Does anyone here self-cannulate with sharps?

[kickingandscreaming]

Or is everyone using buttonholes?  Or a partner that uses sharps?

[cassandra]

To use button holes, you have to create button holes first. You do that by using sharps. You stick the sharps in the same hole, in the same angle for maybe 6 sessions or so. I was not allowed a Nxstage machine at home until I'd established button holes.

When you have buttonholes it's still occasionally necessary to use sharps to create a new buttonhole or to reopen one which annoyingly closed overnight.

[Simon Dog]

My clinic had me create my own buttonholes, and trained me on how to do sharp canulation.   When the buttonholes were new there were some days I just could not get them to work (this was after the "sharp phase" of creating them).   When I did that, the fear of not getting a treatment overcame the fear of the sharps and I successfully sharped on a few occasions.

Vanessa Evans (NxStage home hemo evangelist) tells me she self canulates with sharps.

[kickingandscreaming]

Sticking sharp objects into one's body seems to run counter to EVERYTHING!  And seems like such an abnormal thing to be asked to do.  I just can't imagine it and consider you HHD folks a true breed apart.

[Charlie B53]

I need more informatio n to understand this clearly.  As a Retired Mechanic I have to break things down to the individual parts to see how they work together.   An 'access site' basically some form of 'hose' getting punctured by a sharp needle repeatedly in almost the 'exact' same position every time,  Do I have that part correct?

In my way of thinking, even with material that is available today this repeated punctures may leave a small 'opening' making it easier for the next insertion.     I'm OK with that.   The part that gets me is what keeps this 'hole' from leaking when the needle isn't there to block the opening?

Artificial materials are only so good.    I don't know of anything that seft-seals so well.

But then what do I know?  I'm just a 'Guy' and a mechanical wizard.   I didn't bother to finish my Bachelors, much less go after my Masters.

But I did end up staying at a Holiday Inn the other night in Columbia because of the ice.

[Cowdog]

Buttonholes can only be used if you have an AV Fistula, they cannot be used on an AV Graft so no artificial materials.
Link to Buttonhole info from the Kidney foundation.
https://www.kidney.org/atoz/content/buttonhole-technique

[cassandra]

I need more informatio n to understand this clearly.  As a Retired Mechanic I have to break things down to the individual parts to see how they work together.   An 'access site' basically some form of 'hose' getting punctured by a sharp needle repeatedly in almost the 'exact' same position every time,  Do I have that part correct?

In my way of thinking, even with material that is available today this repeated punctures may leave a small 'opening' making it easier for the next insertion.     I'm OK with that.   The part that gets me is what keeps this 'hole' from leaking when the needle isn't there to block the opening?

Artificial materials are only so good.    I don't know of anything that seft-seals so well.

But then what do I know?  I'm just a 'Guy' and a mechanical wizard.   I didn't bother to finish my Bachelors, much less go after my Masters.

But I did end up staying at a Holiday Inn the other night in Columbia because of the ice.

You got it completely right Charlie. The human body is completely amazing! After using the fistula either ladder (different place every time Charlie) or buttonhole (constant same site) the fistula heals itself (even in people with an illness) If not the exact same place at the exact same angel is used the fistula wall will become very weak in that spot. The fistula could than become a pseudo aneurysm in that spot, a sort of balloon, which will have to be surgically repaired.

The pressure in the fistula is very high. If not properly pressed upon after removing the needle the pressure will push the fistula outwards which will than become an aneurysm, which is a weaker spot in the fistula wall, which should than not be used anymore for needling.

But if the entrance site has the needle properly removed (in the same direction as it went in) and the pressure is not too much, and the needle is completely removed before pressing, the amazing body will heal nicely.

Sticking sharp objects into one's body seems to run counter to EVERYTHING!  And seems like such an abnormal thing to be asked to do.  I just can't imagine it and consider you HHD folks a true breed apart.

Thanx KaS but I find everything concerning dialysis abnormal, as I find it abnormal to be alive in the first place. But sometimes people are prepared to do amazing things just to stay alive.

[justagirl2325]

My hubby has only self cannulated a couple of times (bad eyesight) but always with blunts in the buttonholes.

I do the needles.  Mostly blunts, unless like a previous posted said, one has miraculously "over healed" and the blunt won't push through. Our nurses say try once with a blunt and if you can't get it use a sharp.  But I have infiltrated him twice...you really have to be sure you're on the right track with sharps.

That being said, we have created our own buttonholes a couple of times.  When one starts acting up like it's clotted we move up on the track and use sharps in that spot about 8 times and voila, new buttonhole.

[Simon Dog]

In my way of thinking, even with material that is available today this repeated punctures may leave a small 'opening' making it easier for the next insertion.     I'm OK with that.   The part that gets me is what keeps this 'hole' from leaking when the needle isn't there to block the opening?

A channel of scar tissue forms.  It clots over, but does not heal enough to prevent re-use with a dull needle.  I find it is harder to start the blunts after a day off than it is if I dialyzed the previous day.   Think of it as a small artificial anus.

[kickingandscreaming]

I've been told that a buttonhole is similar to a pierced ear.  When it's used daily, it is easy to put the earring in.  If it lies fallow for a while then gunk can form in the hole.