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Author Topic: Couple of questions?  (Read 3739 times)
Angiepkd
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« on: February 18, 2013, 06:09:52 PM »

Sorry if I am asking too many silly questions, but I am a bit of an over-planner. When I went for my DaVita interview Friday, I mentioned to the nurse that I wanted to use button holes. She acted surprised and asked if my doctor was ok with that? Am I missing something about using the button hole technique? From everything I have read, they help prolong the life of the fistula and reduce some of the pain associated with those big needles.

I was also wondering what you NxStagers do if you are hospitalized? Are you allowed to use your blunts and self-cannulate? I am generally good for a couple of hospital stays per year and have read horror stories about button holes ruined by sharps at the hands of hospital dialysis techs.

Thanks again for putting up with my questions! Don't worry, I start my training on March 4th, so I might not ask so much lol!
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PKD diagnosis at 17
Cancer May 2011, surgery and no further treatment but placed on 2 year wait for transplant
October 2011 first fistula in left wrist
April 2012 second fistula in upper arm, disconnect of wrist
January 2013, stage 5 ESRD
March 2013 training with NxStage home hemo
April 2013 at home with NxStage
April 2013 fistula revision to reduce flow
May 2013 advised to have double nephrectomy, liver cyst ablation and hernia repair. Awaiting insurance approval to begin transplant testing. Surgery in June.
June 2013 bilateral nephrectomy.
August 2013 finishing testing for transplant, 4 potential donors being tissue typed.
January 2014 husband approved to donate kidney for me
March 4th 2014 received transplant from awesome hubby. Named the new bean FK (fat kidney) lol!  So far we are doing great!
cattlekid
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« Reply #1 on: February 18, 2013, 06:50:37 PM »

I have been hospitalized three times since I started on NxStage. I calmly inform the dialysis tech that I cannulate myself. They are more than happy to stand back and let me take care of things. Just be aware that you might have to go up or down a needle size as they don't often have an arsenal of blunts at their disposal.
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boswife
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us and fam easter 2013

« Reply #2 on: February 18, 2013, 07:19:53 PM »

Im always surprised now when a nurse would ask such a question about buttonholes.  You've done your reasearch so you know your in the right in wanting them so i'll leave my thoughts at that  ;)  As far as silly questions....... NOTHING is silly!!  your should have seen me/mine...  your a lightweight..lol  so dont ever feel bad about asking.  It's the best thing you can do!  As far as hospital stays,,, Hopfully with home hemo you'll have less  :pray; but, so long as your 'ok' as in functioning ok, then you should be let to do your needles.  Im the wife/partner, and I have gotton (ha) to do hubbys needles when he has been in the hospital.  They actually think it's cool :)  and though they are surprised that we want to do this, it is perfectly under your control ......... At least that is what they have told me.  Through my questioning here, i was also told that 'if' you are to have them do it for any reason, to have them uses sharps in a different area than your buttonholes.  I would love for others to come on and verify this as we never had to do that so dont know if things/suggestions on that would be different now.
Doggone it, im pretty tired tonight... so hope i've made sence.  I'll check in the morning..lol  All the best to you..
oh, i see that cattlekid has just posted and !!!!!! due to that possibility of them not haveing your size needles..I always bring some with us just incase..
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im a california wife and cargiver to my hubby
He started dialysis April 09
We thank God for every day we are blessed to have together.
november 2010, patiently (ha!) waiting our turn for NxStage training
January 14,2011 home with NxStage
Angiepkd
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« Reply #3 on: February 18, 2013, 07:49:25 PM »

Thanks! This helps a bunch. Always running through the things that might come up. I will try to quiet my brain for a while lol!
Logged

