I use to LOVE dialysis.

[BigDadii]

Seven month ago, when I first started treatment... it made me feel so much better I could hardly believe it.So for six months I enjoyed going three days a week and going to work afterward. Then they started pushing me to get the fistula put in my arm. I had already had one failed attempt on my left arm. (I blame the surgeon for that) So I had it put in. After they (Davita) found out that the surgery went fine they pushed to use it. Recently I allowed them(the nurses) the use the access. The first time I couldn't believe the pain the went through my arm, and that was only the 14 gauge needle. Thank God they only used one needle and my catheter. Now they've gone up to a 15 gauge needle and they tried to use two needles. They dig with the upper(I don't know the name of the vein)needle but can't find the vein. So much pain. Using that second needle has caused my  arm to become hard and sore. Mostly b/it leaked. They are just using one and one at this time.

I've come here to ask how do you deal with the pain. I've tried this cream but it's not stopping the pain. I know that there are people that have been doing and dealing with this for years. Please expound your knowledge and help me with the pain.

Thank you

[goofynina]

BigDadii?  are you talking about the pain when they first insert the needle?  or do you have pain while you are dialyzing?  or do you have pain after they remove the needles and you go home?   I used lidocaine each and every time and then i got benadryl that knocked me out so i really didnt feel any pain during, there were some times when i didnt get benadryl and stayed awake and i dont remember being in any pain while i was dialyzing.   Ohhh but trust me,  that injection of lidocaine hurts just as much (if not more so i have been told)  it just gives a burning sensation while they are injecting it, but i was so scared of them big ol' hollow daggers they called needles that i just couldnt work up the courage to get poked without the lidocaine (big ol' baby that i am)   I am currently doing PD and enjoying it while it lasts but i know i will probably end up in hemo someday again    Good luck to you and please keep us posted 

[Adam_W]

Well, for one thing you're staff needs to be patient with using the access. A fistula usually takes four to six months to mature. It also sounds like the nurses/techs aren't as careful as they could be. Maybe learning how to stick yourself might be a good idea. I do home hemo, so I put in my own needles. Once I learned how to do that, I won't let any tech or nurse touch my graft if I can avoid it. As for the pain, I've had good success with EMLA, even though I just stopped using it, because once I've gotten used to using the graft and sticking myself, I've realized it doesn't really hurt that much. Hope this helps.

Adam

[boxman55]

if your arm gets hard around the injection site you are being infiltrated that in my opinion is causing most of the pain. also the gauge needles are usually, first is 17gauge then 16 then 15 the higher the number the smaller (if you want to call any of those small) the needle. Infiltration has happened to me and they have to stop the pull asap or you feel major pain and your arm swells up best thing to do is first put cold pack on it then heat after that.  Boxman..

[pdpatty]

OMG,I get an acces put in on the 23rd of this month. Reading all this,OMG,I can't take much pain. I wondered how much it hurts,the people with fistulas at my center don't seem to be in a great deal of pain when they are hooked up. I should ask some of them what they do to ease the pain of the needles.(Never heard any screams,yet)

[st789]

 

[Bajanne]

When I moved from catheter to my graft, I used to take lidocaine.  But two things made me stop - 1. the lidocaine itself gave a real sting as the medication went in.  2.  the nurses said that lidocaine tended to harden the skin.
So I decided to stop with the lidocaine.  I just grit my teeth very hard and hold onto my pillow.  The pain usually stops right away as the needle goes right in, and there is no more pain (until when they are taking the needle out, but some nurses get it out with no pain at all).
My philosophy is that it is only for a minute or two.  So I bear it.

[RichardMEL]

I generally feel no pain after the needles are in. Maybe for a minute or so after they are in (specially when they wash in the saline and the cold saline translates to a sting for some reason or other) usually it settles down real quick after the needle goes in (and that's if I feel pain when they go in which is about 40-50% of the time). Sure, I can feel the pressure of the needles being there, but in general I don't feel anything.

So if there's pain DURING dialysis you really should be telling the staff about it because that's not normal in my opinion.

[fluffy]

Im not sure if i got infiltrated. all i know is that theres a gigantic bruise on my bicep and it hurts alot. im currently dreading going to treatment tomorrow cause i know they're gonna have to stick needles in my gigantic bruise  F***

[thegrammalady]

did the surgeon say it was ok to use the fistula or did divata just push to use it and you gave in. the center doesn't get to make those kind of decisions, no matter what they say. if you are having pain during dialysis, something is wrong, go see your doctor. if the pain is only during insertion and you don't want lidocain injections, try lidocain cream, it doesn't completely eliminate the pain but does make it tolerable. never, ever let the techs or nurses at the center make decisions, always consult your doctors first. remember it's your life, they need to do it your way or they don't need to do it at all.

[AlasdairUK]

I'm not sure if i got infiltrated. all i know is that theres a gigantic bruise on my bicep and it hurts alto. I'm currently dreading going to treatment tomorrow cause i know they're gonna have to stick needles in my gigantic bruise F***

If you have bruising on your arm, it normally means you have had an infiltrate. While it is not the end of the world and new fistulas often "blow". This helps to make them stronger. As Adam mentioned above that you need to make sure your fistula has matured before you at art using it for dialysis and you need to exercise your fistula to make it stronger. I would start with the 17 gauger needles also known as pediatric needles as they are the smallest and work your way up to the bigger needles with a faster pump speed.

