New fistula problems

My fistula was created mid-October 2005 and in mid-December we started trying to stick it, doing one & one with my permacath. It went okay for a time or two, but ever since it’s been either infiltrated, healing from an infiltration, or truly unbearably painful to have the needle in even when the machine’s not running. Needless to say, we’ve been using my catheter more often than not.

Someone suggested to me that the pain may be from tension. Xanax helped a little, but when the pain starts it’s so bad that I’m THIS close to ripping the needle out myself - I’ve had a hard time convincing the staff just how painful it is.

Two weeks ago I had an angioplasty done to widen a narrow section, and since then my baby fistula bulge has all but disappeared. Like, once the pressure from the constriction was gone, the vein just evened out to normal.

My neph wants to send me to a surgeon that does a procedure where a big vein from the back of the arm is brought around to the front and - I guess - used to make a new fistula. Anyone heard of this? Hopefully the surgeon would check me over and discuss all options. The techs say my fistula is very deep, so I just thought it may need to be revised. Or maybe it just needs more time, I don’t know. Even though I’m now leaning heavily towards switching to PD, it would be good to have my fistula working in case I do poorly on PD.

Also, has anyone had the experience of elma NOT doing the job? It was working fine for me until the last two sticks. I’d put a good coating on and it still hurt. What’s that about?

Any thoughts would be appreciated.


Don’t fear, I’ve had mine revised a few times now…keep it it till they got it right…once is all good you will be good to go for long…

Give it some time, Karen. Problems like you describe are typical and to be expected. You’re using a fistula which has not had enough time to develop yet. What they are doing is going ahead with developing it with actual use - which is what they do now as much as they can.

Ideally, a person should get the fistula surgery a good 6 months before dialysis is expected. Even a year is not too early. My fistula took 4 months to really develop, and at that, only because I “exercised” it regularly every day using a little hand weight (and cycling on my drop bar road racing bicycle). I started dialysis 6 months after the surgery, and even then, they still had to use what they call a “new fistula protocol”, because even a well-developed fistula is not truly well-developed until it has seen a few weeks of actual dialysis. Infiltrations are common, as are pains in the arms, tingles and numbness in the hand, etc. It all goes away eventually.

If they opened up a kink or something with the fistula/angiogram, I wouldn’t worry about whatever it did, because opening that up with the balloon doesn’t last that long anyway. It should be back the way it was within 3-6 months.

Good luck. Don’t get discouraged. The first month or two on dialysis with a new fistula are always the hardest - but it goes by fast.


Hi y’all,

Karen wrote:

has anyone had the experience of elma NOT doing the job? It was working fine for me until the last two sticks. I’d put a good coating on and it still hurt. What’s that about?

Usually if EMLA (or Topicaine, LMX, Less-n-Pain, or any of the other topical lidocaine products) doesn’t work, it’s because they haven’t been on long enough. These products need to absorb into the skin, and the longer they are on, the deeper they can penetrate. They need to be on for a minimum of 60 minutes; 90-120 minutes is better.

Also, you need to use a thick enough coating and cover the product with plastic wrap so it doesn’t wipe off before it has a chance to absorb.

Did you change anything about the way you applied the product?