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The Thrill of the Fistula
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| I got operated on for an AV fistula a few weeks ago, to prepare for
eventual dialysis, and when I put my finger on the incision I can feel
the "thrill" underneath. (I know that is a Good Thing.) My question
is, why do I feel the thrill? Why don't I just feel a regular pulse? I
tried Googling for it, but didn't find an explanation why. Thanks in
advance for any enlightenment on this topic!
Adam
--
Email: rubin AT bestweb DOT net
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| Charles Torrisi 2006-07-04, 9:24 pm |
| Adam, my son just started dialysis and had the fistula put in about a
year before. His healed very nicely, large and every time they stick
him they are thrilled to work with such a big vein. I touch it once in
a while and can feel it too. I t seems that because they have hitched
an artery with a vein, it becomes vericose and you can just feel it to
be stronger because of the amount of blood flowing through it.
Have a great day!!
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| Larry Krzewinski 2006-07-04, 9:24 pm |
| On Tue, 04 Jul 2006 17:25:27 -0400, Adam <look@bottom.for.address>
wrote:
>I got operated on for an AV fistula a few weeks ago, to prepare for
>eventual dialysis, and when I put my finger on the incision I can feel
>the "thrill" underneath. (I know that is a Good Thing.) My question
>is, why do I feel the thrill? Why don't I just feel a regular pulse? I
>tried Googling for it, but didn't find an explanation why. Thanks in
>advance for any enlightenment on this topic!
>
>Adam
The "thrill" is blood flowing over an uneven connection where the
artery and vein were spliced. Think of it like rapids in a stream.
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| Paul Bartram 2006-07-05, 2:32 am |
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"Larry Krzewinski" <Feerless_Freep@madmagazine.com> wrote
> The "thrill" is blood flowing over an uneven connection where the
> artery and vein were spliced. Think of it like rapids in a stream.
That's a very good analogy!
Mine has moved. It is now at the needle site instead of the fistula site.
I've got to go for an ultrasound next week to see what's a happenin'...
Paul
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| Larry Krzewinski 2006-07-05, 2:32 am |
| On Wed, 5 Jul 2006 12:28:26 +1000, "Paul Bartram" <p.bartram AT OR
NEAR optusnet.com.au> wrote:
>
>That's a very good analogy!
>
>Mine has moved. It is now at the needle site instead of the fistula site.
>I've got to go for an ultrasound next week to see what's a happenin'...
Good luck with it. One of the things that most dialysis patients
aren't aware of when they start dialysis is that it isn't uncommon for
them to clot or for there to be other problems with your fistula or
shunt. Some folks have a lot of problems with them clotting,
including immediately after surgery to unclot them.
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| Larry Krzewinski wrote:
> The "thrill" is blood flowing over an uneven connection where the
> artery and vein were spliced. Think of it like rapids in a stream.
Thanks, Charles, Larry, Paul, and everybody else!
Adam
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| Paul Bartram 2006-07-06, 9:24 pm |
|
> "Larry Krzewinski" <Feerless_Freep@madmagazine.com> wrote
[vbcol=seagreen]
[vbcol=seagreen]
[vbcol=seagreen]
> Good luck with it. One of the things that most dialysis patients
> aren't aware of when they start dialysis is that it isn't uncommon for
> them to clot or for there to be other problems with your fistula or
> shunt. Some folks have a lot of problems with them clotting,
> including immediately after surgery to unclot them.
Yes, the nurses pretty much said the same. I guess it's asking a lot of the
old bod, already sick, to have numerous needles the size of drainpipes
shoved in its veins, have your blood pumped through various machinery etc.
yet keep circulating hundreds of litres a day non stop without any hitches.
Your car wouldn't put up with it!
Paul
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| Larry Krzewinski 2006-07-07, 8:28 am |
| On Fri, 7 Jul 2006 12:06:41 +1000, "Paul Bartram" <p.bartram AT OR
NEAR optusnet.com.au> wrote:
>
>
>
>Yes, the nurses pretty much said the same. I guess it's asking a lot of the
>old bod, already sick, to have numerous needles the size of drainpipes
>shoved in its veins, have your blood pumped through various machinery etc.
