Gee, does this mean I get an award or something?

[Sax-O-Trix]

First, let me send my sympathies to you.     I don't know how you have the guts to do what you do!

I am not on D yet, so I have only a creative imagination idea of what button holes are.  From what I have been reading in this post, a buttonhole is a hole that stays a hole in the skin (like a pierced ear) and for some reason doesn't hurt as much to use because the veins don't have nerves?  Is this a close explanation?  It seems that creating a "piercing" so to speak would be painful.  Is this a better alternative to being jabbed with a sharp needle?  Can you do "sharps" yourself at home or buttonhole "blunts" yourself without an assistant?  I live with minor aged children, so they wouldn't be of much help to me.

I ask these questions because I have been thinking that PD will be the way to go when the time comes, but maybe this "buttonhole" technique would be a viable option.  Can you travel with the machine?  Go camping etc.?  Are the outcomes better than in-center?

Oh, I also have a severe needle phobia, well I.V. needles anyway.  I can have blood drawn and not pass out or cry, but the damn I.V.'s are a problem (esp. when it takes 4-6 pokes/diggin around to get it started.)   And I assume the D needles are at least the guage of an  I.V. needle.

[Desert Dancer]

Since no one wants to stick themselves if they don't have to, I've decided to just do sticks on the off days only if I start having trouble cannulating on treatment nights. So far, so good - the one sharp stick I did seems to have done the trick.

Sax-O-Trix, the buttonhole technique is a method of cannulating your fistula and is independent of which machine you use for hemodialysis. (As far as machines go, I use a Fresenius Baby K and most definitely can NOT travel with it, but many people use the NXstage machine for just that reason.) It is the creation of a 'tunnel' into your fistula; here is a link that explains it better than I can:

http://www.fistulafirst.org/LinkClick.aspx?fileticket=aM7Q86GDN-w%3D&tabid=105

And as far as the dialysis needles being at least the gauge of an IV needle... yes.  At least. Here's a picture I sent to a friend to give her an idea; don't scroll down any more if you don't want to see needles. The one on the left is a sharp and the one on the right is a blunt:

[Sax-O-Trix]

Nice pic...  They look like nails (spikes actually!)  Thanks for the info.  Dialysis will definitely suck anyway it happens   

[Bruno]

DD, I was looking around today and I saw someone testing a shorter needle on the arterial access it was called a 3/5 which I think means it is 3/5 the size of a 1 inch needle. Apparently the idea is that a shorter needle might be better on the artererial. I was interested because I had my first run at nocturnal last night and ended up lying immobile because I kept getting low pressure arterial alarms which could only be the needle hitting the wall of the fistula.
Or do you think it was just one of those things that bring to back to reality every now and then?

[Desert Dancer]

bruno, I've heard of the shorter needles but I've never seen them. The way I solved my arterial pressure alarms was by 1) putting gauze under the wings of the needle, and 2) flipping the arterial needle 'upside down' once I had it in, so the backeye is on the top. I've never had a pressure alarm since.

[jg]

DD:
I have a similar problem. I got a fistula in March 2009 and started home nocturnal hemo training in May 2009. From the beginning I
had several needling problems including tunnel overgrowth. The dialysis is one blunt  15 gauge needle (with double pumps) six nights a week alternating
between my 2 buttonholes. A few times I have had to go back to the kidney clinic to have a nurse  use a sharp to break through the tunnel overgrowth.
They gave me a dozen SEMI-sharps to use if I can't get the blunt through and that has succeeded. I don't want to risk using a sharp.
I am in my early 50s and a fast healer. Also as my buttonholes mature and the surrounding scar tissue heals, there is less overgrowth.
My theory is my body wants to heal completely (its not in reality lol) and wants to fill in the tunnel. Hopefully when the surrounding area is
fully healed, it will leave the tunnel alone ( I live on hope   ).
Jeff

[Stoday]

The way I solved my arterial pressure alarms was by 1) putting gauze under the wings of the needle, and 2) flipping the arterial needle 'upside down' once I had it in, so the backeye is on the top. I've never had a pressure alarm since.

Is that right? Don't you cannulate with the bevel on top, which means that the black eye is on top when it goes in, not the red eye?