buttonhole Cannulation

[bioya]

Is anyone using the buttonhole technique? If so, how is it going? Do you like it better? Are you self cannulating? Just curious how it is going in the clinics that are using it.

[kitkatz]

http://ihatedialysis.com/forum/index.php?topic=1545.0

Go look here for more information on buttohole technique.  You can use the search feature to find what you want to ask a question about, too.





kitkatz,moderator

[mark j]

I use buttonhole cannulation for my NxStage.  I nver have a problem with my arterial access, but hat doang venous gives me the hardest time.   Im 10-15 minutes trying to get the needle in, the whole time worrying that its taking too long and my arterial is going to clot.  I think alot of it has to do with the arm angle, and when I do get it,I try to remember my exact position

[bioya]

Thanks. i was curious what the outcomes have been. We were just starting it when I left dialysis. From the presentation that I received on it, it did not sound too bad. good luck!

[Sara]

I had Joe ask his center about it, but they either didn't know what he was talking about, or told him it was a bad idea.   

[glitter]

I had Joe ask his center about it, but they either didn't know what he was talking about, or told him it was a bad idea.   

Thats what Jacks center said too- I had to insist they research it- now they will not let him try it until a vascular surgeon signs off on it. The first one who made his fistula said no- he didn't know anything about it....he is to see a new one next week, hopefully this guy will have heard of it.

[Black]

Mike's buttonholes were started the very first day of dialysis on 2/5/07.  He has never used any other site on his fistula.  Unfortunately the arterial site is very near a very sensitive nerve and so is still more painful than it should be, (but it is still improving) and the pathway seems to close up more than the venous, which is almost pain free.

We have not used a tourniquet since the first week at home, his fourth week of dialysis.  It takes the venous about 6 minutes to clot, and the arterial about 8 minutes.

I attribute his good results to several things but primarily to the surgeon  who did the revision  a couple of months before he started dialysis.  The second most important thing was his months of using the squeeze ball to enlarge his veins.  He said there were some days he probably exceeded 600 repetitions on the ball - he wore out the first one and the second one was just about shot.   The third thing which helped, is that he had his original fistula done almost exactly a year before he started dialysis, which allowed plenty of time for the blood flow to expand the vein.

Here are a couple of sites with good information which you can print out and take to your nephrologist and to the dialysis center.

http://www.fistulafirst.org/tools.htm

Scroll to section 8 on cannulation (entire fistulafirst site is great source iof information)
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http://www.homedialysis.org/learn/buttonhole.php

Detailed instructions and graphics, and an 800 number for ordering a video
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I'm not surprised there is still ignorance.  It took many, many months to find a clinic (200 miles away) with a NxStage program and using the buttonhole cannulation technique.  Most people in the centers we visited didn't know what a buttonhole was and I had a nurse at one center tell me that it could not be done without destroying the fistula.  When I told her there are people who have been using the same buttonholes for over 20 years, she didn't believe me.    Thank God for on-line information!!!!  (Thanks Epoman.)

[Amanda From OZ]

I use buttonhole cannulation for my NxStage.  I nver have a problem with my arterial access, but hat doang venous gives me the hardest time.   Im 10-15 minutes trying to get the needle in, the whole time worrying that its taking too long and my arterial is going to clot.  I think alot of it has to do with the arm angle, and when I do get it,I try to remember my exact position

mark you seem to have the same poblem i do!! it takes me so long to get the blunt neddle in, i usally just give up and go to the sharps....   

[charee]

At my training centre in Sydney(Australia) buttonhole has been done for 3 years with outstanding results, the very first person there to do it 3 years ago is still using the same holes and has had no problems with blowing the fistula or any other problems. Mine are 6 weeks old and finally going good, had a few problems in the beginning finding the right spot that didn't hit a nerve also i had alot of pain with the sharp needle but once i went on to blunts the pains not as bad , I'm still having difficulty doing it myself but i will keep trying my hubby can do it no worries. I think its worth trying to find somewhere that will do it,but then again i have never done it the other way !

[jonn r]

hey everyone i use the buttonhole and i love it....that way i dont look like a herion junkie

[Fierceheart]

I have button holes and both had to be redone, the artiaral one was to painful and venus to much trouble getting in. I do home hemo and dont use a tourniquic I use my finger. 

[petey]

We've been using buttonholes since we started home hemo (July 2007), and Marvin LOVES buttonholes.  I cannulate (because Marvin still won't look when a needle goes in him -- even after 13 years on dialysis), and I usually have no problems getting the blunt ones in.  When I do, I switch to a sharp and it slides right in.  Also, his fistula was over two years old when we established the buttonholes, so it had been stuck plenty of times with sharps (ladder method) before we started the buttonholes.  I've read that buttonholes will make a fistula last longer (and, this is so funny because when Marvin first started dialysis in 1995, sticking in the same place even two treatments in a row was a BIG "no no" -- my, how things change).

[terry3004]

When I started with my fistula, I immediately had them start making buttonholes.  I knew that I was wanting to go on NxStage, so I had my center start the buttonholes for me.  They normally don't do buttonholes, but will if you ask them to.

Now, I am doing it myself and the needles just slide right it...it is wonderful!!   

It's especially great if you don't like being stuck with needles (like me)