I Hate Dialysis Message Board
Dialysis Discussion => Dialysis: General Discussion => Topic started by: Desert Dancer on December 09, 2010, 01:20:31 PM
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Apparently I have tough skin. No, I mean REALLY tough skin. As a bonus - go figure - I'm also apparently the world's fastest healer. (See the big 'H' on my chest?) :waving;
I started creating my buttonholes while I was training, and training consisted of short daily hemo, five days a week. I think they sharp stuck my arterial 8 or 9 times - and the venous twelve times - before switching to blunts. While I was in training the blunts worked great, but since coming home it has gotten harder and harder to get them in. Finally - on Tuesday - I had to call off my treatment for the first time due to access problems; I dug around for almost a half-hour in my arterial buttonhole, got flashback and then couldn't advance the needle, not one smidge. All I could do was look at Andy and say, "It's my skin! I can't get it through my skin! What the hell am I supposed to do?"
The next day - Wednesday - I had my in-center doctor's appointment. At this point it had been 24 hours since I cannulated the arterial buttonhole, and 72 hours since I'd cannulated the venous buttonhole. Lo and behold, it wasn't my imagination: the venous buttonhole was GONE. G.O.N.E. :waiting; It looked like a big pore or a tiny freckle, but either way it was obvious I wasn't getting a 15 gauge blunt in there. That meant I had to sharp stick it, and performing a sharp stick is the only thing I hadn't done to date. I was nervous as hell and certain I was going to screw it up and slice up my buttonhole track or infiltrate myself, but it went GREAT - until I got flashback. Then my skin just sucked up tight around the needle and wouldn't let it advance. One of my nurses took over and was visibly and verbally shocked at how much force she had to use to drive the sharp home.
So the upshot of this whole episode is now I have to cannulate myself every single day (I dialyze every other day) just to keep my buttonholes from speed-healing and closing up on me, and sharp stick as necessary to open them back up. On the plus side, I am overwhelmingly relieved that I've now done a sharp stick successfully; the anxiety beforehand was - as usual - worse than the actual stick. And I just have to say: 'Just like a pierced ear', my foot. :banghead;
I don't suppose there's any point to this little diatribe. I just want sympathy. ;D
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hugs and smypathy. :cookie;
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Thanks, grammalady! :'(
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Whopping big needles aren't they? And a sharp point does NOT make them look any prettier.
How about some congrats for doing it, instead of just sympathy? (Although I do sympathize!) - :bow; :bandance; :cheer: :2thumbsup; :yahoo; :clap;
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:cuddle;
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DD, that all sounds dreadful! And you seemed to have had it all going so well. Good on you for doing the sharp stick so well (I have no real understanding of all this as I'm on PD but it seems to me that it has all become a tad harder for you) :cuddle;
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An interesting post, DD.
A bit traumatic, but you won through in the end.
:cuddle;
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Im definatly offering my sympathy as well :'( and :cuddle; Once again, i have to add my experience with this 'sort' of thing. I did my hubbys first 'stick' on wednesday and dang, it seemed awful tough and i fear now that i wont be able to get it into his rolling vein either.. Sooooo, i ad my very heartfelt sympathy with a bit of experience of woe, and i ask for yours as well ;) Not really, this is your time to ??shine?? yeah, not quite shine, but your turn for heartfelt hugs. Hope tomorrow brings a wonderfuly welcoming fistula, and it's easy and smooth!!! (and for me too....lol, i cant help it! :( :( )
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I want you to know that despite my neurotic fear of needles I read your whole post DD.
You have my deepest sympathy. :cuddle; :cuddle; :cuddle;
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jbeany, thank you! Yes, they are whopping and the sharp point tends to make them even more intimidating! I really am happy and relieved I could do the sharp stick, because I was really dreading it. Thanks for your congrats!
galvo, thanks for the hugs.
chook, I've decided to look at it as another opportunity to prove how badly I want this. I'd be delusional if I thought this would all be peachy from start to finish; I've just been lucky so far.
stoday, I'm not sure how much virtue there is in 'winning through' when it can be chalked up to simple pigheadedness!
boswife, of course you have my sympathy! :cuddle; And the sharp stick really helped; now the blunts go in on the first try, like they should (for now, anyway).
okarol, I can't tell you how much I admire your sacrifice in the name of moral support. (Absolutely no sarcasm there.) Thank you so much!
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DD, hubby does nocturnal home hemo and there have been several times when there has been no way a blunt needle was going in the vein and I have had to open it up with a sharp. He may go months and blunts work fine and then he may have to stick with sharps for a couple of treatments to get it opened up.
