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  • Exercising Arm

    Hi Guys:

    Just a question I need answered. How do you build up the veins in your arm prior to having your fistula surgery? I do barbell curls currently with 15 lb barbells. Is there something else I can use to build up my arm?

    Thanks again for your assistance.

  • #2
    Originally posted by bikerchick View Post
    Hi Guys:

    Just a question I need answered. How do you build up the veins in your arm prior to having your fistula surgery? I do barbell curls currently with 15 lb barbells. Is there something else I can use to build up my arm?

    Thanks again for your assistance.
    15 pounds Good job.

    I would suggest also using a squeeze ball. It really develops the lower arm with minimal effort. Be sure to concentrate on your non-dominant arm. That will leave your dominant arm free during dialysis, and really helps with the fine motor skills needed for self-cannulation.

    Your neph should have squeeze balls - the drug reps give them free. If not, try the toy and sports section at WalMart, or pet section for dog toy balls. Get one small enough to be comfortable in your hand. (Need I say avoid the ones with squeakers? )

    My husband was doing about 600 reps a day by the time he got his done. He carried it with him most of the time and he kept it in his hand while watching TV and squeezed during every commercial. He has a wonderful "Cimino" (natural A/V) fistula which by the third week of dialysis was running at maximum speed 500ml/m

    Here is a detailed description of the different types of access. and information on the Cimino fistula, which is the "Gold Standard".

    http://msl1.mit.edu/ESD10/kidneys/HndbkPDF/Chap09.pdf

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    • #3
      Black - let me get this straight - there are different types of fistulas? So you're saying I should get a Cimino fistula - these are better than the other types? Sorry to act stupid, but I thought a fistula is a fistula....

      Comment


      • #4
        A fistuala is a fistula according to my husband's vascular surgeon. My husband's veins are too small for a fistula so he has a graft and they run at 550-600 so he get great treatment, too. His first graft was man-made stuff and it got infected at one end so it had to be removed. Now he has a cow vein graft that has less chance of infection and sure works good.

        Squeeze that ball before and after surgery and your artery and vein will be in great shape!

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        • #5
          I have a box of those squeezy balls, so if anyone needs one, I will send it to you for free!! Just PM me.
          Shannon
          KidneyFun // Kidney Korner // Organ donation awareness products!
          If the world didn't suck...........We'd all fall off!

          Comment


          • #6
            Bikerchick, the gold standard for fistulas is an AV fistula using your own veins and arteries. If your veins are too small or your natural fistula fails then you would go for some type of a graft. I don't know if weight-lifting does anything for improving vein size. Squeezing a soft rubber ball does. I also use a soft rubber ball and do 750 reps per day. Do this with your non-dominant hand.
            To the stars through difficulty!

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            • #7
              Originally posted by bikerchick View Post
              Black - let me get this straight - there are different types of fistulas? So you're saying I should get a Cimino fistula - these are better than the other types? Sorry to act stupid, but I thought a fistula is a fistula....
              You're not stupid. You already know a lot more than I did when my husband was first diagnosed and you are eager to learn. You will do very, very well.

              Yes, fistulas are named based on where they are located and which vein and artery are joined - brachio-cephalic, radial-cephalic, etc.

              From the link I gave in the previous post: "... The Cimino fistula is the preferred type of permanent hemodialysis access; it has a lower incidence of clotting and infection than synthetic grafts. Unfortunately Cimino fistulae cannot be made to work for all patients. (A fistula is any abnormal connection between one part of the body and another; in this case the fistula is created between an artery and a vein and is therefore called an arterio-venous fistula. Cimino was the physician who originally described this technique in 1966.) A Cimino fistula is created by joining a large vein directly to an artery, typically in the forearm at the wrist, or higher in the arm near the elbow crease...."

              The vein mapping done with Doppler ultrasound prior to the surgery will determine where they will first attempt to put your fistula. It is important that you have a vascular surgeon with a good track record. Don't be shy, ask what their success rate is 6 months post first use. The best ones will know, some of the good ones won't, the poor ones will be offended that you asked. Check out www.fistulafirst.org and http://www.kidney.org/professionals/...oqiupva_i.html (Be sure to read down to Guideline 7 - very important for you.)

              Actually the best way to find a good fistula surgeon is to introduce yourself at the local dialysis clinics. (Call first and ask when would be a good time to visit.) Tell them you will be starting dialysis soon and you are just checking out the local centers. In the course of the conversation ask everyone you speak with, who they would use if they were going to have a fistula done. (This also will give you a chance to eliminate the clinics with difficult and uncooperative staff, stinky smells, dirty floors and baseboards, stained equipment and furniture, which all indicate poor cleaning practices. We visited several and some were really disgusting!)

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              • #8
                fistula

                not to rain on your parade, but a small percentage of fistulas don't work ( I had two failed fistulas) so I argee with Black that it's important to get a good surgeon. Please don't rule out peritoneal dialysis. I didn't want to go that route at first, but I am pretty happy with my decision now (especially because the roads are so icey!)
                Have you had a tour of a local dialysis center? I also agree with Black that there are some good ctrs. and some not so good. My center is 1/2 hour away but the one closest to my house is pretty awful.

                good luck with your decision and keep us posted (no pun intended) on how you are doing!

                Comment


                • #9
                  Fistula

                  That's what I love about this site - you not only get the positive, but the negative. I'm on a constant roller coaster here because I get to a point where I feel good about what may be coming down the pike, only to hear negativity. I'M THINKING POSITIVE here! Give me some hope....give me some courage...don't tell me the negative things.