>yet keep circulating hundreds of litres a day non stop without any hitches.
>Your car wouldn't put up with it!
Ask for an oil change and lube the next time you go. <grin>
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| Maybe a bit of a late response *grin* but a good fistula is a life
investment, if its new, follow the instruction booklet (always exercise
it lightly when its new, NEVER put heavy weight on it, AND NEVER EVER,
let anyone use the fistula arm, or leg, to take you blood pressure.)
My fistula is about 17 this year, & came in handy when my third
transplant decided it couldn't cope with the side effects of meningitis
on my body..
But its' still going strong. Self needling is a skill you really should
consider, it's you body, despite alterations, & you will be in control.
hope this is helpful.
J
Adam <look@bottom.for.address> wrote:
> I got operated on for an AV fistula a few weeks ago, to prepare for
> eventual dialysis, and when I put my finger on the incision I can feel
> the "thrill" underneath. (I know that is a Good Thing.) My question
> is, why do I feel the thrill? Why don't I just feel a regular pulse? I
> tried Googling for it, but didn't find an explanation why. Thanks in
> advance for any enlightenment on this topic!
>
> Adam
> --
> Email: rubin AT bestweb DOT net
--
My Blog at: http://www.livejournal.com/users/sw33tf00l/
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| Paul Bartram 2006-07-08, 2:31 am |
|
"JW" <wapmad@hotmail.com> wrote
> My fistula is about 17 this year, & came in handy when my third
> transplant decided it couldn't cope with the side effects of meningitis
> on my body..
Three transplants? Wow, they won't even give me one... But this makes me
wonder, is it common for people to have more than one 'go' at replacement,
and if so is the likelihood of rejection or failure increased or decreased
by having so much foreign tissue 'pass through'? In our ward there is only
one person who is on her second organ.
(I'm assuming here that you meant 3 kidney transplants, not multiple
transplants of different organs.)
Paul
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| Paul, by curiosity, which hospital are you under.
Correct, if I have another transplant it will be my fourth, and even
more risky operation than a 1st, 2nd, or 3rd.
My current one was slaughtered by meningitis last year, not kidney
related but possible food poisoning.
I would urge anyone to go to :
http://www.meningitis-trust.org/
then
http://www.meningitis-trust.org/dis...?category=18&se
ction=2
& at least note the basic symtoms of the disease, what could be flu or a
rash can turn out to be letthal.
Getting back to the point, I have the oportunity to risk a 4th
transplant, or go onhaemodialysis, probably at home.
Its a big decision at the age of 29.
All the best
JW
"Paul Bartram" <p.bartram AT OR NEAR optusnet.com.au> wrote:
> "JW" <wapmad@hotmail.com> wrote
>
>
> Three transplants? Wow, they won't even give me one... But this makes me
> wonder, is it common for people to have more than one 'go' at replacement,
> and if so is the likelihood of rejection or failure increased or decreased
> by having so much foreign tissue 'pass through'? In our ward there is only
> one person who is on her second organ.
>
> (I'm assuming here that you meant 3 kidney transplants, not multiple
> transplants of different organs.)
>
> Paul
--
My Blog at: http://www.livejournal.com/users/sw33tf00l/
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| Paul Bartram 2006-07-09, 2:33 am |
|
"JW" <wapmad@hotmail.com> wrote
> Paul, by curiosity, which hospital are you under.
Princess Alexandra, south Brisbane. This is the main hospital for
transplants and renal research in Queensland.
> Getting back to the point, I have the oportunity to risk a 4th
> transplant, or go on haemodialysis, probably at home.
> Its a big decision at the age of 29.
Good grief, do you buy them in bulk? :-) We do have one fellow of about
your age on the ward, but he's waiting for his first 'go'. We also have an
18 year old girl who will probably get a kidney soon now that she's old
enough to receive it.
