7th treatment forming buttonholes- questions

[fearless]

two weeks ago my tech stuck me with the intent to form buttonholes.  We've both been excited about how well it's going.  Last Friday was the 6th stick, and she said we could try blunts on Monday (today).  On that same day (Friday) I bled from the needle site during treatment.  No big deal.
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Today (Monday) she tried to cannulate with blunts.  The needle went all the way in but didn't go into the vein.  She tried both sites with the same result.  She seemed mystified (which was not very reassuring to me).  And again the needle sites bled during treatment.  I've never bled from my needle sites, so I don't know what's up with that.

Does anybody know what might be going on here?  Where did the needle go if it didn't go in the vein?

[Hemodoc]

You may be getting what is called the trampoline effect where the needle penetrates the track but bounces off of the vein but hard to tell without feeling how the needle actual went. With the bleeding during dialysis, you may be getting a whole too large which is a risk with the buttonhole. An excellent source is Stuart Mott on Home Dialysis Central. He is a cannulation expert and you can ask him individual questions on cannulation and he will give you an expert opinion.

http://forums.homedialysis.org/forums/15-Ask-Our-Experts

I hope this helps.

God bless,

Peter

[fearless]

thanks for your reply hemodoc.
I've tried twice to register at that site tonight to ask a question, but it says I'm banned!  I've never been registered at that site, so I don't know what's going on.  I'll try again tomorrow.

[Desert Dancer]

fearless, I've had nights where I can get through the buttonhole but just can't find the door into the vein. Sometimes - like Hemodoc said - I just bounce off the vein or push it off to the side; it has a tendency to roll around. I clench my fist to hold the vein in place since I don't use a tourniquet anymore. Other times it'll feel like I got in but the blunt is only under the skin. The thing with buttonholes is your arm has got to be in the EXACT same position EVERY time. Just a smidge one way or the other and you won't get it. Pay really, really close attention to how your arm is positioned and how the heel of your hand touches the surface of the table. Sometimes it helps if you palpate very, very carefully before you start.

I don't have any familiarity with the bleeding issue.

[Hemodoc]

thanks for your reply hemodoc.
I've tried twice to register at that site tonight to ask a question, but it says I'm banned!  I've never been registered at that site, so I don't know what's going on.  I'll try again tomorrow.

Go on as a guest and leave a message for Dori Schattell and they should be able to get you squared away.

I would recommend learning about "touch cannulation" which Stuart Mott can explain in more detail. Works well.

[fearless]

thanks to you both very much!