I Hate Dialysis Message Board

Dialysis Discussion => Dialysis: General Discussion => Topic started by: G-Ma on September 11, 2008, 01:05:53 PM

Title: Self Cannulation
Post by: G-Ma on September 11, 2008, 01:05:53 PM
Help Please......I was doing ok during training and first week home and this week has been terrible...I am for some reason not finding the vein..it rolls so much I either go past it or too close to the vein and very high pressure.  This is with someone else holding the vein as I can't hold and stick at the same time and I'm using a tournequit too.  Does anyone have any suggestions that I might be able to try?  I know a lot of you have been doing self c for a long time and I am close to giving up.   :Kit n Stik;
Title: Re: Self Cannulation
Post by: Jay72 on September 11, 2008, 01:25:13 PM
Sorry to hear you are having trouble.  I have a big problem with my vein rolling too but I just have to take my time and it works, other times I feel like I am going to push the damn needle through the back of my arm.  So what I find help is to heat a saline bottle in the microwave for a couple of minute and hold it on your arm for about 5 minutes before you stick.  Hope this may help you and good luch.
Title: Re: Self Cannulation
Post by: Meinuk on September 11, 2008, 01:37:56 PM
G-ma,

I am so sorry that you have had such a difficult time of this.  I've been following your posts but haven't had a lot of time to reply.

Have you watched Bill's Cannulation video? http://www.billpeckham.com/from_the_sharp_end_of_the/2007/12/cannulation-vid.html I'm not sure where your fistula is, but he has a lower right fistula, so the video might be a little help.

Are you using blunts or sharps?

I actually don't use a tourniquet, and I have an up arm left fistula.  I stabilize with my cannulation hand. (I hold my needle like a pencil, and splay my fingers to over my fistula, and then slowly insert the sharp into the arterial buttonhole. - yes, although I have buttonholes, I still have to use sharps in my arterial)

I don't have a rolling vein, but I do have a pretty twisted fistula and had a lot of trouble when I was in center.  What worked for me was really trying to visualize the fistula, I could feel the edges fo the vein, and I aimed for the needle to go right in the middle of it.  I also advance very slowly.  There is very little pain, and after a deep breath, and settling my thoughts, cannulation always seems to go smoother.

I have noticed that things can get overwhelming for me very fast in all of this things just seem to snowball.  And it helps to just take a step back and get some perspective.  When I first sit down in my chair, I run though a short mental check list: door, lights, phone, water, remote - once everything is in place, then I move on to the next step.

You should always be able to take a break as well, leave your equipment in place, and go in center for a few runs, and try self cannulating in there.  You should not have to quit so fast.  Ease yourself into all of this.  If your unit is not cooperating in all of this, then, they are not putting you the patient first.

Self Dialysis really is practice, practice, practice - don't stress yourself out, we have ALL had those moments.  I just want you to be healthy and happy.  You have put a lot of effort into home dialysis, and if it works, great, and if not, then you know that you gave it your best effort.  But remember, you are still in early days of home hemo.  It does get easier.  As long as your fistula cooperates.
Title: Re: Self Cannulation
Post by: twirl on September 11, 2008, 01:40:18 PM
you are sticking yourself :o
I could never do that :(
you are brave beyond your years :thumbup;
Title: Re: Self Cannulation
Post by: Jay72 on September 11, 2008, 01:48:36 PM
Twril... One you learn to needle yourself you will never and I mean never want anyone else to do it.  And it is nowhere near as bad as it seems. :beer1;
Title: Re: Self Cannulation
Post by: flip on September 11, 2008, 04:15:55 PM
We used to have a tech who only had one arm. He would stick with two fingers while using his thumb to hold the vein. It sounds wild but he was really good at it.

