What is fistula?
AVF, or an arteriovenous AVF is a vessel created by connecting a vein with an artery inside your arm during an operation . This is to form a blood vessel that allows for a greater flow of blood sufficient for dialysis. The procedure connecting the vein to artery permits an expansion of diameter of the vein, as well as the flow of blood through it as well as this section of vein referred to as the “fistula”.
As per the best Fistula Doctor in Kolkata, Dr. Azhar Alam, in order to perform dialysis, two needles are placed into the fistula. Afterward, after dialysis, they are taken out. Fistulas are the most effective access to dialysis as it is less likely to cause issues and lasts longer than other forms of access to dialysis.
What can I do to treat my fistula?
- There are many ways to ensure the safety of your fistula. Fistula is frequently referred to as”lifeline” due to the fact that it’s so crucial to helping to ensure a successful dialysis.
- Clean your fistula while infections are more unlikely due to a fistula, they can occur. Cleanse your arm using water and soap every day and make sure to wash it prior to dialysis.
- Examine your fistula every dayThe nurse will show you how to detect an electric pulse or a vibration in the fistula. You may also hear the sound (called a rumble). If you don’t feel it, make contact with your unit or renal ward on the next day.
- Do not allow anything to block the flow of blood in your arm. Do not let your blood pressure be monitored in your fistula arm. Also, avoid wearing restrictive clothing or jewelry.
- Don’t carry large shopping bags onto your fistula arm. Avoid sleeping on your fistula arm.
Things to watch out for
While a fistula is not the most convenient type of access, and it is less likely to create issues, you need be aware of any issues that may arise so that they can be dealt with swiftly for: –
- Swelling and bruising- when blood leaks from the vessels into the tissue surrounding it, it could cause bruising as well as the region to expand.
- Heat or redness- while the risk of infection is lower to develop within a fistula but it can happen. It is important to contact an renal specialist or unit immediately if you feel swelling, redness, or pain on the site of your fistula.
- Aneurysms – these are swelling area that develops because of the vessel weakening generally because needles are frequently inserted in the same spot. There are aneurysms that can develop on fistulas which have been established for a prolonged period of time. Aneurysms are less likely form if needle sites are replaced every dialysis (rope ladder) or if buttonhole needle needling is utilized.
- Steal syndrome- due to the fact that your fistula is able to drain the region below it is full of blood. It could cause your hands as well as fingers to be cold, tender or feeling numb. Sometimes, this may cause more serious symptoms like ulceration or hand numbness because of discomfort. If the condition is expected to develop, it typically occurs shortly after the fistula has formed.
- Reduced flow in the fistulaCheck daily for flow of your fistula by looking at the ‘bruit’ and the’. If one appears to be less or absent, consult the renal department or ward right away. This could be due to a narrowing of the vessel, or due to an enlargement of blood and must be dealt with immediately to ensure that your fistula functioning.
- Fistulas are bleeding, this could be a serious issue in the event that it happens when you’re not on dialysis. However, these kinds of emergencies are extremely rare.
- Another type of bleeding to be aware of is the presence of blood flowing around the needles, especially during dialysis. If you notice bleeding after dialysis, or it is flowing slightly from the fistula on other occasions could mean that the vessel has narrowed and has increased pressure within the vessel. It could also result in elevated pressure readings for venous vessels in your machine for dialysis. the nurses will inform you of the best way to spot this. The bleeding might be due to any blood thinning” drug you are taking, for instance, warfarin. If you are noticing any of these signs , please inform your doctor and nurses be aware so that they can look into the issue. The majority of these issues are easily solved so that your fistula is healthy.
- Allergies – If your fistula is swollen, red and painful after applying the cream for anaesthesia or the cleaning agents or chlorine solution, let your nurse know so that you can choose a different product to be applied. Also, let your nurse know if there is an allergic reaction to the plaster or tape that are used.
Investigations and tests
- Monitoring Access and Recirculation flows
- Ultrasound (often referred to as Duplex (also known as Doppler)
- The fistula is closed
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