After a consultation with one of the top Vascular specialists in the US, I have been informed that my AV Fistula is a Gold Star, which means no additional surgeries at this time and LDL Apheresis treatment can begin...Several points that I have learned in regards to the AV fistula (I have named buzz) 

• It's not going to break or weaken
• The fistula can be reversed
• The tightness that I feel in the upper and forearm is the fistula growing which in return puts additional pressure on the surrounding tissue
• My fistula is about 1cm wide and is on the surface (usually in a thinner arm this is the case)
• I can carry and lift and pull objects as long as it's comfortable
• Cold weather it will constrict-hot weather expand
• The brewee and thrill will become louder or more active with blood pressure changes and or strengthening or weakening of the Fistula itself
• The fistula needs to be monitored usually with Apheresis treatment and routine ultra sounds
• Surgery to tie off veins may or may not relief the discomfort
• Because I am ambidextrous, biofeedback for nerve issues may be relevant

Buzz and I have started a new relationship, as I now feel that I have a better understanding of this entity in my body many thanks to the Doc that took the time with my husband I and shared what educational information that he is aware of for this rather new treatment in the  Cardiology world.