we can to prevent
>problems like that in the future. Anyone aware if that kind of problem in
>the treatment can cause the clotting. Also, any experience with either of
>the procedures I mentioned? Thanks

Hemodialysis patient's grafts and fistulas clot. That is just a fact
of life when you're on hemodialysis. The clot could possibly have
been brought about the multiple needle sticks or for another reason
all together.

I used to hate to find a clot on the weekend. Standard procedure was
to go immediately to the ER and they would draw blood and call in the
vascular surgeon on call who would always schedule me for surgery or a
declotting by balloon angioplasty the following Monday or Tuesday. I
was ALWAYS in the ER at least 8 hours and nothing other than labs were
ever done. After three or so of these weekend occurrences I stopped
going to the ER on the weekends and instead went in on Monday morning
and saw my vascular surgeon directly. If the vascular surgeons who
saw a lot of these didn't consider it that much of an emergency not to
treat it right away then I decided not to either. I never experienced
any harm by waiting as much as four days without being dialyzed due to
a clot. I did, however, never miss any other scheduled dialysis in
almost nine years.

I'm not advising you to not follow your doctor's advice. I am telling
you that this does happen one a somewhat regular basis. I had two
grafts and five unclottings done in the course of almost nine years.
I knew many other patients that had a lot more declottings and grafts
placed.

Your husband should be fine. Don't feel overly pressured into making
a decision that you aren't comfortable with. My advice would be to
ask the surgeon that if it was his graft being operated on what his
choice would be. I've had both the surgical declotting and the
balloon angioplasty and I prefer the surgery. At times the balloon
angioplasty can be somewhat unpleasant.

Larry