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Fistula First

There is a campaign to ensure that potential dialysis patients have a fistula created prior to needing it (so that it matures), rather than wait until the last minute and have a catheter put in.

A fistula is when the surgeon connects an artery to a vein side-by-side. The greater pressure in the artery causes the vein to get larger, thus creating an “access” for dialysis. However, they take several months to get larger, so they should be done before the person needs dialysis.

Shortly after starting dialysis, there was an older gentleman that started as well. He had a catheter in his chest, and they used that. I was next to him when his doctor came in to discuss a fistula, and it just so happened that the treatment prior to this, I had an infiltrate. He mentioned to the doctor that he saw what happened to me, and wanted to keep the catheter, because he saw the pain I was in with the infiltrate. Anyway, the doctor gave him the spiel about catheters being infected easily, the veins stenose when catheters are inside them, lower flow rates with dialysis vs a fistula, etc. He finally got a fistula several months ago, but the nurses are having a hard time accessing it; I assume that it’s probably too deep.He’s been insisting that they use the catheter, even though they could probably use the fistula.

Well, on Saturday, Mr W had intense chills. His doctor was in, started him on IV antibiotics, admitted him to the hospital, and told him that if he still had the chills by yesterday, they would take out the catheter.

Even though I’m having my own set of issues with my fistula, I’m still much better off. I understand the hesitancy of someone when they are told they need a fistula (denial; I experienced it first hand), but Fistula First is the best way to go.

Barack had a good comeback yesterday to the controversy surrounding his remarks. ““She knows better. She is running around talking about how this is an insult to sportsmen. She, how she values the Second Amendment, she’s talking like she is Annie Oakley. Hillary Clinton is out there like she’s out in the duck blind every Sunday. She’s packing a six shooter. Come on. She knows better. That’s some politics being played by Hillary Clinton. I want to see that picture of her out there in the duck blind. “

Remembering back to the early to mid 90’s, it was during the Clinton presidency that Bill and his cronies did their best to grab our guns. In fact, that was one of the main issues that caused the Dems to lose control of the House in 1994. Hillary knows that the gun issue can break a candidate, and is trying to make it look like she is pro-NRA/pro-2nd amendment. Far from it. Politicians suck…..

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