Perm cath vs. Fistula.
Everyone has an opinion on the matter and I think I'm in the minority when I say I hate my fistula and wish I had never had it done.
Honestly, if I hadn't been high on Creatine, I never would have agree to have one put in because, looking back on it, none of the pitch they gave me sounds particularly cool.
We tie an artery and a vein together and when it's ready, we start jamming GIANT NEEDLES into your arm. Yeah, it'll hurt but eventually there will be so much scar tissue you won't feel anything:)
HOW THE HELL DOES THAT SOUND LIKE A GOOD IDEA????
Needless to say, dopey me agreed to it and had the damned thing put in. Super Doc, as I call him, was so eager to use it that he insisted the nurses start needling when it was a tender 3 months old.
Oh yeah, that went well.
The nurses didn't like to use a local to freeze it, so I started using EMLA cream. Long story short, the cream gave me a huge chemical burn that was weepy and crusty and gross and the stuff didn't work consistently either.
Then the fun of trying to get the second needle in started. I spent several weeks where my entire forearm was purple, from wrist to elbow.
Eventually, since he was going on vacation, Super Doc broke down and gave me a perm cath. If I hadn't been doped up on whatever it was they gave me to relax me, I probably would have danced.
I love My Precious. I cannot say that loud enough or enough in general. I LOVE MY PRECIOUS! I do know the risks and the down side to having a giant plastic tube sticking out of your chest but I don't really care. I don't really think the nurses do either, given that near the end of the fistula adventure, 5 or 6 of them would stand around in a circle, arguing over who was going to have to stick me.
For the TL;DR crowd (because I know you're out there): For me, fistula=EVIL!!!!! catheter=MY PRECIOUS!!!!!
Do I recommend one over the other to people? No, because I know that there are people who have had absolutely no problems with their fistula at all, people who love them and would never go back to the catheter. But for me? I think I would consider switching to PD before I would let Super Doc tell them to start needling me again.
I was "lucky" that I got my fistula 2 years before I started dialysis. By that time, it was matured, and depending on which part of it they stuck, it rarely hurt. Mine is at the crease of the inner elbow, and forms a "mountain range" all the way to my shoulder. However, infiltrates SUCK (I had 3 major infiltrates), and I've had to have several fistulaplasty's with ballooning in 5 areas of my arm as well as stents. Towards the end of when I was on dialysis, I was self-cannulating, which gave me more control over where I would be stuck.
Would I suggest one over the other? I would still suggest a fistula first, because they have much less risk of infection, but they are not without problems. If a person is able to get a fistula in and have it mature for a while before using, that's the best option. But if it doesn't work, they can always throw in a Perma Cath and use it right away. Don't get me wrong; I don't have the rose colored glasses on when it comes to accesses, as each one has its own set of problems.
Thank God about the Rose Coloured glasses! You know, you are one of the first people ever to respond to a post I've done like this that talked about the good and the bad of fistula use.
Can you have your fistula undone now that you have decided to keep the catheter?
I have no idea, probably, but keeping it there keeps Super Doc happy. Even if he does get that evil little glint in his eyes when ever he sees it.
I hated my catheter. Living in Phoenix and not being allowed to swim or shower was not cool at all. I don't enjoy being stuck, and they definitely had problems finding it when they first started using it, but it's all worth it now. The catheter is out, just in time for summer. It's been over 100 degrees for months. I never had a problem with my catheter though. If you don't swim, keep it clean, and put a clean dry dressing over it the second you get out of the shower, it shouldn't get infected.