Folks on nocturnal

Hi Folks

Any body out there doing nocturnal with a fistula, having issues with the arm being sore or stiff after a long (8hr)tx.

I have to try and keep my arm from moving freely or I end up getting alarms. And after tx my arm is sore at the elbow and shoulder.

Thanks
bob o

You bet I do Bob! Particularly if I have taken a sleeping pill and haven’t moved much! My hands feel both feel sore as well as my shoulders and elbow on dialysis arm. I try to roll onto my sides by using a small pillow to prop my dialysis arm up(left arm) when i roll onto my right side. I can sleep quite comfortably for an hour or so then have to roll back onto my back. Usually (touchwood) having buttonholes taped securely and covered with an elasticised sleeve I can roll over fairly smoothly now without disturbing the blood flow. I try not to raise it too high or I get alarms though. i also try to move my fingers and have a wriggle around as I am awake every hour or two.

I try to do a lot of exercise which seems to help get the blood flow back in the joints, a good massage also helps and I have started taking Glucosamine/Condroitin.
Cheers

Hi Folks
Thanks Beachy.

I ask due to the fact that this just started for me as for my discomfort. After the first month of getting used to nocturnal, sleep was going good. I then had my fistula clot. I had to have a dr. reopen it, since then my arm and hand have been left in a state of pain and numbness in my hand. And I don’t know if the two are related. The thrill in my fistula area is good. The nurse said that as to the numbness that the fistula might be takeing some blood flow from my hand. But that won’t answer the pain issue. I will see the nurse on 10/9/07. and I like going to my meeting with questions and answers.

thanks
bob o

It sounds like you may have “steal syndrome” in which blood flow is diverted from the hand. Steal syndrome can cause coldness and pain in the hand. I’d report these symptoms to the surgeon that did the declotting of your fistula. He/she can do access flow measurement to see how the blood is flowing through the arm. If too much blood is diverted from the hand, this can limit hand mobility and can even cause ulcers and tissue that doesn’t get enough blood can die.

Here’s the National Kidney Foundation KDOQI guideline that recommends ways to treat fistula complications, including steal syndrome. Look under Access Evaluation for Ischemia:
http://www.kidney.org/professionals/KDOQI/guideline_upHD_PD_VA/va_guide5.htm

Hi Folks

Thanks Beth

That was what the nurse said might be happening. But I think they wanted to give it some time to see if the issues came to an end on own. No real time line was given as to when. So I will see them on the 9th.

Thanks
bob o