                  Now, on the other side of the coin, I'm sure it won't be peaches and cream. I'm expecting the bumps in the road and the large potholes to come about on my journey. But that's to be expected. And if my fistula fails, I will deal with it.

                  Right now I'm on new BP medicine and I feel super. Creatinine is still at a 3.4 - nothing has changed in six months. Can I hold out long enough for a transplant? I hope...I pray, but know God can throw in a monkey wrench at any time. But again, I think positive and keep positive - if the bottom falls out, then I pick myself up, pray harder and take whatever comes my way.

                  Shay send me one of those balls!!!

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                  • #10
                    Hang in there, Bikerchick. My creatinine is at 4.0, which brings me to around 11% function. I'm holding out for the transplant. My dr. started talking about a fistula, then decided to wait because the transplant option is rolling. My son was going to donate, but they've put him on the backburner. He's the perfect match, but he's only 20, too soon to tell if he would ever have high blood pressure or adult onset diabetes. My husband was also cleared as a donor, so now he's going through the physical stuff. Like you, I still feel ok. Sure, I could complain if I wanted to, being tired, painful joints, I forget what a good night sleep feels like, but I still have a good appetite and I'm not at all nauseous, so we're waiting... and concentrating on the good things. Just keep thinking positively. Sure, there are people with horror stories, but that's human nature to want people to know how much we suffer and bring everyone down in the swamp with us. But keep remembering those who are doing well, who don't have fistula problems, who can continue to work and live a normal (whatever that is) life.

                    Keep educating yourself. Knowledge is power. Remember, God is in control!
                    It's not about waiting for the storm to pass, but learning to dance in the rain.

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                    • #11
                      MissedTheBoat - the real question is whether I would want to do the transplant thing. I hear the horror stories of people with medication problems and all the side effects - makes you wonder if Dialysis isn't the better life.

                      Yes, again, I am very much like you. Unfortunately, I still have a ragging appetite, but it's difficult when you have to watch your protein, potassium, sodium and phosphorus. I want to eat everything - you know what it's like watching football on Sundays only to see five hundred Papa John commercials? God it's enough to drive me crazy!! There are times I want to cheat, but know that it will affect me.

                      Sorry if I ask so many questions guys, but I simply want people opinions in how they have experienced clinic dialysis, transplants, dealing with fistulas, home dialysis, etc., etc., etc. I just hope that when my time comes, I will have the courage to deal with it. Believe me I will be thinking of all of you.

                      Right now, it's the holidays - time to think of family and friends and the good life (whatever that may be - pre-dialysis, dialysis or transplant). Happy Holidays to you all...thank you for your support.

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                      • #12
                        I hear you about the transplant medications and side effects. I've heard all those horrendous stories as well, but just like with dialysis and fistulas, I've also spoken with people who have done quite well with the transplant. I'm trying to put the horror stories out of my mind. I just want a few good years to do some travelling with my husband. The kids are finally out of the house and we have the time and means to actually do some things. We planned our 2nd honeymoon to Tahiti. It was our 25th anniversary trip. We only had one other trip in 25 years that we took by ourselves sans kids. We ended up having to cancel it because I ended up in the hospital in acute renal failure 3 days before we were to leave. I can't see taking a trip there on dialysis. I know there are people who will say it can be done, but the thought of it is too overwhelming for me. It feels to me that just when we were empty nesters and ready to spread our own wings, we got grounded and life came to a screeching halt because of this stupid disease. I refuse to give in to it and, by golly, one way or another, we're going to Tahiti!!!

                        I also sympathize with the food issues. It is always in your face when the TV is on, especially the football games. I'm pretty fortunate in that I only have to watch the protein and phosphorus. I can have all the sodium and potassium I want. Many times I've thanked God that fruit is still on my menu. I'll have a baked potato for lunch at least once a week. I would go crazy if I had to watch the sodium and Potassium too.

                        Well, keep us posted as you learn more and make your decisions. I learn an awful lot from your posts. I know I may be there someday soon myself, so you're asking questions for both of us
                        It's not about waiting for the storm to pass, but learning to dance in the rain.

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                        • #13
                          I hear you about all the horror stories but you also have to see and if possible meet with the successes and they far outnumber the others and every year it gets better. The newer drugs have less affect on the kidney and fewer side affects. Talked to a friends brother on the week-end who has had both a kidney (12 years ) and a pancreas (9years) and he admits there are issues from time to time but nothing like being on dialysis. I make it point to call these people when someone says "I have a friend.. aunt etc. I get their number and the stories are great. I feel we don't see too many here because once the transplant is successful they are too busy and may want to leave all this behind. I just had mine cancelled AGAIN and this time two days before, But I'm still hopeful and my husband is ready with his Kidney. Like you our kids are gone, I'm retired and he's ready to as soon as I can go!! The fact that we have live donors relly helps because they make sure we are in the best possible shape and they usually last longer. Good luck to all and Happy Holidays.
                          Mariyn

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                          • #14
                            I deleted my PMs, but I kept the names and addresses of the two people who PMed me wanting a squeezy ball. I am sending them out some times next week. I included 5 DaVita recipe cards in each of them also to give you guys a head start with that. I was just trying to let whoever PMed me know that they are being sent to you soon! Hope you all have a happy holiday!!
                            Shannon
                            KidneyFun // Kidney Korner // Organ donation awareness products!
                            If the world didn't suck...........We'd all fall off!

                            Comment


                            • #15
                              Exercise Ball

                              Shay - mucho thanks!!! I owe ya.... Happy New Year guys.

                              You all have given me hope that perhaps the New Year won't be so bleak after all.

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