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Oh DD you have scared the living hell out of me! I don't know how you have the guts to sharp needle like that, I'm sure I wouldn't although I know I might have to one day. When I went home they gave me some 15g sharps in case I ran into trouble and I've stuck them at the back of the wardrobe and I pray every day...please God, don't make me use the sharps...and I'm not the slightest bit religious.
And every day, for ....sake! The best think about being at home is that you don't have to do it every day.
I'm so worried about my buttonholes and the fact that they might heal up that when I read your post I thought .....b...me, it's true, the little b.....s can disappear.
One a more enlightened note, I picked up an old Epoman post which suggested 'twirling' the needle while inserting. I found that helpful. I have also found taking the needle out and starting again helpful although I think you have to be careful doing that.
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DD, hubby does nocturnal home hemo and there have been several times when there has been no way a blunt needle was going in the vein and I have had to open it up with a sharp. He may go months and blunts work fine and then he may have to stick with sharps for a couple of treatments to get it opened up.
I'm in center, but the same thing happens to me. I'll go for a couple of months using blunt needles, and then after a weekend, suddenly have to use sharps. My techs act like it's the most bizarre thing they've ever seen, so I'm glad to know it's not just me that heals fast.
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del, I'm sorry you have to go through that, too; I'm glad it's only every couple of months.
Oh, bruno, I didn't mean to scare you! I did the same thing with my sharps - I stuck them under the bed and prayed I'd never have to use them. Well, I guess they ordered sharps for a reason. Trust me, it wasn't NEARLY as bad as the anticipation. I just went very, very, VERY slowly and it went in exactly the way it was supposed to go. I kind of grumbled about having to cannulate every day, but if it's a choice between doing it every day (and having the blunts go in on the first attempt, every time) OR doing it every other day (and having to dig around for 30 minutes per hole and resort to a sharp)... then I guess I'll do it every day. Either way, it's better than the alternative! And yes, both 'twirling' and starting over are quite helpful.
brandi1leigh, I'm also glad to know it's not just me! I was starting to feel like a bit of a freak.
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DD you gave me hope that maybe I can stick myself someday...I am so scared!
xo,
R
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rsudock, if I can do it, you can do it! Honestly, what I'm finding is 99% of the time the anticipation is 80 times worse than the actual __________ (fill in the blank). Just don't think about it until it's absolutely necessary or you'll make yourself crazy! :urcrazy;
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You are a true champion, Dancer Dancer and an inspiration as well.
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You used a sharp on the buttonhole that healed up or started a new one?
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bruno, I'm just plugging along a day at a time, best as I know how.
calypso, they had me go right into the buttonholes to open them up. That's why I was so nervous about it, because I was convinced I'd slice everything up and ruin it.
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DD, I thought I heard you say that every day is better for the button holes? I'm 4 times a week and mostly every second day.
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bruno, apparently for me cannulating every day is better than every other day. My buttonholes were fine while I was in-center, because I was doing short daily and had to cannulate every day. Once I came home, though, I began cannulating every other day and that appears to give my body enough time to heal these buttonholes. I lasted about one month at home before the venous buttonhole closed up completely, after a 72-hour span.
Andy made a good point, which I'd never taken into account: the fact that I'm younger (though not young) than the average dialysis patient so of course I'm going to heal more quickly. I don't think that's something I ever saw addressed in all my research on buttonholes.
I was supposed to cannulate last night (an off night) but was just too damned tired to wake myself up for it, so we'll see how it goes tonight.
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i think you are more than brave. needles are the main reason i never became a nurse. i have enough trouble with the nurse at the center doing the needles, there is no way i would or ever could do them myself.
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grammalady, I don't think it's so much bravery as the fact that I have always been able to do whatever is in front of me at the time. I have been known to deliberately back myself into corners in order to do things that had to be done. As I said to stoday, it's just pigheadedness! I don't think I ever really gave the needles any thought, because I put blinders on and was only looking at outcomes. When it came time to cannulate, it was basically, "Oh, heck, needles. Darn, I forgot about that part of it. Oh, well, nothing I can do about it now, the moment is here." If I had let myself dwell on them overmuch beforehand it might be a different story.
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Grammalady, needles are the worst part of dialysis, I'm terrified of them and have to pluck up my courage every time I pick them up.
What makes me do that is that I'm prepared to do almost any thing (including sticking 2 needles in my arm every other day) that lets me avoid the centre. They are lovely people there but I am determined to have some control over my life and once you are there you are dancing to someone else's tune.
I feel you have a little bit better grab on life's chances if you can make most of the call.
