Tell me about Lidocaine!

[Bajanne]

Had a bad experience today.  I was feeling so good about the use of my graft since on Monday everything went very well.   NOT TODAY!!!!!   The first needle went in fine.  Just a little pain and then there it was with the blood in the tube trobbing nicely.  The second needle just hurt like the dickens!!  I must have made an involuntary movement (at least, that is what she said) and MORE PAIN!!  I even cried like a baby.   It seems that it went right through.  She was probing and trying, but I couldn't stand it.  She took it out and said she would have to use another place.  But she gave me lidocaine before she did it.  I felt absolutely nothing and everything went fine.
Tell me, what are the pros and cons of lidocaine usage?  I am ready to do that every time, if it stops me hurting.
Epoman, I do not understand how you could possibly do your own needles!!    I can't even look when they are doing it.

[Epoman]

Had a bad experience today.  I was feeling so good about the use of my graft since on Monday everything went very well.   NOT TODAY!!!!!   The first needle went in fine.  Just a little pain and then there it was with the blood in the tube trobbing nicely.  The second needle just hurt like the dickens!!  I must have made an involuntary movement (at least, that is what she said) and MORE PAIN!!  I even cried like a baby.   It seems that it went right through.  She was probing and trying, but I couldn't stand it.  She took it out and said she would have to use another place.  But she gave me lidocaine before she did it.  I felt absolutely nothing and everything went fine.
Tell me, what are the pros and cons of lidocaine usage?  I am ready to do that every time, if it stops me hurting.
Epoman, I do not understand how you could possibly do your own needles!!    I can't even look when they are doing it.

Well I was scared at first sticking my own needles AND I have a fistula which is harder to stick than a graft. But anyway lidocaine works great however the medical community is split some say it's bad for the graft some say the benefits outweigh the risk. I personally never wanted to take that chance and when I had a graft I never used Lido. And also I have never used it with my fistula. I would say the best thing for you to do is take the pain now and get the area nice and dead. The area where you stick the needles will deaden and you will eventually have very little if any pain at all. I have seen patients ALWAYS use lido and their graft is fine, so it is up to you. Or you can just use lido for a little while, say the first few months and slowly wing yourself off of it.

The pain involved with needle sticks is determined by many factors one being how sharp the damn needle is, I have had some really dull needles another is the skill of the tech/nurse, another is your own tolerance of pain and of course how fast the needle insertion lasts. If you have a tech/nurses who is sticking the needle in slow then the pain will last longer. I have seen techs/nurses put a needle in in about 1 second. Yes that's right about 1 second and usually those were the talented ones. The longer you are at your center you will know which techs are the best stickers and which techs to avoid. Unfortunately some centers are really small so you may not have a choice that is when I recommend you learn to stick yourself.   

Also in the future DO NOT let the tech dig around for too long if they don't get it right away have them pull it out and try a new spot. By them digging around too much they may clog the needle with tissue and will have stick you in a new spot anyway. Believe it or not you are the boss, remember it is your arm not theirs.

[hurlock1]

Well, I use EMLA CREAM. you have to put it on at least an hour before dialysis. then you have to cover it with plastic. Most people use Saran wrap type stuff. I'm alone in the morning and I can't wrap my upper right arm one handed with my left hand. I use plastic bags that I cut into strips, and put strips of tape on the sides. and put that on there, where my fistula is. I don't know  why, but sometimes the emla cream doesn't do the trick. Some times it numbs my access really well. I've heard that continued use of lidocaine toughens the vien and creates problems. They are using 14s on me, from what I undersand 14s are the larger size needles and the larger the number, 15, 16, the smaller the needle.

[peleroja]

Ah, good old Lidocaine, what my friend used to refer to as "chicken juice."  In the past I've used Topicaine when I was going to get my blood drawn, until I found an exceptional phlebotomist and the terror was gone.  You can get Topicaine with 5% Lidocaine.  I think the techs don't like using Lidocaine cuz (1) it costs them money, and (2) allegedly it hardens the skin over time and makes it difficult/impossible to put the needles in. 

[jbeany]

Yes, the lido can cause skin problems.  Personally, I hate the sensation, and I'd rather just get stuck with the regular needles.  I have to argue with the nurses in pre-op every time I go for a procedure - they always grab for the lido immediately when they are starting an IV.

I followed Epoman's advice my first day of dialysis, and tried it without the lido.  I haven't used it yet, not even when sticking my own needles.

[Bajanne]

I have come a long way since those early days.  I did use the Lidocaine for a while, but after a time I decided to stop.  The liidocaine stick used to sting!!
I only used it again for a while when my newest graft was healing and the spot they were using was particularly painful.
Now back to the rough stuff!!

[Lucinda]

I'm a pussy.  I use lidocaine.  When I was learning to do my own needles the cannulas just looked a little too threatening for my liking.  The little fine needle - although it does sting a bit - was a good starting point.  I probably let it go eventually - but not just yet!!

[twirl]

I do not use the lidocaine shot - the techs say it is 4 needles instead of two
- I thought the shot burned -
I use the cream and I rarely feel any pain -
if I do - it is nothing like going without the cream

[kitkatz]

Never used lidocaine on the access grafts I have had.  Why have four needles when you can just have two?

[swramsay]

Well, I use EMLA CREAM. you have to put it on at least an hour before dialysis. then you have to cover it with plastic. Most people use Saran wrap type stuff. I'm alone in the morning and I can't wrap my upper right arm one handed with my left hand. I use plastic bags that I cut into strips, and put strips of tape on the sides. and put that on there, where my fistula is. I don't know  why, but sometimes the emla cream doesn't do the trick. Some times it numbs my access really well. I've heard that continued use of lidocaine toughens the vien and creates problems. They are using 14s on me, from what I undersand 14s are the larger size needles and the larger the number, 15, 16, the smaller the needle.

I found I don't need to do all the saran wrap or tagaderm to cover the cream. I put just a little dap of the cream on each buttonhole spot and I simply cover that with a little 2" piece of scotch tape or two! That's it. Works just fine. I also found out I don't need an hour. 20 - 30 minutes is enough.