For anybody with a fistula on HD.....

[Phil]

Ok so I'm about to start HD..and the only real question that I have is how painfull the needles are....so...eventhough I understand that its different for everybody..i would like an average opinion.....if lets say on a scale of 1 to 10, where 1 is your regular blood test (small pinch) pain, and 10 is cutting your leg-off without anaestetic pain...where would you put HD needles? (Bear in mind that I think in Italy they dont use any sorts of creams or spray to numb you down).

[Des]

I can honestly say that I still cry or tear up everytime they stick me as my second stick goes rigth through nerves and because my fistula is so young it is still deep. So they dig through mussle to get to it. MINE IS VERY PAINFULL. They say that as you stick it lots you develop scartissue and the "hurt" gets better.   

I don't know when that is going to happen.

But again I can handle the pain from kidney stones and infections but not the needles - so I really don't know what to tell you.

Get EMLA cream  - it numbs the skin for a few minutes only, but it helps   

[RichardMEL]

my first treatment I had locals and that was OK. the second one I went with no local (I know many of them are bad) and look the pain was there, but in reality it was no worse(for me) than getting a regular blood draw or something. Also note that over time as the fistula matures and hardens up the needles will hurt much less. most of the time I just feel the pressure of the needles rather than pain. Yeah sometimes they might touch the wall and that hurts a bit, but that's a different issue, and you can tell anyway. In general while I *never* watch them sticking me, I don't really worry about pain or anything. Sometimes there's some of course, but it's really not a big deal for me.

[Stacy Without An E]

I don't want to frighten you, but personally it is very painful.  I was on immunosuppressives for a total of twenty years with two transplants, so my resistence to pain has been altered.  The lidocaine burns every time, but its more tolerable than the fifteen gauge needles.

I wish it didn't hurt.  I wish I was a masochist.  I wish it wouldn't burn for the entire treatment.

I wish you nothing but pain free Dialysis.

[RightSide]

I'm surprised that hemodialysis is done anywhere without at least offering the patient a topical anesthetic.

But I've done hemodialysis without any topical anesthetics, and on a scale from 1 to 10, I would give the needle sticks about a 4.  I sure feel it, but it's easily tolerable.

Have you considered meditation?  I have found meditation to be a great way to let the pain just pass through you without bothering you much.

I've had a few fistula surgeries.  In one surgery, the nerve block they had injected into me accidentally missed the nerves, so it didn't numb the pain anywhere as much as it was supposed to.  Rather than delay the surgery, I opted to go ahead with it as is.  The surgical team was stunned that with meditation, I could tolerate the pain of surgery without a full dose of anesthetic!  On a scale from 1 to 10, that pain was an 8.  I could actually feel the surgeon's knife cutting through tissues, etc.  But I just let the pain flow around me.

They kept asking me "How are you doing?"  I kept telling them to shut up because their questions were disturbing my meditative consciousness.

[Rerun]

I would be moving from Italy!

             

[Bajanne]

I think I would grade my pain as a '6'.  However, if the spot is used for a bit, then the pain is a '3'.    An absolutely new spot is definitely an '8'!!  I used to get lidocaine, but that itself was a bit painful at first, so after a time I took the needles without it.  I still flinch and am sometimes told that I shake my arm.  Like RichardMel, I definitely look away.
[I don't have a fistula, but a graft.  I think the initial pain is the same, anyway]

[Pam]

I've been on D for a year. The first 3 months I used the cream and the pain was 0. I now have buttonholes and there is no pain. Sometimes if I have a different tech, that doesn't happen very offten, there will be some pressure. Sometimes they really have to push hard to get those blunt needles in. Tell them you want their best tech to stick you. At my unit only the most experienced techs are allowed to stick new fistulas. Good luck!
Pam

[totosidney]

I have had a couple grafts and a fistula over the past 15 years. I just started with a new graft. I stick myself. Sometimes it hurts a bunch and sometimes it is totally effortless. Over a period of time nerves are completely killed off and then there is virtually no pain. If you use a numbing agent it will always cause extra stinging. I think getting past the pain issue is important as it is a constant of hemodialysis life. Learning to stick yourself is an interesting experience and can be helpful with the pain for some folks. 

[FindingNeverland]

I use a numbing cream but I still feel kind of a pinch when they insert the needles, it's not that bad though, I would give it a three at most. They have to use a tourniquet right now and I think that thing hurts more than anything.

[natnnnat]

When Gregory started, he says they hurt more, then they settled down.  He used to stick himself. 
He puts it at about three.  ( I love your pain scale)   

[sullidog]

I'd say about a 2 to a 3 for me. You are right it gets better over time.
As far as burning during treatment, that is not right and you need to notify your team if that happens.
You can get creams that you rub on so you don't have to inject a local.
Troy

[chiefsfan301]

I will have my 100th treatment this Friday, I have upper arm fistula and I would rate the stick about a 1 - many time I don't feel it.