I only feel pain with the needles going in and that only lasts half a minute at the most. You should not feel pain with the needle coming out, if you do it is when they scrape the needle along the inside of your fistula. This is often done with the nurse applying pressure with gauze before the needle has been pulled out as they are worried about blood squirting out your fistula so they press down to soon.

[mmmmdeedee]

Great advice everyone. But everyone is right that your doctor should be calling the shots with your direct input. I have learned that communication is so key when dealing with health issues. To them, sometimes, we are just a file folder in their stack of files.

I also used lidocaine each and everytime. Yes, it stung but it was better than the needle in my case. I had to use huge needles as I could not handle the higher speed. This stuff is so individualistic.

Good luck BD.

[Rerun]

Do you know the difference between a "fistula" and a "graft"?  There is a difference so make sure you know what you have.  A graft can be used much sooner than a fistula. 

Those 14 gage needles are HUGE.  I won't use them.  My gosh just get a hose and siphen the blood!  I agree with everyone else, start with a 16 and go to a 15 and STOP!  The bigger the number the smaller the needle.  Makes as much sense as any other medical procedure!!

[kidney4traci]

BD,

I had a hard transition to my fistula at first too.  I too used the cream - try wrapping up your site with plastic wrap after you apply the cream, and do it about an hour before you go in for treatment.  The cream is better, as someone mentioned, my nurse said repeated lid. sticks will toughen your skin.  I used to wait for this one nurse to stick me because he was good and fast and therefore less pain.  Infiltration sucks plain and simple, but be encouraged as it does get easier.  I stick myself now at home and it is better than those nurses. 

[fluffy]

I'm not sure what size the needles are the nurse ignored me when i asked about it, the needle has orange plastic "wings" on it tho.

[kidney4traci]

Fluffy - That makes me soooooo mad!  I hate it when they ignore you.  $&*(@#)*!!  You can look at the package if they leave it out to prep before you get there.  It will say the gage.  I don't remember the orange one, mine is blue and it is a 15.  I thought I remembered a green one too.  Be assertive!!!  They are there for YOU!

[fluffy]

i saw the green ones today, the nurse was gonna use it but she didnt, Maybe i should get mad too  problem is im pretty passive i usually get mad thinking about it later on and im like WTF? at the time im just grateful they're done with the needles

[Adam_W]

The green ones are 16 gauge, which is what I use. Orange is 17 gauge.

Adam

[fluffy]

thanx man. I guess they're keeping me on the wuss needles then...i like it that way, the less pain the better

[BigDadii]

did the surgeon say it was ok to use the fistula try lidocain cream, it doesn't completely eliminate the pain but does make it tolerable. never, ever let the techs or nurses at the center make decisions, always consult your doctors first. remember it's your life, they need to do it your way or they don't need to do it at all.

Thank you for confirming what I thought. I think I am using the lidocain cream. I wasn't sure if it was working. You are right though. It doesn't numb the area but does make the pain less. Today they used two needles and it wasn't all that bad. Yes the surgeon did give permission to use the access.Thanks again.







EDITED: fixed quote tag error- kitkatz,moderator

[BigDadii]

Good luck to you and please keep us posted 

Thank you for replying. I had thought about PD but was told I was not a good candidate for it. Plus I had a friend die from an infection while using PD. Well back to the pain...I'm using a cream which I think is lidocain cream and it lessens the pain alot. Today they used two needles and it wasn't bad.

Thanks for your reply


EDITED: Fixed quote tag error - okarol, Moderator

[BigDadii]

I didn't realize that replying meant I wasn't replying to any one person. My Bad Thank you all for answering my question. As I said earlier I'm using the Lidocain cream and it is making the pain easier to deal with. I am not having pain during, the nurse educated me about infiltration. My tricep is still kind of hard but I can move my arm can move better and the soreness has gone away. Today they used two 15 gauge needles and it wasn't that bad. Thank you all again for your advice. I like this web site.I will probably keep coming back to help others as you have helped me.

  

[Jaybird]

I got a fistula prior to doing dialysis. Anyway, I got my first dialysis treatment in a hospital and they screwed the pooch with it. They tried too big of needles and too much flow rate.. I infiltrated quick!

However, 1 week later I went in for my first clinic treatment. We used a 17 guage and I had no problem. It still HURT like hell when they put it in though. But that might be because my arm was black and blue from the infiltration at the hospital.

Anyway, I started my buttonhole at that clinic and the More i used that same hole the less it hurt. About 2 weeks after goin to clinic i started stickin myself! When I stick myself in the buttonhole access, I feel minimal pain. I am using the same buttonholes a year later. Hardly anypain at all.

My advice is to start a buttonhole with small needles and work your way up. Also, when you learn to stick yourself, you dont have to rely on some stranger to hurt you, you can hurt yourself  .

Jaybird

[BigDadii]

I don't know what a buttonhole is an never heard of it before. Also, I've never seen anyone at my clinic that sticks themselves.I hated sticking myself when my internalist had me on insulin. I think I'd rather have a nurse or nurse's aid stick me. Then I have some one I can be mad with.

[Jaybird]

You should research the buttonhole! Please do. It will cut down on track marks on your arm, and leave you with two little marks. Also I hated the idea of sticking myself too! I dreaded it until I did it for about 2 weeks, then I realized its not so bad. Plus the buttonholes is like a bullseye to stick everytime, gives you somewhere to focus on. Just look it up a lil, i"m sure theres lotsa posts about it on this site too.

Jaybird