They won't keep me on the public list because of heart problems, so I'm in
hunt mode right now... I'm 54.
Paul
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| Paul, , yoo say the girl will probably get a kidney soon now she's 'old
enough' Surely they do paediattric transplants in Aus.??
I had my first transplant soon after the age of 10 I think..
Do we buy them in bulk, some wish we could, here in the UK we have a
shortage of organ's from the 'list'
AND a shortage of treatment faciilites for those in need.
I would guess most countries are similar?
Jim
"Paul Bartram" <p.bartram AT OR NEAR optusnet.com.au> wrote:
> "JW" <wapmad@hotmail.com> wrote
>
>
> Princess Alexandra, south Brisbane. This is the main hospital for
> transplants and renal research in Queensland.
>
>
> Good grief, do you buy them in bulk? :-) We do have one fellow of about
> your age on the ward, but he's waiting for his first 'go'. We also have an
> 18 year old girl who will probably get a kidney soon now that she's old
> enough to receive it.
>
> They won't keep me on the public list because of heart problems, so I'm in
> hunt mode right now... I'm 54.
>
> Paul
--
My Blog at: http://www.livejournal.com/users/sw33tf00l/
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| Paul Bartram 2006-07-11, 2:26 am |
|
"JW" <wapmad@hotmail.com> wrote
> Paul, , you say the girl will probably get a kidney soon now she's 'old
> enough' Surely they do paediattric transplants in Aus.??
> I had my first transplant soon after the age of 10 I think..
I had no idea that was possible. The girl in question said herself that she
couldn't have a transplant until after her 18th birthday (I was just
listening in on a conversation another patient was having with her) but who
knows why that is. Maybe the hospital has a policy on the subject, or maybe
the family has some kind of legal restraint in place.
> Do we buy them in bulk, some wish we could, here in the UK we have a
> shortage of organ's from the 'list'
> AND a shortage of treatment faciilites for those in need.
> I would guess most countries are similar?
Yes, I was being 'tongue in cheek' there. I'd never heard of anyone
receiving more than two transplants. I only know about my state (Queensland)
where the average public waiting list is 3 years, other states are quite a
bit longer. Changes in donor law (proper declarations of intent) may improve
this in future.
Paul
| |
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| JW wrote:
> Maybe a bit of a late response *grin* but a good fistula is a life
> investment, if its new, follow the instruction booklet (always exercise
> it lightly when its new, NEVER put heavy weight on it, AND NEVER EVER,
> let anyone use the fistula arm, or leg, to take you blood pressure.)
> My fistula is about 17 this year, & came in handy when my third
> transplant decided it couldn't cope with the side effects of meningitis
> on my body..
> But its' still going strong. Self needling is a skill you really should
> consider, it's you body, despite alterations, & you will be in control.
>
> hope this is helpful.
> J
Thanks for all the suggestions. The vascular surgeon gave me a whole
page of explicit directions. I am gradually getting used to wearing my
wristwatch on the "wrong" (dominant, non-fistula) arm. My nephrologist
also told me to never have blood drawn from the fistula arm, too. Is
there a limit as to how much weight I should lift with that hand? (I'm
not into weightlifting, just thinking of carrying stuff around the house.)
I'm not up to the point of self needling yet, because I'm not yet on
dialysis. (Obviously the fistula is preparation for eventual dialysis.)
I visited the dialysis center and noticed that most/all of the chairs
have the dialysis machine on the left side of the chair. This should
work out better for me because I am right-handed, as I assume most
members of this group are, and so the fistula is in my left arm.
Adam
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| Paul Bartram 2006-07-12, 2:25 am |
|
"Adam" <look@bottom.for.address> wrote
> Is there a limit as to how much weight I should lift with that hand? (I'm
> not into weightlifting, just thinking of carrying stuff around the house.)
