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Author Topic: What Needles do you use?  (Read 8241 times)
Meinuk
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« on: January 28, 2008, 01:00:48 PM »

In my never ending quest to get my fistula to work at optimum performance.  (I am demanding!)  I am wondering what needles other people use.

Me:

Venous - Medi system 16 gauge 1 1/4 inch blunt
Arterial - Medi system 16 gauge 1" sharp  (my buttonhole is just a mass of scar tissue and eventually, I'll have to establish another one....)

I noticed that there are some new blunts out there:  http://www.medisystems.com/hemodialysis/buttonhole/ADV152-11086ForWeb+ADV290SteriPickReduced.pdf

And I've asked my nurse to order them in 16 inch length.

Right now, my pressures are running in the high 100's (average 190 arterial and 170 venous) I am hoping that if I go to a 15 gauge maybe my pressures will come down.
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52 with PKD
deceased donor transplant 11/2/08
nxstage 10/07 - 11/08;  30LS/S; 20LT/W/R  @450
temp. permcath:  inserted 5/07 - removed 7/19/07
in-center hemo:  m/w/f 1/12/07
list: 6/05
a/v fistula: 5/05
NxStage training diary post (10/07):  http://ihatedialysis.com/forum/index.php?topic=5229.0
Newspaper article: Me dialyzing alone:  http://ihatedialysis.com/forum/index.php?topic=7332.0
Transplant post 11/08):  http://ihatedialysis.com/forum/index.php?topic=10893.msg187492#msg187492
Fistula removal post (7/10): http://ihatedialysis.com/forum/index.php?topic=18735.msg324217#msg324217
Post Transplant Skin Cancer (2/14): http://ihatedialysis.com/forum/index.php?topic=30659.msg476547#msg476547

“To doubt everything or to believe everything are two equally convenient solutions; both dispense with the necessity of thought.” - Henri Poincare
Adam_W
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« Reply #1 on: January 28, 2008, 01:50:41 PM »

When I was still able to use my graft, I used Baxter 15g x 1". I started on 16g, but because of flow problems I had to switch to 15g. They helped with flow for a while, but as the graft deteriorated, the biggest needle in the world wouldn't have helped. Now I'm strictly using my chest catheter, so I'm not using needles at all. As much as I hate needles, I still wish I could get a good graft/fistula, because I hate having this bloody catheter in my chest.

Adam
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-Diagnosed with ESRD (born with one kidney, hypertension killed it) Jan 21st, 2007
-Started dialysis four days later in hospital (Baxter 1550-I think, then Gambro Phoenix)
-Started in-centre dialysis Feb 6th 2007 (Fres. 2008H)
-Started home hemo June 5th 2007 (NxStage/Pureflow)
-PD catheter placed June 6th 2008 (Bye bye NxStage, at least for now)
-Started CAPD July 4th, 2008
-PD catheter removed Dec 2, 2008-PD just wouldn't work, so I'm back on NxStage
-Kidney function improved enough to go off dialysis, Feb. 2011!!!!!
-Back on dialysis (still NxStage) July 2011 :(
-In-centre self-care dialysis March 2012 (Fresenius 2008K)
-Not on transplant list yet.


"Don't live for dialysis, use dialysis to LIVE"
charee
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« Reply #2 on: January 28, 2008, 02:53:38 PM »

i use nipro 15g x 1 inch blunts, pressures are arterial 140 venous 120, but with that said the next time i get an order they could be a different brand, hope not as these seem  to be working really well :ausflag;
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jbeany
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« Reply #3 on: January 28, 2008, 05:44:45 PM »

15 gauge x1" "Wingeaters" are the only thing I was offered.  That's what they are supposed to use at my clinic, so that's what I get, like it or not.  I can't stand the annoying little plastic protector that is supposed to cover the needle after it's pulled, so I just snap them off.
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silverhead
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« Reply #4 on: January 28, 2008, 06:29:26 PM »

I use Baxter 15g , 1 inch sharps and blunts, the sharps are used after the day off, because the buttonholes seem to close off to much to penetrate without lots of pushing and pain for Sharon, after that the blunts work fine. I too just discovered that I can snap off those darn "covers", wish I would have learned it sooner.....
Tom
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terry3004
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« Reply #5 on: January 28, 2008, 10:01:27 PM »

Both of my needles are 15g 1" blunts.  I run about 200 on both sides at a blood flow rate of 600.
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Become a living organ donor...you never know who's life you're going to save!

