Sep 22, 2021 News
Kaieteur News – A team of doctors from the Annandale East Coast Demerara, Doobay- Gafoor Medical Centre has assisted 21 dialysis patients with Arteriovenous (AV) fistula surgeries.
The team, which was led by Guyanese -Canadian Philanthropist and founder of the Doobay- Gafoor Medical Centre, Dr. Budhendra Doobay, successfully performed the simple, but critical procedures in two days.
Dr. Doobay was assisted by three doctors from Canada, Dr. Jennifer Frendo, Dr. Faysal Naji and Dr. Ram Mohan. Dr. Carlos Martin from the Georgetown Public Hospital Corporation (GPHC) also assisted the team.
Speaking with Kaieteur News following the surgeries, Dr. Doobay explained that the AV fistula surgeries are very critical to patients, who are on dialysis.
He noted that this is due to the fact that the catheter used to facilitate dialysis that is usually inserted in the region of the upper chest or neck can get infected.
“And an infected patient can even lose his/her life, when there is an infection, it can be really bad. So with this procedure, we would take the catheter out and replace it with a device,” Dr. Doobay said.
He noted that the procedures, which would usually cost patients hundreds of thousands of dollars, were conducted free-of-cost.
“We were assisted by the Georgetown Public Hospital’s Dr. Madan Rambarran and Dr. Fawcett Jeffrey to perform 14 of the surgeries there, and the remaining seven was conducted at the St. Joseph Mercy Hospital,” Dr. Doobay said.
He explained further that the team regularly performs operations to assist the dialysis patients every three months, but because of the COVID -19 pandemic, they were unable to do so.
“We were not here for 18 months, so we had some new patients and replaced the fistula on some patients that had been done before,” he added.
In a previous interview with this newspaper, Dr. Doobay had explained that usually for dialysis, a catheter is inserted into a large vein in either the neck or chest.
The catheter, he said, is usually a short-term option, but there have been instances when it is used as a permanent access.
Meanwhile, research information shows that with most dialysis catheters, a cuff is placed under the skin to help hold the catheter in place. The blood flow rate from the catheter to the dialyzer may not be as fast as the AV fistula. Added to this, catheters have a greater tendency to become infected than the other access types because the device is both inside and outside of the body.
A catheter, therefore, must always be kept clean and dry; thus swimming or bathing are usually restricted. Getting dressed may disturb the catheter at the exit site, so care needs to be taken.
However, an AV fistula is created by connecting a vein to an artery using a soft plastic tube. After the graft has healed, hemodialysis is performed by placing two needles: one in the arterial side, and one in the venous side of the graft.
The graft allows for increased blood flow. Grafts nonetheless tend to need attention and upkeep. As such, patients at the renal centre are instructed on how to ensure that theirs are well cared for, in order to ensure that the optimum result is maintained.
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