PKD diagnosis at 17
Cancer May 2011, surgery and no further treatment but placed on 2 year wait for transplant
October 2011 first fistula in left wrist
April 2012 second fistula in upper arm, disconnect of wrist
January 2013, stage 5 ESRD
March 2013 training with NxStage home hemo
April 2013 at home with NxStage
April 2013 fistula revision to reduce flow
May 2013 advised to have double nephrectomy, liver cyst ablation and hernia repair. Awaiting insurance approval to begin transplant testing. Surgery in June.
June 2013 bilateral nephrectomy.
August 2013 finishing testing for transplant, 4 potential donors being tissue typed.
January 2014 husband approved to donate kidney for me
March 4th 2014 received transplant from awesome hubby. Named the new bean FK (fat kidney) lol!  So far we are doing great!
noahvale
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« Reply #4 on: February 18, 2013, 07:54:20 PM »

^
« Last Edit: September 21, 2015, 06:50:01 PM by noahvale » Logged
Angiepkd
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« Reply #5 on: February 18, 2013, 08:41:12 PM »

My meeting was with one of the home hemo training nurses and I was so stunned by the question that I didn't  ask her why she said it. My nephrologist knows I want to use button holes and thought that was a good idea. The nurse I met with originally was not at this second meeting, but he will be the one doing my training. I spoke with him about the button holes at our first meeting and he was very gung-ho about me wanting to use them. I have put off my start date because he is unavailable until march 4th. I am a little concerned about several of the things I have heard from the other nurse, social worker and dietician.  Unfortunately, this is the closest center to me that uses NxStage and also where my neph recommended. I am hoping the training goes well, but my anxiety level has doubled since that second meeting. (As you all can tell by the number of questions I am posting)! Thanks for listening and responding!
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PKD diagnosis at 17
Cancer May 2011, surgery and no further treatment but placed on 2 year wait for transplant
October 2011 first fistula in left wrist
April 2012 second fistula in upper arm, disconnect of wrist
January 2013, stage 5 ESRD
March 2013 training with NxStage home hemo
April 2013 at home with NxStage
April 2013 fistula revision to reduce flow
May 2013 advised to have double nephrectomy, liver cyst ablation and hernia repair. Awaiting insurance approval to begin transplant testing. Surgery in June.
June 2013 bilateral nephrectomy.
August 2013 finishing testing for transplant, 4 potential donors being tissue typed.
January 2014 husband approved to donate kidney for me
March 4th 2014 received transplant from awesome hubby. Named the new bean FK (fat kidney) lol!  So far we are doing great!
noahvale
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« Reply #6 on: February 18, 2013, 08:57:00 PM »

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« Last Edit: September 21, 2015, 06:48:21 PM by noahvale » Logged
Angiepkd
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« Reply #7 on: February 19, 2013, 08:40:44 PM »

The dietitian said very little, even when I asked about dietary and fluid restrictions while on dialysis.  The social worker asked about my insurance co-pays and said she thought it would be a good idea to look into Medicare. She thought I could apply online (you can't) and said she would dig up some paperwork for me and have it on my start date. Maybe I am an over-thinker/ over-preparer, but wouldn't you have something to give the patient when they come for a scheduled meeting and have a start date assigned? No worries, I took care of scheduling my Medicare appointment and have a pretty good idea of the dietary and fluid restrictions (both dad and younger brother on dialysis in the past). I feel like I have done my homework since I have a family history of dialysis and transplant recipients, but what if I didn't know anything? They hadn't seen my medical history and didn't know why my kidneys failed. My progression has been a slow one, but many people are caught off-guard by their diagnosis. Sorry for the rant - I just think we deserve better when it comes to our health care.  Thanks for the link!
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PKD diagnosis at 17
Cancer May 2011, surgery and no further treatment but placed on 2 year wait for transplant
October 2011 first fistula in left wrist
April 2012 second fistula in upper arm, disconnect of wrist
January 2013, stage 5 ESRD
March 2013 training with NxStage home hemo
April 2013 at home with NxStage
April 2013 fistula revision to reduce flow
May 2013 advised to have double nephrectomy, liver cyst ablation and hernia repair. Awaiting insurance approval to begin transplant testing. Surgery in June.
June 2013 bilateral nephrectomy.
August 2013 finishing testing for transplant, 4 potential donors being tissue typed.
January 2014 husband approved to donate kidney for me
March 4th 2014 received transplant from awesome hubby. Named the new bean FK (fat kidney) lol!  So far we are doing great!
M3Riddler
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« Reply #8 on: February 21, 2013, 03:55:14 PM »

