My fiance has a catheter in his chest and hates it as well. He had a fistula created but it is unusable because it doesn't flow at a high enough speed in one direction (can't remember if it's in or out). My understanding from the doctors is that his catheter is only a temporary solution because of the risk of infection and proximity to the heart. I get the sense that fistulas are a bit of work as well and need "maintenance" but are safer overall than a catheter.

In our case we're waiting before trying for another fistula because he has been cleared for a transplant and has some potential donors. But if for some reason that all falls through then another fistula will be the next option...hoping that won't be the case though.

Best wishes to you and your husband!

Thanks for replying....I am afraid he thinks the fistula will be so much better. We will see.....eeeeks!

I think we felt that way too, and then after months of waiting for it to mature and then having a fistulogram to try to make it workable so he could finally get rid of the damn catheter, it just ended up that they couldn't use the fistula anyway...very disappointing.

I hope you and your husband have better luck and that it actually does end up being better than the catheter!

me too....my husband (and me too!) is getting sick of all the doctor appts but I think this is just part of the way it is going to be from here on out.

The Dr told me a fistula is the best choice, they can last forever, just need a little unclogging now and than which is normal.

If you are having problems with veins, ask the Dr about getting a graph. They are not as optimal as a fistula, are said not to last more than 2 years on average... But, I have a graph, I could not have a fistula because my veins were too small and deep to handle one. I am 15 months into mine and just saw the surgeon. He told me mine is strong and could last 30 years with proper maintenance when needed.

Advantages to a graph is they can be used 2-3 weeks after being put in. Mine got infected and I had to go into the hospital with it and receive my first treatments in the hospital. They didn't think it could be used because of the infection. I had an excellent surgeon and he told them use it anyway. I didn't have any complications with it.

I did develop Steal Syndrome and the surgeon told me I could have surgery to correct it but it would compromise the life of my graph. Or, I could learn to live with it. I choose to live with it and with the use of a pillow and simple adjustments to my arm position I am seldom ever effected by the Steal Syndrome.

I would much rather have a fistula than a graph, but with the right surgeon a graph can be just as good and long lasting as a fistula. A graph is used for those, as yourself, who have problems with their veins.

Hubby had the first part of the surgery for the fistula last week. In about 6-8 weeks he will have the 2nd part. they need to take the vein that was connected to the artery and move it close to the surface. Apparently the only good vein is one that is buried deep. He will have a incision from just below his elbow up to just underneath his armpit. Not looking forward to this next surgery....eeks!

Some Vascular surgeons create the arteriovenous fistula (AVF) in one step while others do it in two. One is not preferable over the other per se and it's a surgical preference. The second procedure is called a superficialization procedure where they will bring it closer to the skin so that it can be accessed by a hemodialysis (HD) technician. An AVF is definitely regarded as the gold standard of vascular access for HD and they can last for many, many years. They tend to have fewer problems than tunneled catheters or arteriovenous grafts (AVG) but not everybody has the vasculature necessary for an AVF due to age, diabetes mellitus or small vessels. Catheters can be trouble free for a while but they pose a significant risk for infection and are a hassle to bathe with. An AVF or AVG is under the skin, which poses an excellent barrier against organisms. Patients can shower, bathe or swim with them. Sometimes treatment time can be reduced with a successful AVF or AVG depending on your dialysis adequacies i.e., how good your dialysis session is cleaning your blood. Only your Nephrologist can decide that though.