putting needles too close together?

[sullidog]

I just wanna clarify, is it a no no to put needles too close together? I have a tech that will do this and then say sorry I had to do that, but doesn't it cause recirculation?

[Riki]

yep. That's why they're not supposed to put them too close together.  I think there are other reasons, but I"m not sure.

[thegrammalady]

i'd refuse to let that tech come near me!

[mcclane]

I think the needles have to be at least an inch apart, the needles I use are at least that length so if it is too close together it could cause sucking problems for one of the needles.

[Stoday]

My button holes are 38mm apart.

I think they are supposed to be at least 50mm apart but hey ho, they are working OK. 

[Riki]

2 of my sites are about an inch apart from each other.  The needles were almost on top of each other, but they were far enough apart that they didn't cause any issues.  When a 3rd site developed, they stopped using the site closest to my elbow, so the sites that are used now are a good 2 inches apart, at least.  Having 3 sites is helpful, in case of infiltration, I can still have treatment, and I know I'm lucky to have them

[lmunchkin]

I was told no less than 2" apart.  My husbands fistula runs from wrist to elbow, so that is not a problem!

lmunchkin   

[YLGuy]

I was just talking to my tech about this yesterday.  He has been a tech for 20 years.  At the other center he works at he only does hard sticks.  He told me that in the last 3 months he has stuck 5 patients that were on chest catheters for about a year.  He told me that he got into a discussion with another tech about his technique.  He said that some of the fistulas were not very well developed.  He said that to help the fistula mature he does put the needles too close together on purpose.  He says that it really does help and that as the fistula develops, he moves the needles farther and farther apart.

[lmunchkin]

Yl, I do agree to some point with the tech.  In my personal experience in cannulating my husband, I believe that his fistula has grown more, due to my doing the ladder method.  No I don't think it has grown, I know it has grown!  It makes sticking him much eaiser, cause it runs length wise up his arm and has thickened emmensly.

I was told that too close together can mess with the in and out flow of blood!  I just don't do it.  Wouldnt want to chance it!

lmunchkin   

[sandra3105]

  just having a read about fistula and needles, been on PD overnight for 3 years but the blood results are not too good so i started a day dwell as well as the 9 nights at night and now they added an exchange at  6.00 pm after i finiish work - so next tues i am having the operation to gt a fistula - looking at home dialysis during the night - in Uk home treatment is actively advised. as i live on my own i am a bit dubious about having to do such a procedure, i will spend 3 months 3 x times a week being trained.  i just thought the PD would last out and never even in my mind had an option for haemo !! fistulas putting needles in yuk i really dont like the sound of it BUT if it cures my severe case of restless legs ( arms,body an all ) then bring it on !! coz that is the worse thing i have suffered with this renal failure then having to work  a full week.  i was wondering if anyone felt the same way switching and do they feel the benefits ?

[Riki]

sandra3105.. I was forced to switch, against my will, due to infection.  I don't see much of a difference except I have a bit less energy, and I don't hold near as much fluid now as I did when I was on PD

[mcclane]

just having a read about fistula and needles, been on PD overnight for 3 years but the blood results are not too good so i started a day dwell as well as the 9 nights at night and now they added an exchange at  6.00 pm after i finiish work - so next tues i am having the operation to gt a fistula - looking at home dialysis during the night - in Uk home treatment is actively advised. as i live on my own i am a bit dubious about having to do such a procedure, i will spend 3 months 3 x times a week being trained.  i just thought the PD would last out and never even in my mind had an option for haemo !! fistulas putting needles in yuk i really dont like the sound of it BUT if it cures my severe case of restless legs ( arms,body an all ) then bring it on !! coz that is the worse thing i have suffered with this renal failure then having to work  a full week.  i was wondering if anyone felt the same way switching and do they feel the benefits ?

yes !!

when i first started pd, i thought it would last for a long time (forever), but the nurse told me your peritoneal membrane doesn't last forever and it will wear out eventually.  little over 3 years on pd i got my transplant.  but it failed quickly thereafter and back on pd i went.  pd worked well for the first few months, then everything started going downhill.  I started retaining fluid (my right eye lid puffed out alot), then eventually the membrane just died (my blood results came back terrible). 

eventually, hemo was the only route to take.  Like yourself, I was trained to do home hemo.  My training lasted about 3 weeks, but i had to go in everyday (m-f) for training.  I was also trained on self needling.  After you get comfortable with it, you get to a point where you don't want anyone else to needle you. 

The benefits ?  i'm not as puffy anymore.  The hemo machine does a really good job in removing fluids and anything else.  I can eat alot more than i did on pd, and my fluid intake has increased, due to the fact that the hemo machine was suck out the fluid.  My bloodwork is coming back good, with the levels well within normal ranges.

downside ?  you need alot of room in your house for the supplies.  You'll also need alterations to your electrical and plumbing.  the machine (if it isn't a nxstage) is high maintenance.  I'm req'd to clean it weekly. 

[lmunchkin]

PD was a good modality for husband, but I like home hemo with NxStage.  His labs have never been better and it he feels super.  I wonder if we had done this years ago, would he have been able to keep his leg & toes.  Plus, Nxstage is definately user friendly and doesnt require as much room for storage.  The machine is very portable, but yet is still heavy for a little person as myself.

You can travel with it and we love it!

The draw backs (which doesnt bother me) is that you pretty much have to do it 5-6 days a week.  We currently do it 3 on & 2 off.  Other than Nocturnal & transplant, I believe it is the best choice of all, IMO.

lmunchkin