Dialysis - Is this normal?

[Jaz]

Greetings to the community.

I’d like to begin by saying it’s a relief to see such a dedicated community actively supporting each other through this incredibly tenacious and dreadful condition. I would personally like to wish you all the best of health and success with your individual treatments.

My reason for reaching out to you all is due to my concern for my grandmother, who has been on dialysis for the past year and half. We live in Georgia (the country) and we've been taking her to the most "reputable" clinic here. Unfortunately, it has been a heartfelt and painful sight to observe her condition after each visit.

The issue here is that she seems to suffer from internal haemorrhages following every procedure, which seems to swell in size with each visit. It is very heartbreaking to see the condition of her arm every time she returns from there. She’s had a fistula implanted in both arms, because the doctors have had issues operating with them.

I’ve read online that both needles are usually inserted into the fistula itself to begin the filtering procedure. According to my grandmother however, the doctors there seem to be inserting them into the arteries and veins themselves. I’m failing to understand their reasons.

The issue they seem to be having is that they usually cannot locate her vein successfully, and end up pricking her arm in many places with needles whilst squeezing at the same time - a procedure she describes as extremely painful - and the result is a haemorrhaged arm.

She’s also made the observation that the majority of patients there of all ages seem to be suffering from this same outcome. A woman in her 40s has been a patient for 12 years - her arm is completely dark purple top to bottom.

I’m reaching out to the community - and attaching pictures (please view at your own discretion) - in an attempt to hear your opinions and for you to possibly tell me whether this is standard procedure for a patient. In other words - are we right to suspect that this is being done unprofessionally and should we seek help elsewhere?

Your response is much appreciated,
Thank you all!

[Michael Murphy]

In 2 years of In center Dialysis I have seen arms like that in fact I have had it happen to me 2 times.  Both times it was my fault I moved around too much and infiltrated my self.  Infiltration is when the needle pokes through the wall of the fistula and blood is leaked under the skin. This should be a occasional risk if the patient doesn't flop around in the chair a lot. One patient in the center I use is constantly throwing him self around the chair so he frequently has bruises.  Now to answer your question either the techs are not good at sticking or the needles are not taped down right.

[OlManRivah]

 
Where is the Doctor in this clinic?
Those hacks have no business treating any patient!

[Alex C.]

If everything you say is what you claim, I'd be taking here to a different clinic ASAP.

[Bungarian]

I have infiltrated a few times like that. Happens more when you first start or if your fistula is small. Should not happen every time.

[Alex C.]

 No...if it happens EVERY time, then they have techs that are terrible.

[Simon Dog]

Happened to me twice.  Second time was a going away present - my last in center treatment before starting home hemo training.  I've been back in center since on occasions, but don't let the techs do any needlework.   I had one minor infiltration when doing a sharp at home, but I was able to catch it, stop the infiltration, and minimize brusing much more quickly that on either occasion a tech was doing the work.

[Michael Murphy]

One more thing the CMS (Center for Medicare and Midicaid Services)  provides a online score card for every center that treats Medicare or Medicaid dialysis patients.  It more reliable then word of mouth.

[Relentless]

I've been on dialysis 5 years and probably been infiltrated maybe 4 times and the bruise was never that bad. You need to talk to clinic manager. I don't understand how they keep sticking her when they clearly don't know how.

[Jaz]

Thank you all so much for your replies.
It's a relief to see our suspicions were correct and that this isn't right.
We'll be checking out our alternatives.

Thank you all again!