Fistula questions
kirbyboy posted:
Hello, I know that it's better to get a fistula sooner than later even if you don't have to use it from what I have read. Now the question is this. When did some of you on this group get yours? For example, if you get it in dec when would it be good to use? I read about the needle not being sharp and that it helps with pain. Is dialysis itself painful? Is there anything that you need to do when you get one if you don't have to use it yet. I mean protecting it of course. Does the vein get really big? The dr said that mainly happens if you are younger?? Is there a book or something I can read that Really tells you what to expect when you get a fistula and all the details of who, what where when etc? I am wanting to know so I can be prepared for my husbands sake. Does anyone here live in so california and have kaiser for insurance. Thanks so much
john-skpt responded:
It can take from 6 weeks to a few months for the fistula to 'mature'. The vein does tend to enlarge somewhat; that is what the maturation process is all about. The machines work most effectively when they get a lot of good, unobstructed blood supply, so a larger diameter vein gives better flow. That's the whole idea. Obviously younger, stretchier, springier veins may enlarge more than older, less resilient ones. But if the vein wouldn't enlarge at all then that would defeat the purpose of doing it.

There are generally a few minor restrictions to activity right after the fistula surgery is done, mostly to let the incision heal completely. You don't want an artery to tear and suddenly start bleeding. (Remember, we are attaching an artery directly to a vein without passing through the tiny capillaries. So the pressures and the bloodflow right at the fistula are greater than you'd have in the tiny capillaries of the skin.)

Anyway, that area will need to be protected while it heals, and continue to be somewhat protected as the artery/vein combo matures and enlarged.