peritoneal vs. hemo with a fistula

The tunnel catheter I currently have placed in my juggular is apparently somewhat of a high risk for blood infections. Go figure. the "tunnel" part of my spiffy cath is for more long-term dialysis care, as it is thought to make infection less likely. There are very few catheders at my dialysis center, because catheders are for new patients that had no warning, and needed dialysis right away. I had no warning, I needed sialysis right away. On my very first day of "D" I started hearing the question P.D. or Fistula? In all honesty I didnt even really know what that meant, but I knew I did not want a fistula. Because the tunnel cath IS temporary, I am being forced with making a quick decision.

A fistula would be the "easiest" way to go. But it is most unsightly.

This is a very nice fistula, they can get a lot uglier. To create a fistula, a vascular surgeon joins an artery and a vein together through anastomosis. Since this bypasses the capillaries, blood flows rapidly through the fistula. It is usually placed on the non-dominant arm. This for me means my left, and although I would prefer to have it on my upper arm, I have a tattoo on my upper left that I am quite proud of and do not want to destroy. This is really what I would like to do, but I have enough unsightly scars, and I dont think I could handle a fistula, too.

My next option, gives me a TON more freedom, but with freedom comes an influx of responsibilty, as always. The P.d. tube is much more hidden than my current cath and a fistula.

Peritoneal dialysis uses a natural filter inside your body—the lining of your belly, called the peritoneal membrane—to remove wastes and extra fluid from your body. The dialysis fluid fills the belly and pulls out extra minerals and fluids from the bloodstream, these wastes then drain out of the body along with the dialysis fluid into a collection bag. P.d. is done at home, so they send you a months worth of supplies (tons of shit) and you have to store it and you take classes and you learn what to do. it's done by hand so I can pack up a car load of "the shit" anytime and go wherever I'd like, and they will ship supplies pretty much anywhere I want to travel. With this I am also allowed to eat or drink more, and might FINALLY be able to shower (I have not showered since March 17th, and counting.) after mastering the art of P.d. I may be a candidate for a night time "cycler", which dializes overnight, and grants me even more freedom.

Sounds like an easy choice, but my reason is more complex than which is "easier." I like hemo dialysis, I enjoy the people here, techs and patients alike. And I like that I pack up in the morning, dialize, pack up again, and I get to leave all the medical stuff there and still have one place I can kindof "escape." I barely even take pills now so I dont have much medical shit at home. I like it that way. With a fistula that can continue, and with P.d. it's in my room, it's in my closet, it's in my car. It's all over my life.

And it seems even writing this all out has not gotten me any closer to a decision :/