According to Wikipedia ….

A Cimino fistula, also Cimino-Brescia fistula and arteriovenous fistula, is a type of vascular access for hemodialysis. It is a surgically created connection between an artery and a vein in the forearm.

The procedure was invented by doctors Cimino and Brescia in 1966. Before the Cimino fistula was invented, access was through a Scribner shunt, which consisted of a Teflon tube with a needle at each end. Between treatments, the needles were left in place and the tube allowed blood flow to reduce clotting. But Scribner shunts lasted only a few days to weeks. Frustrated by this limitation, Dr. James Cimino recalled his days as a phlebotomist (blood drawer) at New York City’s Bellevue Hospital in the 1950s when Korean War veterans showed up with fistulas caused by trauma. Cimino recognized that these fistulas did not cause the patients harm and were easy places to get repeated blood samples. He convinced surgeon Kenneth Appel to create some in patients with chronic kidney failure and the result was a complete success. Scribner shunts were quickly replaced with Cimino fistulas, and 40 years later, they are still the most effective, longest-lasting method for long-term access to patients’ blood for dialysis.

After her dialysis treatment this morning Irene and I drove to San Francisco and consulted with the Vascular Surgery team at UCSF to discuss the FISTULA procedure.  Candidly, in some ways, it was somewhat of a letdown.  As previously reported, on December 11, 2007, Irene and I traveled to UCSF for the “vein mapping” …. which is the pre-procedure work in preparation for the fistula process.  Unfortunately, UCSF has no record of the December 11 work.  So, we’re re-scheduling another date in the near future to go through the process again.  Irene did, however, have another blood draw for the current Amyloidosis value.  We hope to learn the results inside of two weeks.

We remain hopeful that Irene’s kidneys will “wake up” so she won’t endure the fistula procedure at all.  In the meantime, Irene’s Journey of Faith continues on a circuitous path.

Thanks for caring.

Caminando con Fé

Dave