fun with buttonhole creation

[mcclane]

Where to begin ...

At the end of july, they began to needle me for buttonhole.  At first, they did a 2 hour run (twice a week) using double needle.  starting with 18g. The very first time they did a double needle, things went fine.  The 2nd time, not so well.  I wound up with a huge bruise on my left bicep area.  It looked awful, it looked like i went 1 round in the octagon with tito ortiz 

They didn't do any needling for a week or so (for the bruising to go down), then started up again.  For 2 weeks, they did double needle and everything went fine, eventually moving up to 15g (2 hour dialysis runs to see how well the vein would hold up).  Last week, they were satisfied that the vein was strong enough, so it was the start of buttonhole creation.  I got 2 sharps in, no problem, nurse pulled them out, I held the site for 10 min, nurse checked, all was fine.

I walked out to the elevator, looked down at my arm, and it was bleeding profusely.  I quickly hurried back to the unit, leaving a trail of blood from the elevator, down the hall, and into the unit.  I know I should put pressure on it, but at that time, I wasn't thinking.

So for the remainder of the week, using the sharp, needling was smooth.  They moved me to a semi sharp, and for the life of me, I cannot find the hole in the vein.  The track is there, but can't seem to puncture the vein.  This morning was the longest, I was digging around the buttonhole area for over an hour without any success.

Ahhhhh, i hope this buttonhole fully develops soon, digging around with a needle to find the 'hole' isn't fun. 

[Pam]

Don't give up! I've been using the same buttonholes for 2 yrs, Sometimes the Venus wants to roll but that is the only problem I have,
Pam

[Lindia]

Hi Mcclane --   are you the only one sticking yourself ?    Don't they want one person doing it, as someone else would probably have different angles, etc. ?    My hubby started this week, and its been a slow process for him - he is going really slow, getting blood clots occasionally - etc --  but, the last 2 treatments, the head nurse says that I need to learn how also (as his caregiver)    I really don't want to touch them until they are established....

What would be your take on this ? ?

[mcclane]

Hi Mcclane --   are you the only one sticking yourself ?    Don't they want one person doing it, as someone else would probably have different angles, etc. ?    My hubby started this week, and its been a slow process for him - he is going really slow, getting blood clots occasionally - etc --  but, the last 2 treatments, the head nurse says that I need to learn how also (as his caregiver)    I really don't want to touch them until they are established....

What would be your take on this ? ?

Yes, I am needling myself.  I have to, as I'm on home hemo.  I was nervous and scared in sticking a horse needle into my arm, and at this point i'm not sure if I'll ever get used to it (even with aranesp injections, and the needle there is super small, I'm still hesitant).

But I know this is something that has to be done, and I try to block the hesitation/nervousness out of my mind.

The track is there, I have no problems in getting thru the first 'hole', it is the second 'hole' that provides a challenge.   I'm just trying to figure out the angle, and i have the weekend coming up to figure that out (hospital gave me a bunch of needles to self needle at home).

My take, once a person becomes confidence with self needling, they really don't want anyone else to needle them.  They become familiar with their track and know what angles will provide success.  However, learning how to needle wouldn't be a bad idea either, just in case your husband is sick or something then you can still help him do dialysis.

btw, I go slow with the needles too, i guess it just takes time to get used to.

[monrein]

I had one buttonhole in particular that required huge pressure to get in there...always did but I had to really push to pop through the vein.  I hope things get sorted for you.

[mcclane]

I had one buttonhole in particular that required huge pressure to get in there...always did but I had to really push to pop through the vein.  I hope things get sorted for you.

good news is i got one blunt in, and the nurse got the other blunt in.  took me over half hour of digging around before i found the hole in the vein, it is like finding a needle in a haystack 

so over the weekend, the nurse gave me some blunt needles and wants me to try poking at home.

[monrein]

I used to do 5 days a week, and the toughest time was when I'd had a day off in between. 

[Lindia]

I had one buttonhole in particular that required huge pressure to get in there...always did but I had to really push to pop through the vein.  I hope things get sorted for you.

Thanks for this information -  hubby's been talking about needing a lot of pressure also -  I will let him know this -- he's just so scared of infiltrating himself.

[monrein]

It was a  weird thing to be pushing really hard but also being prepared to stop really fast once you felt that little pop... it eventually feels like you know exactly what you're doing though.  If it's any consolation, I think it's much harder to infiltrate with a blunt since it doesn't "nick" the vessel wall as easily as a sharp can, but obviously the thing is pointed and skin does give and blah blah blah.

Sometimes, it drove me a bit crazy cuz it wouldn't go in so I'd stop, and breathe deeply to calm myself then start all over again with a fresh blunt.