I am starting to use my AV fistula and my surgeon said that it was matured. Well last thursday the nurse went through it. and then left the needle in. Now my arm looks like Popeyes..and I cant extend it straight. I also feel pain when picking up a can of coke. They said (nurses at center) that it was normal and that it is just part of the maturation process. Anybody else have this happen?
This is the third time this same nurse couldnt get it right. I am thinking of going to peritoneal because of this place. Any comments or thoughts would be greatly appreciated.

A new fistula should also not be used until at leaste 3-4 months to give it sufficient time to mature and it should be run at no more than about 300 graudally going somewhat higher ( I think there may be info on the correct procedures at the vascular access board). A tech later told me that the nurses like to blow patients' new fistulas. They did this to me too turning the speed up to almost 400 my first time and trying to rush me to start using it at only 7 weeks! There is a lot of ignorance amongst the nurses and then they actually believe the myths about thinking its normal to blow a fistula. They hide all this from the patient and think its their job to be secretive about this initiation. Perfect example of dialysis malpractice. In my case, I complained to the doctor and he told them to only allow a good sticker to cannulate me. But my doctor really didn't know the correct procedure for starting a fistula either. It shows that some units operate without sufficient knowledge of dialysis, which is very unethical. In such units one always has to protect himself. Do whatever you can to protect yourself!

It would be absurd for a nurse to purposely blow a fistula. If a tech said such a thing, it was a very inappropriate and should be reported immediately to the medical and/or supervisory staff.

Here is a posting on how to correctly break in a new fistula:
http://www.renalweb.com/ubb/Forum13/HTML/000069.html


[This message has been edited by Gary Peterson (edited 01-09-2002).]

Thank you for the info. I had the actual surgery Sept tember of last year,,,Then they flow was somehow redirected..so they fixed it in Octoboer. They just started using it the middle of December..so the waiting period is well and good. They really didnt do it on purpose but I just cant stand this certain nurse. I also have a split ash catheter that they are using because I refuse to let them use my fistula again. As far as teh guage of the needle..I believe they said it was a 16. And as far as my neph...I dont even want to get into that...he is very unprofessional. I havent seen him since I moved out of the unit that he was the Director. (I got tired of driving 45 mintues one way) He hasnt even called my new unit in the past 4 months to get my monthly labs!.so needless to say..Im switching doctors .One that came highly reccommended.
As far as telling the nurse in charge...She was the pone who infiltrated the fistula the first time. So I really dont rely on her either. There is only one nurse that i have found that is a good sticker..but shes not there all the days I go. But I am thinking of going on peritoneal anyway. I hate sitting in a chair for 4 1/2 hours 3 times a week

Once again..thanks for the info! This board has been very informative.

Lin - you bring up a good question. I have a gortex graft in forearm....when I started dialysis the unit I was at wanted us to hold both sites at the same time - there was not a rush to free the chair for the next patient. The unit I am at now, insists that holding both sites is bad. What is the truth?

Lin..what do you mean ..do not use clamps ? What can it do ? Are you talking about the clamps that they use at the end of treatment to stop the bleeding at the point of insertion? or site ? they use them at my center. Would like info. I am still considering PD so I do have to depend on..what seems to be....uneducated or trained properly nurses.

The clamps with the springs are not neccessarily a bad thing. They hold the site at a constant pressure. Usually less than what the patient would hold it at. The only question is how long it would be left on the patients arm.

Hi:

I think readers of this posting have to keep things in perspective. I don�t think anyone has accused any nurse of deliberately blowing a fistula. As we all know, some nurses are better than others.

I, too, lost the use of my fistula because a nurse - I�m sure it was accidental - blew the vein. From there on I used a chest catheter. It would be nice if we could all walk into the dialysis unit and �pick� the nurse we thought was the best and turn away those we had no confidence in. But that�s just not practical.

I�ve had other injections in the past, where some nurses seem oh so gentle and others seemed like Mike Tyson.

Work with the nurses rather than circulate rumors of "initiations."

Best,
Mike