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Andy made a good point, which I'd never taken into account: the fact that I'm younger (though not young) than the average dialysis patient so of course I'm going to heal more quickly. I don't think that's something I ever saw addressed in all my research on buttonholes.
That's pretty much the reason the center gave me for why my buttonholes seem to heal over weekends. The weird thing is that for me it doesn't happen all the time. I can go two or three months and my buttonholes will work like clockwork, then all of sudden I'll come in on a Monday and they'll be closed.
Good luck!
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First, let me send my sympathies to you. :cuddle; I don't know how you have the guts to do what you do!
I am not on D yet, so I have only a creative imagination idea of what button holes are. From what I have been reading in this post, a buttonhole is a hole that stays a hole in the skin (like a pierced ear) and for some reason doesn't hurt as much to use because the veins don't have nerves? Is this a close explanation? It seems that creating a "piercing" so to speak would be painful. Is this a better alternative to being jabbed with a sharp needle? Can you do "sharps" yourself at home or buttonhole "blunts" yourself without an assistant? I live with minor aged children, so they wouldn't be of much help to me.
I ask these questions because I have been thinking that PD will be the way to go when the time comes, but maybe this "buttonhole" technique would be a viable option. Can you travel with the machine? Go camping etc.? Are the outcomes better than in-center?
Oh, I also have a severe needle phobia, well I.V. needles anyway. I can have blood drawn and not pass out or cry, but the damn I.V.'s are a problem (esp. when it takes 4-6 pokes/diggin around to get it started.) And I assume the D needles are at least the guage of an I.V. needle.
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Since no one wants to stick themselves if they don't have to, I've decided to just do sticks on the off days only if I start having trouble cannulating on treatment nights. So far, so good - the one sharp stick I did seems to have done the trick.
Sax-O-Trix, the buttonhole technique is a method of cannulating your fistula and is independent of which machine you use for hemodialysis. (As far as machines go, I use a Fresenius Baby K and most definitely can NOT travel with it, but many people use the NXstage machine for just that reason.) It is the creation of a 'tunnel' into your fistula; here is a link that explains it better than I can:
http://www.fistulafirst.org/LinkClick.aspx?fileticket=aM7Q86GDN-w%3D&tabid=105 (http://www.fistulafirst.org/LinkClick.aspx?fileticket=aM7Q86GDN-w%3D&tabid=105)
And as far as the dialysis needles being at least the gauge of an IV needle... yes. At least. Here's a picture I sent to a friend to give her an idea; don't scroll down any more if you don't want to see needles. The one on the left is a sharp and the one on the right is a blunt:
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Nice pic... They look like nails (spikes actually!) Thanks for the info. Dialysis will definitely suck anyway it happens :banghead;
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DD, I was looking around today and I saw someone testing a shorter needle on the arterial access it was called a 3/5 which I think means it is 3/5 the size of a 1 inch needle. Apparently the idea is that a shorter needle might be better on the artererial. I was interested because I had my first run at nocturnal last night and ended up lying immobile because I kept getting low pressure arterial alarms which could only be the needle hitting the wall of the fistula.
Or do you think it was just one of those things that bring to back to reality every now and then?
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bruno, I've heard of the shorter needles but I've never seen them. The way I solved my arterial pressure alarms was by 1) putting gauze under the wings of the needle, and 2) flipping the arterial needle 'upside down' once I had it in, so the backeye is on the top. I've never had a pressure alarm since.
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DD:
I have a similar problem. I got a fistula in March 2009 and started home nocturnal hemo training in May 2009. From the beginning I
had several needling problems including tunnel overgrowth. The dialysis is one blunt 15 gauge needle (with double pumps) six nights a week alternating
between my 2 buttonholes. A few times I have had to go back to the kidney clinic to have a nurse use a sharp to break through the tunnel overgrowth.
They gave me a dozen SEMI-sharps to use if I can't get the blunt through and that has succeeded. I don't want to risk using a sharp.
I am in my early 50s and a fast healer. Also as my buttonholes mature and the surrounding scar tissue heals, there is less overgrowth.
My theory is my body wants to heal completely (its not in reality lol) and wants to fill in the tunnel. Hopefully when the surrounding area is
fully healed, it will leave the tunnel alone ( I live on hope :angel;).
Jeff
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The way I solved my arterial pressure alarms was by 1) putting gauze under the wings of the needle, and 2) flipping the arterial needle 'upside down' once I had it in, so the backeye is on the top. I've never had a pressure alarm since.
Is that right? Don't you cannulate with the bevel on top, which means that the black eye is on top when it goes in, not the red eye?