Caring For & Developing Your New Fistula
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Patient Information Series After Fistula Placement After Fistula Placement Caring For & Developing Your New Fistula Caring For Caring For & & Developing Developing Your New Your New Fistula Fistula Contact your Contact your surgeon’s or surgeon’s or your doctor’s your doctor’s office office and and tell tell their staff their staff ifif you the following: following: younotice notice any any of of the Your red,warm, warm, Yourincision incision is is swollen, swollen, red, ororyou these are aresigns signsofof yousee see pus pus -- these infection. infection. Promoting and facilitating high quality care standards for dialysis and kidney transplant patients in Iowa, Kansas, Missouri and Nebraska. Your apart. Yourstitches stitches come apart. Yourbandage bandage becomes becomes soaked Your soaked with blood. blood. with PATIENT PATIENT EDUCATION EDUCATION SERIES SERIES Youdevelop develop aa high temperature. You temperature. What You Should KnowKnow What You Should Knowing what what to expect, how tohow to Knowing to expect, care care for your and signs for fistula, your fistula, and ofsigns of problems can help problems can you helpkeep you your keep your fistulafistula working for many years. working for many years. Thethrill thrill is is The gone. gone. bulging in in your your AAbulging accessthat that previously previously access wasn’t there. wasn’t there. Your fingers become cold, blue or Your fingers become cold, blue or numb. numb. Heartland Kidney Network 7306 NW Tiffany Springs Pkwy Suite 230 Kansas City, MO 64153 Phone: Main Fax: Data Fax: ( 800) 444- 9965 ( 816 ) 880 - 9088 ( 816 ) 880 -1775 Web: heartlandkidney.org Email:net12 @ nw12.esrd.net Designed and distributed by Heartland Kidney Network under Contract 500-06-NW12. Revised under contract HHSM-500-2006-NW012C, December, 2006 INSIDE! Lower & Upper Arm Exercises Checking for Bruit & Thrill After-Care & Follow-up This publication has been approved as appropriate community This publication has beenapproved approved asappropriate appropriate community been as educationThis by publication the Centers has for Medicare & Medicaid Service’s community education by the the CentersMembers. for Medicare Medicare Service’s education by Centers for && Medicaid Fistula First Breakthrough Initiative Feel free toMedicaid copy Service’s Fistula First Breakthrough Initiative Members. Feel free free to tocopy copy Fistula First Breakthrough Initiative Members. this resource in its entirety for educational purposes. 2006.Feel this resource resource in its entirety for this for educational educationalpurposes. purposes.2006. 2006. This resource was developed while under contract with Center for Medicare & Medicaid Services (CMS), Baltimore, Maryland. Contract #HHSM-500-2006-NW012C. The contents presented do not necessarily reflect CMS policy. Exercises: Exercises: Exercises: Lower Lower Lower &&Upper & Upper Upper Arm Arm Arm Finger Finger Finger Tip TipTouches Tip Touches Touches Exercising Exercising Exercising your yourarm arm your before before arm before and andafter after and after Lastly, another good exercise Lastly, Lastly, another another good good exercise exercise surgery surgerysurgery may may encourage encourage may encourage a a fistula’s fistula’s a fistula’s toto help strengthen and tohelphelp strengthen strengthen andand development development development and andmaturation. maturation. and maturation. Fistulas Fistulas Fistulas develop your are develop develop yourfistula your fistula fistula arefinger are finger finger may maytake take may upuptake toto6 up 6months months to 6 months totomature. mature. to mature. tiptiptouches. Touch each finger touches. tip touches. Touch Touch each each finger finger Some Somephysicians physicians Some physicians believe believebelieve exercising exercising exercising the the the the your thumb, opening your totothe tiptip ofoftip your opening upupyour to the of thumb, your thumb, opening up your fistula fistulahelps helps fistula it itstrengthen helps strengthen it strengthen and anddevelop. develop. and develop. handhand afterafter each touch. Touch tips hand after each touch. Touch tips tototo each touch. Touch tips Once Oncemature, mature, Once mature, a afistula fistula aisfistula iseasier easier is for easier forthe the for the thumb repeatedly for5for 5minutes, minutes, times thumb repeatedly for 6 6times thumb repeatedly 5 minutes, 6 times dialysis dialysisstaff dialysis stafftotostick staff stickfor tofor stick your your for treatment. treatment. your treatment. a aday. day. a day. Below Beloware Below aresome some areexercise some exercise exercise techniques techniques techniques that thatmay may that bebeused may used be toto used help helpto develop develop help develop your your your Upper Upper Upper Arm Arm Arm Fistula Fistula Fistula Exercises Exercises Exercises fistula. fistula. fistula. Hammer Hammer Hammer Curls Curls Curls