Saturday, June 7, 2008

It's a boil! It's a wound! No! It's a fistula, man!

I have a fistula in my left upper arm. I have so many people staring at it that I get a little uncomfortable at times.

Now, fistulae generally are a little gross to see. Mine has the arterial vein dilated like crazy. That makes it even worse.

Generally, my shirt or T shirt sleeve covers it but when a small part of it is visible and if I stretch my arms above my hand, pretty much the whole fistula is visible. Reactions to the involuntary exhibition of this prized possession have ranged from a worried "What happened?" to an inquisitive "What's that on your arm?"

An answer like "Its an arterio venous fistula used for dialysis" usually ends the conversation with a mild "Ok" to hide ignorance of most of that.

When I go swimming, I spray a wash proof aerosol spray to prevent water from getting in. And then I cover it with a wrist band. I'm still undecided whether the wrist band attracts more attention then if I had left it bare.

People have asked me in the pool about it and I have given the same answer. I've been advised not to swim if it was a boil. A boil that big? Give me a break!

Why is a fistula needed in the first place? Here's an extract from wikipedia:

"In dialysis, blood is withdrawn from an artery or vein, purified, and returned to a vein. The volume of blood is too great for veins to handle, so a vein must be enlarged. An artery and vein, usually in the arm above or below the elbow, are sewn together, to create a fistula, and arterial pressure eventually enlarges the vein. The enlarged vein can accommodate a cannula or a large needle."

So, a fistula is what makes dialysis possible. I protect it like my life.

Here is a picture of my fistula in all its glory during a dialysis treatment:
You can see the two needles taped securely to my arm almost at right angles and blood in the tubes connected to the needles. I use the buttonhole method which means using the same sites for every treatment. Many people use the step ladder method which means using a different set of sites for each treatment.

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