6 days a week dialysis - too much?

[cev]

After ~ 3years on Nxstage hubby is getting tired to being stuck 6 days a week, it plays on his mind because the initial stick HURTS even tho he has good buttonholes.  He has a fear of and really hates needles.  Anyone out there with suggestions to ease the pain at the initial stick?  He is trying to stay positive and feels pretty good most of the time but the frustration is mounting.



Edited: Fixed spelling in Subject Line - okarol/admin

[thegrammalady]

i too have always had an extreme dislike (that's putting it mildly) of needles. i use a lidocaine and prilocaine cream. i put it on about an hour before i get to the center and never feel a thing. also last time i was in the hospital i was quite surprised. the doctor always forgets to order lidocaine shots and you can't use cream cause you never know when they're going to arrive for you treatment so this last time i just said to hell with it and didn't use anything. i was very surprised it didn't really hurt at all. however i'm still using the cream cause ya just know that can't happen more than once. i've also read on the board that there is a spray that "freezes" the skin, that some people use. then there's always lamaz, breathing works for so much more than childbirth.

hopefully your husband will find something that works for him.

[nursewratchet]

The spray is Ethyl Chloride.  You put in on IMMEDIATLY prior to cannulation.  Your insurance will pay for it.  If you were incenter, the facility could provide it.  We use it at our facility for some, lido for others.  Most patients don't use anything, but it's just patient preference.  The Ethyl Chloride is about 30. dollors if you have to pay out of pocket, but again, insurance should cover it. 

[Lucinda]

I am going to be doing six days but I really have no problem with needles.  I would have thought PD might be a really good alternative to those who have a horror or needles.  I know my father started on PD for that reason but even when he ended up on hemo eventually he was pretty much use to the needles after the first few months.  I think if six days is going to make me feel better and well enough to keep working, the needles will be a small price to pay.       

[willowtreewren]

My husband has been on NxStage since August. We don't do button holes since our center doesn't support them (go figure). We use lidocaine cream before sticking, but there have been times that our routine has been different and he forgot the cream. He swears that sticking without the cream is not much different than with it! I personally think he tells me that so that I don't get upset about hurting him. 

What I'm confused about, though, is that I thought button holes weren't as painful as regular sticks. My sister-in-law has button holes and sticks herself because she can't stand the thought of trusting her fistula to anyone else. 

Maybe your husband could use some self-directed imaging to help him through the stick process - mind over matter. I know that dreading something often makes it even worse.

Best wishes,
Aleta

[jbeany]

willow, I've never used lido, and I'm not usually bothered much by the needle sticks, either.  Once in a while, though, the needle hits a nerve and it hurts like crazy.  Some people have that nerve pain with every stick, regardless of button holes or not - it just depends on how the nerves run.

[monrein]

One of my buttonholes runs right through a nerve but I'm used to the feeling now and just do it.

[Razman]

Have you ever asked your doctor about doing nocturnal hemo.   Studies have shown that  nocturnal  for  approx 7-8 hours every other night  accomplishes almost the same as  6 days a week.    Does anyone else do it every other night ?

[Wallyz]

I do it every night, and its great.

The issue is not the needles, or the dialysis, the issue is the trauma.

He needs to see a psychologist or counselor.  The physical and psychological act of dialysis is very similar to long term abuse.  I allow myself to be injured because I have to in order to survive. This person who is injuring me relly loves me, and I love them while resenting and fearing them and the process of being jabbed with needles.


It's serious stuff, and needs to be dealt with.

[skyedogrocks]

Does his center support NxStage for 5 days a week?  When Rob was first trained, almost 2 years ago, his Nurse said 6 days.  He worked very diligently to get that to only 5 days a week. 
Rob doesn't do buttonholes, he never liked them, but he uses his bottom fistula for his Arterial and he doesn't feel that needle anymore.  He uses his upper arm graft for Venous and feels it, but it doesn't hurt as much.  He never liked the creams or spray, he would rather go without them.

[Zach]

Just remember, it's both frequency and time that will ultimately deliver optimum hemodialysis.

[Dan.Larrabee]

I was trained in center by NxStage themselves. they came to train my home hemo nurses at the same time. NxStage said it is either 5 or 6 days depending on the doc. i looked at the nurses and said 5 or 6? they called my doctor and she said my labs from NxStage class showed i could go 5 days if i was committed to not skip a day or do two days off in a row.

ask your doc, not the center. the center will do anything with a doc's order. I even had my doc change my dry weight..

[cev]

Finally I have time to come back.  Thank all of you for the suggestions.  I think we will try the Lido... I know some is pain of the stick some is burning and a lot is mental ... the lido may relieve some of the pain and help  reset the mental.    Thanks again