Self canulation?

[Alex C.]

My nephrologist has told me to expect to start dialysis in the coming year, and he's really pushing home hemo as the best alternative. I already have an upper-arm fistula (left arm, I'm more-or-less right-handed), and he says that it IS possible to essentially start doing home hemo, if I get the training ahead of time. The one thing that bothers me is the self-canulation.

I assume that, like anything else, with a bit of experience, I can probably do it. Still, I would assume that it's maybe a bit more difficult doing an upper arm than a forearm. As much as I HATE needles, I think that I'd hate having somebody else stick me 3x a week even more.

I guess what I want is for people who have been through this to share their stories. How difficult did you find doing this? What should I know before I get further into the training?

[obsidianom]

Home hemo is a great option as you control much of it and can get more dialysis then just the 3 times a week in center ususal. The self cannulating is a challenge that I cant comment on other then I do it for my wife as her care partner. That is one option. You will need a care partner anyway so you can think about having that person do it for you. The others here who self cannulate can comment on that aspect. I would suspect its like any skill that needs to be learned . It will get better over time.
I am a big fan of home hemo . I would like to see more people do it. I hope you can work it out. 

[cattlekid]

Hello Alex,

Former self-cannulator here.  I was on home hemo for 17 months and I self-cannulated for that entire time.  I started hemo in center with a chest catheter and then I opted for the fistula surgery nine months later after all of my upfront living donor candidates failed the testing and it looked like I was going to be on hemo for longer than I first expected.

I am right handed and my fistula was placed at my left bicep.  They originally wanted to put it in my forearm (and I have the scar to prove it) but that didn’t pan out after they started the surgery so bicep it was. 

I had only agreed to the surgery because I was starting home hemo and knew that I would be able to do buttonhole cannulation.  I wanted NOTHING to do with random techs cannulating me.  I am proud to say that after the original buttonhole formulation, I am the only person who has cannulated my buttonholes.  Even when I had to do hemo in the hospital, I cannulated myself no matter how sick I was. 

There were days that were definitely easier than others.  However, after time, you get to know your own fistula and its quirks.  Some people are freaked out over buttonholes because they are afraid of infections, but I can tell you that if you are going home, then your risk of infection is much less lower as you can take all of the time you need to prepare your cannulation site instead of just the slapdash sometimes done in the center. 

If you have any specific questions, please feel free to post ‘em and I’ll do my best to answer.

[CebuShan]

Hi Alex:
I am currently on Home Hemo. I have a bicep fistula in my right arm (I'm left handed!) I remember being told here on IHD that self cannulation was much less painful than letting someone else do it! I thought they were all crazy!!     But, you know what? It's true! It does NOT hurt as much to stick myself than when I was in center and let the techs do it! I won't let anyone else touch my fistula now!
For me, the bicep is fairly easy to do. Just a matter of practice. Mine takes a funny little curve at the top (where I put the venus) and I think it would be too hard to try to explain to someone else. The biggest obstacle for me was simply getting over the fear of doing it the first time! If you can get a good nurse, s/he can walk you through it.
Best of luck to you! Home hemo is the way to go. I feel so much better than when I was in clinic!
Hope this helps! Let me know if I can give you any other help!
         

[jeannea]

I've never done self-cannulation. I assume that with time and experience it gets easier and feels more normal. You won't know if you can do it until you try. So go for it!

[cassandra]

Hi Alex, I cannulate my right (dominant)arm biceps fistula with my left hand (weak +neuropathy after 17 yrs D)
So yes it's poss. I first started training coordination, and strength through writing etc with my left hand.
And I used Emla cream (lidocaine ) to feel less anxious in case it would hurt.

Nearly 2 yrs of self canning, and I wish I'd started 17 yrs earlier.

It's doable, you'll be fine!!!

Good luck, Cas

[YouDontKnowCecil]

Been doing this for years now. Provided you are able-bodied, there is no other person on the planet that can react as well as you can in case there's something wrong, such as going in too deep or going off to the side or hitting a "bend."


Best of luck!

[Angiepkd]

If I can do it, anyone can do it!  I made my own button holes and am the only one to use them. It was not hard to learn and it doesn't hurt at all now. I have a left upper arm fistula and have been doing home hemo for almost 9 months.  No real problems.  Best of luck to you!  You can do it!   

[jr1234]

Alex I started self cannulation   on my third dialysis day.  I have right handed and my fistula was on my right upper forearm.  The initial start was all faith.  I found the Emula cream to work well giving me confidence.  My Fistula was very hard for the nurses to find.  I was able to cannulate myself with no issues and in fact knowing my fistula saved my life.  I waited 7 years for transplant and going on my 3rd year.   My fistula would have not lasted if I relied on different nurses. 

Guard you Fistula
Know your Labs and Meds.
You can learn to balance your water intake.
Be your own advocate and learn the process.
Find a good dialysis setting that you can tolerate.   
I found this forum to be the best source of information and encouragement during my dialysis.
I wish you well.

[Hemodoc]

My nephrologist has told me to expect to start dialysis in the coming year, and he's really pushing home hemo as the best alternative. I already have an upper-arm fistula (left arm, I'm more-or-less right-handed), and he says that it IS possible to essentially start doing home hemo, if I get the training ahead of time. The one thing that bothers me is the self-canulation.

I assume that, like anything else, with a bit of experience, I can probably do it. Still, I would assume that it's maybe a bit more difficult doing an upper arm than a forearm. As much as I HATE needles, I think that I'd hate having somebody else stick me 3x a week even more.

I guess what I want is for people who have been through this to share their stories. How difficult did you find doing this? What should I know before I get further into the training?

I would advise getting in touch with Stuart Mott at Home Dialysis Central, ask the experts. He has an entire system developed to help you overcome your fear and give you a solid platform to learn self cannulation quickly, easily and correctly.

http://forums.homedialysis.org/forums/20-Stuart-Mott-Cannulation-Expert

You can also find him on FB on their Home Dialysis Central FB page as well.

https://www.facebook.com/HomeDialysisCentral

[Simon Dog]

You can learn if you are motivated.    The best motivation is contemplating the prospect of patient care techs with varying degrees of skill an experience puncturing you to doing it yourself.    If you go the home hemo route, it means an end to negotiating with techs over how much fluid to take off in a treatment.

Yes, it was scary on the third day of hemo training when I was told "time for you to do it".   I have only been doing home hemo for about 4 months, however, I have had ZERO infiltrations in that time.