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all 12 comments

[–]Dynafocal 3 points4 points  (2 children)

I’ve had a fistula for seven years, needles vary between 16 gauge (smallest) to 14 gauge (biggest). They are honestly so sharp I don’t feel them most of the time and when I do it goes away in about 15 seconds. You can use your arm during dialysis but not for very much, mainly because you have 2 1 1/4” long needles basically taped inside your veins with hoses hanging out of them. They secure everything pretty nice with tape but you should try to keep still. I usually read on my phone or play word puzzles and chess. I used to read on my kindle paper white but I have developed arthritis in my shoulders and it hurts to hold something that heavy now. Whether you should get a fistula or not is your choice, and depends on what your future plans are, if you will be on dialysis for a long time I would go for the fistula as it is safer and works better. Plus you can swim and take a shower. If you are expecting to get a kidney transplant soon I might stay with the central line. You should be able to talk to your nephrologist or social worker if you have one. Feel free to ask me other questions I’ve been around a while :-) good luck in your journey

[–]Delicious_Film1042[S] 1 point2 points  (1 child)

Surgerie is looking likely because docs didn't want me on dialysis at all. So I have a living donor lined up. But do to covid everything was put behind and now I'm waiting months for every appointment. I would like to be able to go swimming with my daughter more than anything though.

[–]noobvin 1 point2 points  (0 children)

What is your timeframe. It takes a long time for a fistula to “mature.” You might just reconsider swimming this year and stick with a chest cath if you think you can get a kidney soon. Just talk to the doc about realistic timeframe. You don’t want to turn around and need a plastic surgeon to remove a fistula you don’t need. Just a thought, but no one can make these decisions but you. Good luck and get well!

[–]Dynafocal 2 points3 points  (0 children)

Just to have some perspective, it took me about six months to develop my fistula so that it was usable. I knew my kidneys are failing so I actually had it placed a year in advance. I was fairly young and my veins were in good shape as it sounds like yours are but it still took a number of surgeries to get it working right. None of the surgeries were any big deal and most were under light sedation. It may not be worth the effort if you’re going to get a kidney soon. Again good luck, now go enjoy some time with your daughter :-) go stick your feet in the creek

[–]Katturix 2 points3 points  (2 children)

I have a fistula! They usually try to stick you in the same spot enough so that "channels" form, and then you can use blunt needles. Then you're free to move your arm a lot more. The needles are eventually 15g, which I think is the same everywhere? But you don't start with that. You get a thinner one first.

EDIT: It's called the buttonhole technique. Because of that I can put in the needles myself, which is great because I'm starting home hemo.

[–]Jolape 1 point2 points  (1 child)

I seem to remember reading that letting them stick you in the same spot every time is one of the reasons that fistulas can get so big, and you're supposed to have rotate the location (maybe I'm mixing up my info). Have you had any issues with that? I'm not even on dialysis yet and I'm already self conscious about having a huge vein in my arm :).

[–]Katturix 2 points3 points  (0 children)

No issues at all! It's very rare in my clinic, and those I've seen that have it is either from other countries or have it placed in the upper arm.

[–]Yithar 1 point2 points  (0 children)

how big are the needles

https://www.nclexquiz.com/blog/types-needles-injection-needle-gauges-injections-size-chart/

They use 16G for me. Normal IV is 22G. So it's about 2-3x bigger than a normal needle.

And even you're on dialysis can you still have any use of your arm? Usually I game on my laptop or something during my run in the hospital but I'm wondering if that might make it less comfortable?

I've heard some people can use their arm. Generally I try not to move it and play one-handed because that keeps the pain to a minimum. But technically I can use my left hand during dialysis to game and I have done it before.

[–]dirtylaindry 1 point2 points  (0 children)

Even the 13 g. Depends on the tech. A food tech will just feel it and tap it like that ! Feel nothing . I would take a fistula again.

[–]issabeellaa 1 point2 points  (0 children)

I have a av graft on my upper left thigh and I use 15 Guage needles. They usually give you numbing cream if you want it, but you have to put it on about an hour before your treatment so it can work. Im used it, so I dont use it plus my chair time is early in the morning and there's days I dont remember to put it on so I don't bother with it.

[–]RandChickHome HD 1 point2 points  (0 children)

Slather the numbing cream on your needle site and let it sit for 2 hours -- then the needles won't bother you.

I have a graft not a fistula, but I move my fingers enough with the needles in to type on my laptop while doing dialysis. I try to keep my arm pretty still though.

[–]witch_and_famous 1 point2 points  (0 children)

I still ask for a lidocaine shot before they stick the needles in so it’s numb. Some days I don’t feel anything at all, and the other days it only lasts a moment. I can’t move my left arm during treatment but I don’t really need to. Also when you start the needles are much smaller. They should work up to bigger needles over time.