Nobody has warned me about lifting, just making sure there is no pressure on
the area (say with the corners of a cardboard box).
> I visited the dialysis center and noticed that most/all of the chairs
> have the dialysis machine on the left side of the chair. This should
> work out better for me because I am right-handed, as I assume most
> members of this group are, and so the fistula is in my left arm.
I'm left handed, so they put the fistula in my right wrist. Our ward has a
mixture of chairs and beds, but the staff are happy to move the machine
(with my help) to the other side, rather than have blood lines crossing
over. A needle pulling free would be VERY messy!
From photos I've seen, it would appear that chairs are the 'norm' in most
dialysis centres. I hate the things, I feel very uncomfortable in them, and
I get backache after 5 hours. I find a standard hospital bed with raised
head support is much more comfortable and I'd have thought cheaper than
those electric Gambro chairs, which give me flashbacks to the dentist!
Paul
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| Adam,
Yes. the location of the dialysis machine is USUALLY on the left of the
patient.
Usually fistulas are created on the left, but in my case, because my
left arm had been used for taking bloods for so long BEFORE I had needed
the fistula (& this is at the age of 10) the only place to put it was on
my right arm.
When your fistula is new you should excercise it lightly as usually
directed, but try not to lift anything more than say.. a litre cup.
You really need to look after it. Think of it as a form of life
insurance!:D
Your doc is correct to NEVER let anyone take blood from your fistula, OR
take a blood pressure on that arm.
The only time a tourniquet (as used to take blood) may be used is when
needling the fistula.
Also avoid any clothing that may become tight around the arm, &
definitly try to avoid any bruises.
I can recommend
www.kidneypatientguide.org.uk
a site that is full of useful information, & other helpful people:D
J
Adam <look@bottom.for.address> wrote:
> JW wrote:
>
> Thanks for all the suggestions. The vascular surgeon gave me a whole
> page of explicit directions. I am gradually getting used to wearing my
> wristwatch on the "wrong" (dominant, non-fistula) arm. My nephrologist
> also told me to never have blood drawn from the fistula arm, too. Is
> there a limit as to how much weight I should lift with that hand? (I'm
> not into weightlifting, just thinking of carrying stuff around the house.)
>
> I'm not up to the point of self needling yet, because I'm not yet on
> dialysis. (Obviously the fistula is preparation for eventual dialysis.)
> I visited the dialysis center and noticed that most/all of the chairs
> have the dialysis machine on the left side of the chair. This should
> work out better for me because I am right-handed, as I assume most
> members of this group are, and so the fistula is in my left arm.
>
> Adam
--
My Blog at: http://www.livejournal.com/users/sw33tf00l/
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| Paul I couldn't agree more! I don't like those damn chairs either..
I'm lucky that my normal unit has a majority of beds, so I can stretch
my legs properly!
I'm damn very lucky to have a mum who is a physio!:D
My fistula is in my right arm (near the elbow joint) so ideally I need
the machine on the right.
I was always tought, during my youth, that the lines should not cross
the patient
J
"Paul Bartram" <p.bartram AT OR NEAR optusnet.com.au> wrote:
> "Adam" <look@bottom.for.address> wrote
>
>
> Nobody has warned me about lifting, just making sure there is no pressure on
> the area (say with the corners of a cardboard box).
>
>
> I'm left handed, so they put the fistula in my right wrist. Our ward has a
> mixture of chairs and beds, but the staff are happy to move the machine
> (with my help) to the other side, rather than have blood lines crossing
> over. A needle pulling free would be VERY messy!
>
> From photos I've seen, it would appear that chairs are the 'norm' in most
> dialysis centres. I hate the things, I feel very uncomfortable in them, and
> I get backache after 5 hours. I find a standard hospital bed with raised
> head support is much more comfortable and I'd have thought cheaper than
> those electric Gambro chairs, which give me flashbacks to the dentist!
>
> Paul
--
My Blog at: http://www.livejournal.com/users/sw33tf00l/
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