Married to my wonderful wife 4/2005
Diagnosed ESRD 7/2005
Started PD 3/2006 - Got infected
PD Catheter Changed 4/2006
PD Catheter removed & Perma-Cath placed 5/2006
In-Center Hemo started 5/2006
Tried PD again 5/2007 - Catheter wouldn't drain
Fistula made 8/2007
NxStage started 1/2008!!
Roadrunner
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« Reply #6 on: January 29, 2008, 12:14:28 PM »

NxStage now owns Medisytems.  Hopefully we will now be able to order out blunts from them with our supplies.  I have to go in to the center each time I need a new supply. 

I see that the needles are siliconized with Medisystems SlipCoat advanced silicone lubricant.  Does anyone know if this is a problem with taking labs?  I thought I remembered reading once that if you use silicone to slip in the needles they must be flushed well before labs.  I also know the center said saline will upset the labs.  Can anyone set me straignt?

My husband is using #15 Medisystem button hyole needles.  Almost each time I insert them and tape it I see a white spot in the tubing.  The first time I thought a small piece of plastic was in the tube.  I now think it is an air bubble for some reason.  It seems to disappear when I bleed the line.  Has anyone else noticed this?  Can someone tell me what it is?  Should I be worried?  I've been using these for about 3 weeks.

Roadrunner
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petey
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« Reply #7 on: January 29, 2008, 05:52:21 PM »

My husband uses 15 gauge buttonhole (blunt) needles -- no protective cover, thank goodness (i hate those things).
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RichardMEL
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« Reply #8 on: January 31, 2008, 06:10:55 AM »

I'm on 15 guage needles also. FX80 dialyzer....
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3/1993: Diagnosed with Kidney Failure (FSGS)
25/7/2006: Started hemo 3x/week 5 hour sessions :(
27/11/2010: Cadaveric kidney transplant from my wonderful donor!!! "Danny" currently settling in and working better every day!!! :)

BE POSITIVE * BE INFORMED * BE PROACTIVE * BE IN CONTROL * LIVE LIFE!
Bill Peckham
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« Reply #9 on: February 12, 2008, 02:10:58 PM »

Both of my needles are 15g 1" blunts.  I run about 200 on both sides at a blood flow rate of 600.
What machine are you using? my NxStage goes up to 500 (which seems too fast for me)
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http://www.billpeckham.com  "Dialysis from the sharp end of the needle" tracking  industry news and trends - in advocacy, reimbursement, politics and the provision of dialysis
Incenter Hemodialysis: 1990 - 2001
Home Hemodialysis: 2001 - Present
NxStage System One Cycler 2007 - Present
        * 4 to 6 days a week 30 Liters (using PureFlow) @ ~250 Qb ~ 8 hour per treatment FF~28
Bill Peckham
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« Reply #10 on: February 12, 2008, 02:13:54 PM »

In my never ending quest to get my fistula to work at optimum performance.  (I am demanding!)  I am wondering what needles other people use.

Me:

Venous - Medi system 16 gauge 1 1/4 inch blunt
Arterial - Medi system 16 gauge 1" sharp  (my buttonhole is just a mass of scar tissue and eventually, I'll have to establish another one....)

I noticed that there are some new blunts out there:  http://www.medisystems.com/hemodialysis/buttonhole/ADV152-11086ForWeb+ADV290SteriPickReduced.pdf

And I've asked my nurse to order them in 16 inch length.

Right now, my pressures are running in the high 100's (average 190 arterial and 170 venous) I am hoping that if I go to a 15 gauge maybe my pressures will come down.

At what blood pump speed?
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http://www.billpeckham.com  "Dialysis from the sharp end of the needle" tracking  industry news and trends - in advocacy, reimbursement, politics and the provision of dialysis
Incenter Hemodialysis: 1990 - 2001
Home Hemodialysis: 2001 - Present
NxStage System One Cycler 2007 - Present
        * 4 to 6 days a week 30 Liters (using PureFlow) @ ~250 Qb ~ 8 hour per treatment FF~28
Meinuk
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« Reply #11 on: February 12, 2008, 05:06:11 PM »


At what blood pump speed?

