30 July 2014: Angioplasty Report

Without doing too much explanation, and as clearly as I can, the following is the result of Monday's (28 Jul) Angioplasty of the L AV Fistula...

In short, the procedure was unsuccessful. When the surgeon got in the vein, he could not advance the balloon to the necessary location due to greater narrowing of the vein than evidenced by the ultrasound exam, and therefore, could not inflate the balloon, nor tamp the growth down to the vessel wall. As he did not anticipate such an outcome, the Vascular surgeon did not gain my consent prior to the procedure for additional steps, in the event of the inability to proceed, so he finished the attempt, sutured my arm, applied antibiotic cream, and the day was done.

I awoke feeling extremely groggy, but could not yet completely sleep as I had arranged for dialysis immediately afterwards to remove the contrast dye as quickly as possible to avoid any anaphylactic reactions that I could likely experience. Once there I quickly dozed off, slept for about three and a half of my four and a half hour session. Even after getting home I was dozing in and out all evening. I ate my one and only meal of the day, followed by about twelve more hours of in and out sleep.

Into yesterday I remained somewhat fuzzy until about 0400p. It was then I had to go back to the surgeon's office for more mapping of my Neck (IJ's and Carotids), Upper Chest (Subclavians), and both Arms.

Why?

Because, as the surgeon put it, (referring to my fistula) "You're on borrowed time." In other words, the fistula is quickly dying and becoming unusable.

So, here's what we are going to do...

We have to create a permanent fix. Yes, we can do a Central Line, but with the risk of infection that that carries, we'd really rather not do that, unless unavoidably necessary. Contrary to what I said in my last blog, the surgeon came up with a third option, which we are going to do.

Next Monday, 04 August, I am going back to the hospital for another surgery. This will be to create a brand new fistula on my R arm, again, just above the wrist and medial to the arm. This will take a minimum of six weeks to heal.

In the meantime, I will continue to use my L fistula until the R side heals, or the fistula dies altogether. If the latter happens too soon, the surgeon will attempt a quick and very minor patch of the L fistula. If that is unsuccessful, he will insert a central line in one of the subclavian arteries.

I think I got that correct. This is kind of confusing to ME, so explaining is difficult.

In either case, my standing on the Transplant List will NOT be affected, as I has previously stated. My surgeon was concerned about that, but after speaking with my Transplant Coordinator, a delay will not be in play...which is a huge relief!

Please, ask me any questions you might have. I'll answer them as best I can.

So, that's the latest. I will try to get another entry done before Monday.

And on we continue to go...

Good Health to All!

ScottW