Sorry if I am asking too many silly questions, but I am a bit of an over-planner. When I went for my DaVita interview Friday, I mentioned to the nurse that I wanted to use button holes. She acted surprised and asked if my doctor was ok with that? Am I missing something about using the button hole technique? From everything I have read, they help prolong the life of the fistula and reduce some of the pain associated with those big needles.

I was also wondering what you NxStagers do if you are hospitalized? Are you allowed to use your blunts and self-cannulate? I am generally good for a couple of hospital stays per year and have read horror stories about button holes ruined by sharps at the hands of hospital dialysis techs.

Thanks again for putting up with my questions! Don't worry, I start my training on March 4th, so I might not ask so much lol!

Angie,

Buttonholes are wonderful.  If in the hosptial, I take my needles with me. It is your right to cannulate yourself, especially if you do a different technique that they do not provide in the hosptial.  You have every right to take in your needles and cannulate yourself.   At first, they tried to tell us that I wa snot aloud to cannulate myself, but we demanded it as it was our riight.  Do not let them ever use sharps anywhere near the buttonhole as it can tear a hole in the track and ruin them.   If by chance you dont take your buttonholes with you or cant get any in time,  make sure that either you or the nurse cannulates you away from the buttonholes to be safe.

Hope this helps...
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Peritoneal - 13 years
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Angiepkd
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« Reply #9 on: February 21, 2013, 07:34:54 PM »

Thanks for all the input. I will try to remember to bring my own blunts or send my husband to get them should the need arise. It always helps to have a plan and know what to expect!
Logged

PKD diagnosis at 17
Cancer May 2011, surgery and no further treatment but placed on 2 year wait for transplant
October 2011 first fistula in left wrist
April 2012 second fistula in upper arm, disconnect of wrist
January 2013, stage 5 ESRD
March 2013 training with NxStage home hemo
April 2013 at home with NxStage
April 2013 fistula revision to reduce flow
May 2013 advised to have double nephrectomy, liver cyst ablation and hernia repair. Awaiting insurance approval to begin transplant testing. Surgery in June.
June 2013 bilateral nephrectomy.
August 2013 finishing testing for transplant, 4 potential donors being tissue typed.
January 2014 husband approved to donate kidney for me
March 4th 2014 received transplant from awesome hubby. Named the new bean FK (fat kidney) lol!  So far we are doing great!
amanda100wilson
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« Reply #10 on: February 22, 2013, 03:00:24 PM »

i was in hospital about three months ago, and I insisted on putting my own needles in.  told them that I would'nt dialyse unlss they did!  actually, they were pretty supportive for me to do this.  my husband brought my needles in.
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ESRD 22 years
  -PD for 18 months
  -Transplant 10 years
  -PD for 8 years
  -NxStage since October 2011
Healthy people may look upon me as weak because of my illness, but my illness has given me strength that they can't begin to imagine.

Always look on the bright side of life...
lmunchkin
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"There Is No Place Like Home!"

« Reply #11 on: February 22, 2013, 10:22:52 PM »

Don't know, John hasnt been in Hospital since doing Nxstage.  "knock on Wood"  But this is interesting to know!
His fistula is so Big, I would just let them do it in the hospital.  Maybe take a breck from it.  But hope he never has to go back!  He doesnt do button holes, so no problem there!

God Bless,
lmunchkin :kickstart;
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11/2004 Hubby diag. ESRD, Diabeties, Vascular Disease & High BP
12/2004 to 6/2009 Home PD
6/2009 Peritonitis , PD Cath removed
7/2009 Hemo Dialysis In-Center
2/2010 BKA rt leg & lt foot (all toes) amputated
6/2010 to present.  NxStage at home
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