I start at 400 and usually go up to 450 when my venous pressure goes below 190.

I'm picking up 15 gauge on Friday morning at my clinic visit.
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Research Dialysis Units:  http://projects.propublica.org/dialysis/

52 with PKD
deceased donor transplant 11/2/08
nxstage 10/07 - 11/08;  30LS/S; 20LT/W/R  @450
temp. permcath:  inserted 5/07 - removed 7/19/07
in-center hemo:  m/w/f 1/12/07
list: 6/05
a/v fistula: 5/05
NxStage training diary post (10/07):  http://ihatedialysis.com/forum/index.php?topic=5229.0
Newspaper article: Me dialyzing alone:  http://ihatedialysis.com/forum/index.php?topic=7332.0
Transplant post 11/08):  http://ihatedialysis.com/forum/index.php?topic=10893.msg187492#msg187492
Fistula removal post (7/10): http://ihatedialysis.com/forum/index.php?topic=18735.msg324217#msg324217
Post Transplant Skin Cancer (2/14): http://ihatedialysis.com/forum/index.php?topic=30659.msg476547#msg476547

“To doubt everything or to believe everything are two equally convenient solutions; both dispense with the necessity of thought.” - Henri Poincare
terry3004
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« Reply #12 on: February 13, 2008, 04:19:17 AM »

Both of my needles are 15g 1" blunts.  I run about 200 on both sides at a blood flow rate of 600.
What machine are you using? my NxStage goes up to 500 (which seems too fast for me)

It depends on how your clinic sets up your NxStage.  They can program the max blood flow allowable.  Mine can't go any higher than 600.  I have to get there in stages, though.

I start at 200 just to make sure everything is flowing ok.  Then I go to 300 and check again.  Then to 400, and go up in steps of 50 from there.  I usually have to stay at 450, 500, and 550 for about 15 min each while I wait for my needles to settle in.  I will eventually wind up at 600.
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Become a living organ donor...you never know who's life you're going to save!

Married to my wonderful wife 4/2005
Diagnosed ESRD 7/2005
Started PD 3/2006 - Got infected
PD Catheter Changed 4/2006
PD Catheter removed & Perma-Cath placed 5/2006
In-Center Hemo started 5/2006
Tried PD again 5/2007 - Catheter wouldn't drain
Fistula made 8/2007
NxStage started 1/2008!!
KR Cincy
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Home hemodialysis since May 07

« Reply #13 on: February 13, 2008, 09:59:46 AM »

I'm using 16 sharps for both arterial and venous and max out at 450. I guess eventually we'll move to 15's but don't see any hurry because they prefer me at 450 anyway, so it's all working out ok.
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Bill Peckham
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« Reply #14 on: February 13, 2008, 01:09:43 PM »

Wow Terry that is the fastest I have ever heard. What is your FF?
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http://www.billpeckham.com  "Dialysis from the sharp end of the needle" tracking  industry news and trends - in advocacy, reimbursement, politics and the provision of dialysis
Incenter Hemodialysis: 1990 - 2001
Home Hemodialysis: 2001 - Present
NxStage System One Cycler 2007 - Present
        * 4 to 6 days a week 30 Liters (using PureFlow) @ ~250 Qb ~ 8 hour per treatment FF~28
terry3004
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« Reply #15 on: February 14, 2008, 05:02:57 AM »

My FF is 30.  20L dialysate in 2:15
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Become a living organ donor...you never know who's life you're going to save!

Married to my wonderful wife 4/2005
Diagnosed ESRD 7/2005
Started PD 3/2006 - Got infected
PD Catheter Changed 4/2006
PD Catheter removed & Perma-Cath placed 5/2006
In-Center Hemo started 5/2006
Tried PD again 5/2007 - Catheter wouldn't drain
Fistula made 8/2007
NxStage started 1/2008!!
skyedogrocks
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Rob showing off his pot of gold!

« Reply #16 on: March 12, 2008, 08:19:57 AM »

Rob uses 15 inch Wingeaters right now with a speed of 500.  That's about to change soon as he'll be tapping into his new graft, going back to 17's for a while. 
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Wife to Rob who is currently doing Nx Stage Home Hemo Dialysis.

11/17/09 After 4 years on dialysis, Rob received a kidney from our George.  Kidney is working great!  YEAH!!!!
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