Have you tried using a clamp to hold it?
Title: Re: Self Cannulation
Post by: G-Ma on September 11, 2008, 06:40:19 PM
Thanks so much for your support....my dau in law stuck me at 5 today and run was good except excrutiating cramps which I have not had since in center and we did everything by the book..so filled me with saline (I felt) and ok now..my bp didn't even go down..go figure.
flip: I would like to try a clamp, however I can't find one and Davita would not give me one...they say NO.
Jay: yes you are right, it is not as bad as it seems.
Twirl:  yes you can do it, especially with everyone behind you.
Meinuk:  Thank you so much for all the information.  Yes, today I read through everything I could find.  I am left handed and my fistula is on my left upper arm but I will try what you said.
Jay:  Thanks and yes I have stuck my needle out the other side...not a pretty picture.
I will watch Bill's video again and try to get a grip.
Thanks again.   :bow;  Tomorrow morning is my next shot at it.
Ann
Title: Re: Self Cannulation
Post by: twirl on September 11, 2008, 08:25:40 PM
good luck
Title: Re: Self Cannulation
Post by: flip on September 11, 2008, 08:41:26 PM
PM me and I'll send you one. The nurses give them to me.
Title: Re: Self Cannulation
Post by: twirl on September 12, 2008, 05:26:48 PM
I could never stick myself b/c I would have to close my eyes
Title: Re: Self Cannulation
Post by: Ang on September 13, 2008, 02:54:56 AM
Twril... One you learn to needle yourself you will never and I mean never want anyone else to do it.  And it is nowhere near as bad as it seems. :beer1;

its  not  for  everybody,  but  more  power  to  you  if  you  can


i  did  it  once  but  got  lazy,cause  my  fistula  has  got  more  turns  than  an  indy  race
Title: Re: Self Cannulation
Post by: petey on September 13, 2008, 07:54:23 AM
I could never stick myself b/c I would have to close my eyes

Twirl, you must be kin to my Marvin!  He still closes his eyes and turns his head every single time -- and he's been on hemodialysis for almost 14 years!  He could never, never, never be as brave as G-ma and all the others who do self-cannulation (I tell him I just keep him around because he's so damn good-looking  :rofl; ).  Home hemo works for us because I'm the sticker!

Hang in there, G-ma!  You can do it!
Title: Re: Self Cannulation
Post by: del on September 13, 2008, 08:01:51 AM
I do most of the needling . Hubby can needle himself and does sometimes. Always watches to make sure I am doing it right  :thumbup;  Much easier to self cannulate if you have button holes.
Title: Re: Self Cannulation
Post by: G-Ma on September 13, 2008, 07:10:02 PM
I guess I need to find a "sticker"....is there a sticker for rent site?? or match.com for stickers??.....sticker harmony??? I'm not sure how my friend would take this idea...but he doesn't want to stick me..he closes his eyes....I just have no clue.   :bandance;
Title: Re: Self Cannulation
Post by: flip on September 13, 2008, 08:04:13 PM
It ain't no big deal...get the right angle and a good flash.
Title: Re: Self Cannulation
Post by: twirl on September 25, 2008, 07:25:14 AM
good flash ---- is that a container for liqour and do you need one for Christmas

or is it some light on sticking yourself which I could never do b/c I will not look at the needles
and do you hurt yourself when sticking
Title: Re: Self Cannulation
Post by: monrein on September 25, 2008, 07:36:44 AM
The flash is the blood coming back into the tubing attached to the needle.  A good flash and you know you're in.
Title: Re: Self Cannulation
Post by: G-Ma on September 25, 2008, 03:18:54 PM
News Flash... :rofl; another flash type...
I got right into arterial today and could not find venous, dug 3 diff times, searched inside the 3 diff places and no venous...it was deep, barely able to feel...will try tomorrow, then go to clinic and see what's wrong...will need to dialize somehow tomorrow..hopefully it will be back from vacation....I couldn't have paid it to come back... :Kit n Stik;
Title: Re: Self Cannulation
Post by: monrein on September 25, 2008, 03:22:22 PM
Hot Flash... :rofl; another flash type.

