Here's my concern - my father has recently (1 week) had surgery for a fistula - left arm. Prio to this time he has been on alternating dialysis -pd and hd. The swelling of his arm and hand is still incredible - I would equate it with the size of two to three salamis. He is keeping it elevated and the arm has been painful and throbbing, but he refuses pain meds. I know some swelling is normal, but should it still be this swollen and what is likely causing it to remain swollen?? How great should my concern about this swelling be? Any thoughts will be helpful!

He may have a central vein stenosis i.e. a narrowing in a draining vein in his chest. This could be easily seen on a angiogram or fistulagram---- a small amount of dye or contrast is injected into the fistula and xrays are taken as it travels through the fistula and the draining veins beyond the fistula. Does he also have prominent veins on his chest,shoulder,neck,back on the fistula side?
Good luck!