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Why the Dialisys Center insist in a Fistula vascular access

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  • Why the Dialisys Center insist in a Fistula vascular access

    I start to received dialysis in June 2013. Before that date the Doctors made me a Fistula that never work and in June they also put a soft catheter in my abdomen for the peritoneal treatment that never work either.
    Know I received hemodialysis treatment through a catheter in my chest. Another thing is that I don't like to be pinch in my skin, less, three days a week
    The Dialysis Center insist that the Dr, put me a Draft in my arms or a new Fistula because is better for my health. Is this real or because it's more profitable for the Center?

  • #2
    If the PD did not work then another fistula is better than a catheter. Catheters can easily get infected and you can not bath or shower. I too have a bad and immature fistula. I started dialysis in Oct the 17th and had a catheter put in the chest a week later. Then two fistula grams to open the fistula by the time I was on dialysis two months. They work for a while but then because it is not mature collapse somewhere in the shoulder area. I am getting a second opinion with a vascular doctor in a week. According to what I have heard, drs. like Grafts in the arm more because it is predictable but that is putting a foreign element in the arm and it stick out. It also can get clods in it. Yes, this is real and it is the only way to stay alive , feeling better on off days of dialysis and you can be productive. I would not get through any of this without the support of my God, church and especially my family. My husband is a counselor along with a son who is also in the same profession. My best friend is a teacher counselor who stays in contact with me even though I have retired. See her at church or going out for breakfast is good. I also try to get out each day and not just sit in the house reading and doing my crafts. I need to get out and feel normal even when I don't feel good it perks me up. The rest of the family gave me three new grand daughters this year that adds up to doubling my grandchildren in a year. So even thought this year has been difficult physically, I have so many joys to count and think about. I pray you have support too. If not, seek some from church or counseling. My husband has his card at the dialysis center and the doctors office. It is important to have support and be positive. Hope this helps.

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    • #3
      Hello vicriv101

      Dialysis centers are continously scored on an array of criteria, most of these are related to patient outcomes/health. They receive more points for patients with fistulas and receive point deducts for patients with catheters and grafts. The reason for this is that a fistula is the "gold standard" for vascular access. It is not prone to the clotting and infection that catheters and grafts are subject to. It is your own tissue, so there is no concern for rejection. Getting a fistula to work properly for hemodialysis is entirely another matter. Fistula revisions and fistullograms to reveal flow issues and clear narrowings are not uncommon with hemodialysis patients.

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      • #4
        I got a fistula in my left arm in February of this year as my numbers were such my nephrologist thought dialysis could be needed at any time. I was able to hold off dialysis until October. I went in on October 1 and as they tried to start my left forearm started to swell up so they had to stop. Went to my vascular surgeon the next day and she had me undergo an ultrasound. Turns out they needed to do a fistula gram which was done on October 3. I went to dialysis on October 4 for another attempt and they were able to dialyze me, though at a lower volume. I was told that the fistula is a better way to dialyze than a catheter and me personally, I would rather have it done on my forearm than something on my chest or neck.

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        • #5
          rickster12 I agree with you there but my journey ended up starting on a Monday with no success, Tuesday with no success and Thursday the same but on Friday was successful. It worked for two treatments the next week then stopped on the Friday. I ended up with a catheter and a fistula gram the next week where they did two ballooning and a stint. The ballooning in the upper arm and the stint in the shoulder. The reports which I have read indicated that the shoulder is the problem. I still have the catheter and was glad because after three weeks of success and feeling better and ready for the catheter to come out, the blockage in the shoulder was back and it popped out the top needle so they used the lower needle and the catheter until the second fistula gram 5 weeks from the first one. I was told this will happen every three or four months. I am getting a second opinion to straighten the fistula and have it raised. You would not believe the cost to all of this. I have good insurance and I am on Medicare. I am thanking God for that. Until I see the doctor the arm is healing and I am using the catheter. It is a little scary.

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          • #6
            Originally posted by kcramer View Post
            rickster12 I agree with you there but my journey ended up starting on a Monday with no success, Tuesday with no success and Thursday the same but on Friday was successful. It worked for two treatments the next week then stopped on the Friday. I ended up with a catheter and a fistula gram the next week where they did two ballooning and a stint. The ballooning in the upper arm and the stint in the shoulder. The reports which I have read indicated that the shoulder is the problem. I still have the catheter and was glad because after three weeks of success and feeling better and ready for the catheter to come out, the blockage in the shoulder was back and it popped out the top needle so they used the lower needle and the catheter until the second fistula gram 5 weeks from the first one. I was told this will happen every three or four months. I am getting a second opinion to straighten the fistula and have it raised. You would not believe the cost to all of this. I have good insurance and I am on Medicare. I am thanking God for that. Until I see the doctor the arm is healing and I am using the catheter. It is a little scary.
            Unfortunately not everyone's cases are alike. It is fortunate that there are the other options for dialyzing in the event that one (like the fistula) doesn't work. If my fistula gram was not successful, I am sure my doctor would have sent me to have an immediate catheter put in as waiting for the fistula to mature on its own was not an option for me. I have my work insurance and starting the first I will also have Medicare.

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            • #7
              The fistula is really a better choice as I understand it. bIt has fewer infections than a catheter will have and very often the catheter needs to be replaced.
              Dialysis is not easy, but at the very least three days a week is necessary.This is a life saving treatment that gives me one more day for family and friends.
              i am so sorry that you are having such difficulty. Look outside and see the beauty that is in what God Almighty maker of heaven and earth has made and be thankful for the little things because if you only see the bad you will get depressed. If I can be of any help to you contact me.
              I am going on year 16 of many kinds of dialysis. Blessings and prayer, Hoofpkr

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