Bummer about your venous today G-Ma.  Do they ever let you use single needle at home for times like today?
Title: Re: Self Cannulation
Post by: willieandwinnie on September 25, 2008, 03:23:51 PM
 :banghead; Oh G-Ma, I'm so sorry, I hope they get it fixed tomorrow.  :cuddle;
Title: Re: Self Cannulation
Post by: G-Ma on September 25, 2008, 03:54:18 PM
monrein...interesting...what is single needle???
Ann
Title: Re: Self Cannulation
Post by: monrein on September 25, 2008, 04:09:38 PM
It pulls and returns blood through the same needle which results in lower clearances obviously, especially for shorter dialysis times but it's better than nothing.  Here's a link from
Toronto's home hemo program. 


http://www.renalweb.com/guest/lit/mwilliams/FAQs.htm
Title: Re: Self Cannulation
Post by: G-Ma on September 25, 2008, 04:32:56 PM

Thank you monrein..very interesting.  I am going to check on this...I wonder if I could have some on hand and be able to reset the cycler for a longer time and use when I can't get more than one access...hmmm.
Title: Re: Self Cannulation
Post by: Jay72 on September 25, 2008, 04:36:13 PM
Single needle is usually used for nocturnal patients... you also run at a much slower pump speed...150 instead of 450.
Title: Re: Self Cannulation
Post by: willieandwinnie on September 25, 2008, 04:38:07 PM
It pulls and returns blood through the same needle which results in lower clearances obviously, especially for shorter dialysis times but it's better than nothing.  Here's a link from
Toronto's home hemo program. 

http://www.renalweb.com/guest/lit/mwilliams/FAQs.htm


Very interesting monrein. Thanks for posting that.  :cuddle;
Title: Re: Self Cannulation
Post by: monrein on September 25, 2008, 04:47:58 PM
You're welcome. 

So Jay, you're going to be using them for your nocturnal I'm assuming?
Title: Re: Self Cannulation
Post by: Jay72 on September 25, 2008, 07:38:17 PM
You know it's funny you ask, 10 years ago when I was on dialysis I used one metal needle and one of the flexable ones because of where the needle was placed, right in the bend of my arm.  The last I heard I will be using steel, but they want me to use blunts, but I can't for the life of me get the frickin' thing in my arm.  I am a very fast healer so even after I take the scabs off it is totally closed and I have to use a fair amount of pressure just to get my regular needles in.  That was one of my other hangups with nocturnal, having the steel needle push through the vein wall while I am sleeping.  Also the IV style of needle would be pretty tricky to do yourself because you need two hands to put them in.

I am sorry too....I made that last comment before I read the link you posted... :flower;
Title: Re: Self Cannulation
Post by: monrein on September 25, 2008, 07:55:59 PM
Daily will probably take care of the healing over situation with the buttonhole though, right Jay? 
Title: Re: Self Cannulation
Post by: Jay72 on September 26, 2008, 05:52:08 AM
I sure hope so, something about pushing a dull needle through my skin...Are you back to buttonhole yet momrein?
Title: Re: Self Cannulation
Post by: monrein on September 26, 2008, 06:00:45 AM
No, we're still laddering up the arm to develop the vein.  It's coming along pretty well but it's still not easy for the nurses to hold my vein in place and the depth of the venous is tricky.  Arterial is a piece of cake.  I spoke to the nurses this week though about wanting to try again with the buttonholing.  The issue isn't pain for me.  It's all about prolonging the life of the fistula.
Title: Re: Self Cannulation
Post by: Jay72 on September 26, 2008, 06:17:06 AM
Good call, the longer and stronger you fistula is the better for you, now hopefully you will get a kidney before you even have to switch to the buttonholes.
Title: Re: Self Cannulation
Post by: G-Ma on September 27, 2008, 07:24:01 PM
Saw my new neph yesterday, very good experience..he also gave me hints on how to self cannulate more effectively...said to keep my fistula below heart level as much as possible so the blood does not flow out of it, then I won't lose it or it won't appear to sink, he said sinking is because the blood flows out of it.  Here I've been putting my arm on a rolled up towel to raise it so where I can get at it...so today started without the towel, elbow below heart level, more of a challange but got both sites so will keep working on this.   :clap;
Title: Re: Self Cannulation
Post by: monrein on September 29, 2008, 06:42:19 PM
Well...here is an official announcement.

I started my buttonholes today and had success with both sites.  So psyched.  I thought of you G-Ma as I was lining everything up and praying I'd get them in.
Title: Re: Self Cannulation
Post by: G-Ma on September 29, 2008, 10:03:43 PM
 :2thumbsup;     :yahoo;   Good for you.......great.

Ann