An way totoexercise Aneffective An effective effective way way to exercise exercise Forearm Forearm Forearm Fistula Fistula Fistula Exercises Exercises Exercises anan upper arm fistula, (a(a(a an upper upper armarm fistula, fistula, Ball BallSqueeze Squeeze Ball Squeeze fistula created above your fistula fistula created created above above your your As Assoon soon As asas soon the thepain aspain the from from pain from e el bl bo ow isis arm curls with ew l)b)o w )totoisperform perform to perform arm arm curls curls with with surgery surgery surgery has has subsided, subsided, has subsided, a aweight. ToToperform a a“hammer curl”, weight. a weight. perform To perform “hammer a “hammer curl”, curl”, start startforearm forearm start forearm exercises exercises exercises take pound weight ininthe arm takeatake a1 1toato3 1 3to pound 3 pound weight weight in thethe arm arm bybysqueezing squeezing by squeezing a arolled-up rolled-up a rolled-up your was ininand hold the yourfistula your fistula fistula wascreated was created created and in and hold hold the the washcloth washcloth washcloth orora a“stress” “stress” or a “stress” weight asasshown ininthis picture. Pump weight weight shown as shown this in this picture. picture. Pump Pump ball. ball.Squeeze, Squeeze, ball. Squeeze, and andrelease release and release rapidly rapidlyrapidly for for1010for 10 your down slowly for yourarm your armup arm upand and up relax and relax relax down down slowly slowly forfor minutes, minutes, minutes, 6 6times timesa6aday. times day.Additionally, Additionally, a day. Additionally, you you you 1010minutes, 6 6times a aday. minutes, 10 minutes, times 6 times day. a day. may mayuse useyour may your use other other your hand hand other toto hand squeeze squeeze to squeeze the the the bicep bicepofofbicep your yourfistula offistula yourarm. fistula arm.This This arm.hinders hinders This hinders Curl Bicep Curl Curl blood bloodreturn return bloodand return andcauses causes and causes the thefistula fistula the fistula toto Bicep toBicep Another easy exercise isisthe curl. Another Another easyeasy exercise exercise the is bicep the bicep bicep curl. curl. dilate dilatebecause because dilate because ofofincreased increased of increased pressure pressure pressure AAuseful, household weight isisa is useful, A useful, household household weight weight aregular regular a regular and andblood blood and ininblood the thevein. vein. in the vein. can vegetables. Holding the curl canofof can vegetables. of vegetables. Holding Holding thecan, the can, can, curl curl Clothes-Pin Clothes-Pin Clothes-Pin Grasp Grasp Grasp your upupand yourarm your armslowly arm slowly slowly and up down and down down Using Usinga aclothespin, Using clothespin, a clothespin, squeeze squeeze squeeze open openand open and and for minutes, 66 6 for1010 for minutes, 10 minutes, allow allowtotoallow close close torepeatedly repeatedly close repeatedly for for for times daily. times times daily.daily. 5 5 minutes, minutes, 5 minutes, 6 6 times times 6 times daily. daily. daily. After After AfterSurgery Surgery Surgery After After After surgery surgery surgery your your yourfistula fistula fistula may may may have have havea aabandage bandage bandagetoto to keep keep keep it itclean itclean clean and and andprevent prevent prevent infection. infection. infection.(A(A (Anurse nurse oror or doctor doctor doctor may may may briefly briefly brieflyremove remove removethe the thebandage bandage bandage and and andcheck check checkthe the thestitches stitches stitches shortly shortly shortlyafter after after surgery). surgery). surgery). The The The surgeon surgeon surgeonoror orthe thenurse nurse nursewill will willlisten listen listentoto your your your fistula fistula fistula and and andtouch touch touchit.it. it.This This Thisisisisreferred referred referred tototo asas as “listening “listening “listeningtotothe the thebruit, bruit, bruit,and and andfeeling feeling feeling for for for the the the thrill.” thrill.” thrill.” Thrill Thrill Thrill &&& Bruit Bruit Bruit “Thrill” “Thrill” “Thrill” isisis a aarhythmic rhythmic rhythmicvibration vibration vibrationthat that thatcan can can bebe be felt felt felt over over over your your yourfistula, fistula, fistula,whereas whereas whereas“bruit” “bruit” “bruit” - pronounced - -pronounced pronounced “brew-ee” “brew-ee” “brew-ee”isisisaaasound sound soundthat that that isisheard isheard heardwhen when whenlistening listening listeningtoto toyour your yourfistula fistula fistula with with with a astethoscope. a stethoscope. stethoscope.Ask Ask Askthe the thedoctor doctor doctororor nurse nurse nurse toto to allow allow allowyou youtoto tohear hear hearthe the thebruit bruit bruitand and and show show show you you you where where wheretotobest best bestfeel feel feelthe the thethrill. thrill. thrill. Check Check Checkthe the the thrill thrill thrill and and andbruit bruit bruitdaily. daily. daily. www.fistulafirst.org www.fistulafirst.org www.fistulafirst.org
