Self Cannulation

[G-Ma]

Help Please......I was doing ok during training and first week home and this week has been terrible...I am for some reason not finding the vein..it rolls so much I either go past it or too close to the vein and very high pressure.  This is with someone else holding the vein as I can't hold and stick at the same time and I'm using a tournequit too.  Does anyone have any suggestions that I might be able to try?  I know a lot of you have been doing self c for a long time and I am close to giving up.   

[Jay72]

Sorry to hear you are having trouble.  I have a big problem with my vein rolling too but I just have to take my time and it works, other times I feel like I am going to push the damn needle through the back of my arm.  So what I find help is to heat a saline bottle in the microwave for a couple of minute and hold it on your arm for about 5 minutes before you stick.  Hope this may help you and good luch.

[Meinuk]

G-ma,

I am so sorry that you have had such a difficult time of this.  I've been following your posts but haven't had a lot of time to reply.

Have you watched Bill's Cannulation video? http://www.billpeckham.com/from_the_sharp_end_of_the/2007/12/cannulation-vid.html I'm not sure where your fistula is, but he has a lower right fistula, so the video might be a little help.

Are you using blunts or sharps?

I actually don't use a tourniquet, and I have an up arm left fistula.  I stabilize with my cannulation hand. (I hold my needle like a pencil, and splay my fingers to over my fistula, and then slowly insert the sharp into the arterial buttonhole. - yes, although I have buttonholes, I still have to use sharps in my arterial)

I don't have a rolling vein, but I do have a pretty twisted fistula and had a lot of trouble when I was in center.  What worked for me was really trying to visualize the fistula, I could feel the edges fo the vein, and I aimed for the needle to go right in the middle of it.  I also advance very slowly.  There is very little pain, and after a deep breath, and settling my thoughts, cannulation always seems to go smoother.

I have noticed that things can get overwhelming for me very fast in all of this things just seem to snowball.  And it helps to just take a step back and get some perspective.  When I first sit down in my chair, I run though a short mental check list: door, lights, phone, water, remote - once everything is in place, then I move on to the next step.

You should always be able to take a break as well, leave your equipment in place, and go in center for a few runs, and try self cannulating in there.  You should not have to quit so fast.  Ease yourself into all of this.  If your unit is not cooperating in all of this, then, they are not putting you the patient first.

Self Dialysis really is practice, practice, practice - don't stress yourself out, we have ALL had those moments.  I just want you to be healthy and happy.  You have put a lot of effort into home dialysis, and if it works, great, and if not, then you know that you gave it your best effort.  But remember, you are still in early days of home hemo.  It does get easier.  As long as your fistula cooperates.

[twirl]

you are sticking yourself
I could never do that
you are brave beyond your years

[Jay72]

Twril... One you learn to needle yourself you will never and I mean never want anyone else to do it.  And it is nowhere near as bad as it seems.

[flip]

We used to have a tech who only had one arm. He would stick with two fingers while using his thumb to hold the vein. It sounds wild but he was really good at it.

Have you tried using a clamp to hold it?

[G-Ma]

Thanks so much for your support....my dau in law stuck me at 5 today and run was good except excrutiating cramps which I have not had since in center and we did everything by the book..so filled me with saline (I felt) and ok now..my bp didn't even go down..go figure.
flip: I would like to try a clamp, however I can't find one and Davita would not give me one...they say NO.
Jay: yes you are right, it is not as bad as it seems.
Twirl:  yes you can do it, especially with everyone behind you.
Meinuk:  Thank you so much for all the information.  Yes, today I read through everything I could find.  I am left handed and my fistula is on my left upper arm but I will try what you said.
Jay:  Thanks and yes I have stuck my needle out the other side...not a pretty picture.
I will watch Bill's video again and try to get a grip.
Thanks again.     Tomorrow morning is my next shot at it.
Ann

[twirl]

good luck

[flip]

PM me and I'll send you one. The nurses give them to me.

[twirl]

I could never stick myself b/c I would have to close my eyes

[Ang]

Twril... One you learn to needle yourself you will never and I mean never want anyone else to do it.  And it is nowhere near as bad as it seems.

its  not  for  everybody,  but  more  power  to  you  if  you  can


i  did  it  once  but  got  lazy,cause  my  fistula  has  got  more  turns  than  an  indy  race

[petey]

I could never stick myself b/c I would have to close my eyes

Twirl, you must be kin to my Marvin!  He still closes his eyes and turns his head every single time -- and he's been on hemodialysis for almost 14 years!  He could never, never, never be as brave as G-ma and all the others who do self-cannulation (I tell him I just keep him around because he's so damn good-looking  ).  Home hemo works for us because I'm the sticker!

Hang in there, G-ma!  You can do it!

[del]

I do most of the needling . Hubby can needle himself and does sometimes. Always watches to make sure I am doing it right    Much easier to self cannulate if you have button holes.

[G-Ma]

I guess I need to find a "sticker"....is there a sticker for rent site?? or match.com for stickers??.....sticker harmony??? I'm not sure how my friend would take this idea...but he doesn't want to stick me..he closes his eyes....I just have no clue.   

[flip]

It ain't no big deal...get the right angle and a good flash.

[twirl]

good flash ---- is that a container for liqour and do you need one for Christmas

or is it some light on sticking yourself which I could never do b/c I will not look at the needles
and do you hurt yourself when sticking

[monrein]

The flash is the blood coming back into the tubing attached to the needle.  A good flash and you know you're in.

[G-Ma]

News Flash... another flash type...
I got right into arterial today and could not find venous, dug 3 diff times, searched inside the 3 diff places and no venous...it was deep, barely able to feel...will try tomorrow, then go to clinic and see what's wrong...will need to dialize somehow tomorrow..hopefully it will be back from vacation....I couldn't have paid it to come back...

[monrein]

Hot Flash... another flash type.

Bummer about your venous today G-Ma.  Do they ever let you use single needle at home for times like today?

[willieandwinnie]

  Oh G-Ma, I'm so sorry, I hope they get it fixed tomorrow. 

[G-Ma]

monrein...interesting...what is single needle???
Ann

[monrein]

It pulls and returns blood through the same needle which results in lower clearances obviously, especially for shorter dialysis times but it's better than nothing.  Here's a link from
Toronto's home hemo program. 


http://www.renalweb.com/guest/lit/mwilliams/FAQs.htm

[G-Ma]

Thank you monrein..very interesting.  I am going to check on this...I wonder if I could have some on hand and be able to reset the cycler for a longer time and use when I can't get more than one access...hmmm.

[Jay72]

Single needle is usually used for nocturnal patients... you also run at a much slower pump speed...150 instead of 450.

[willieandwinnie]

It pulls and returns blood through the same needle which results in lower clearances obviously, especially for shorter dialysis times but it's better than nothing.  Here's a link from
Toronto's home hemo program. 

http://www.renalweb.com/guest/lit/mwilliams/FAQs.htm

Very interesting monrein. Thanks for posting that.