Wow thank you Epoman!! I really wanted to see all this :) Now I will feel better prepared for when I learn this :D as it is available in my city :) I have not been set up to learn it as my fistula still is maturing but I already was able to talk to the head nurse finally ;) so hopefully it will be soon if my fistula doesn't blow anymore! When I watched the one guy doing the buttonhole technique I saw one time he had to go back to the sharp because one hole wasn't working. But I watched as he picked off the scab. Doesn't it bleed like crazy when you do that? Well, I will read the PDF :) Thank you Epoman!
If you are using local with the buttonholes it can bleed. Just apply a bit of pressure with some gauze until it stops. If you cannulate without stopping the bleeding, it continues to bleed and creates a very nice moist blood clot, which encourages bacterial growth. I am only saying this because this does happen, but not to everyone. Not everyone continues with local once buttonholes are developed. I still do, as I still get some pain, and it makes it much easier to cannulate.
I can't wait til they start doing buttonhole on me because they seem to make my fistula blow with the sharps :(
Oh I never blow while running. It was always upon cannulation.I can't wait til they start doing buttonhole on me because they seem to make my fistula blow with the sharps :(
How long are they able to run before "blowing"?
OMG I am at least a bit happier now!! I toughed it out and didnt use local on either buttonholes. Arterial hurt a bit, but Im prepared to put up with it. WOOOHOOOO no more local!!!Congrats :) How long did it take to learn Buttonhole anyway? They still are not teaching me :(
OMG I am at least a bit happier now!! I toughed it out and didnt use local on either buttonholes. Arterial hurt a bit, but Im prepared to put up with it. WOOOHOOOO no more local!!!
OMG I am at least a bit happier now!! I toughed it out and didnt use local on either buttonholes. Arterial hurt a bit, but Im prepared to put up with it. WOOOHOOOO no more local!!!
Congratulations! :) Now if you just learn to stick yourself, you will eventually have no pain. :)
Angie, I started doing buttonholes from the very beginning, about 18 months ago. So it only took as long as it takes to get the courage up to cannulate yourself. The nurses guide you all the way, and once you've found a good spot, you are pretty much set. Then its just a matter of practice makes perfect.
OMG I am at least a bit happier now!! I toughed it out and didnt use local on either buttonholes. Arterial hurt a bit, but Im prepared to put up with it. WOOOHOOOO no more local!!!
Congratulations! :) Now if you just learn to stick yourself, you will eventually have no pain. :)
Stick myself? What?
Angie, I started doing buttonholes from the very beginning, about 18 months ago. So it only took as long as it takes to get the courage up to cannulate yourself. The nurses guide you all the way, and once youve found a good spot, you are pretty much set. Then its just a matter of practice makes perfect.
it is because the head nurse that does it is only on the morning shift. I have only seen her once or twice on my shift but only because someone called in sick and she had to pull a 12-hr day.
Ya but with all the trouble they've already been having with my fistula I don't think I really trust them to start something new on me they just learned from the head n :-[urseit is because the head nurse that does it is only on the morning shift. I have only seen her once or twice on my shift but only because someone called in sick and she had to pull a 12-hr day.
Well that just sux!!! Theres no reason why she couldnt train the other nurses to do it. Its not hard!
Wow! I am getting more and more scared of travelling but now that my fistula finally has stopped blowing (they fixed it with the last fistulogram) I am getting ready to go to mornings to have the buttonhole taught to me. I am still scared to stick myself but as soon as the catheter comes out I can finally learn (I hope!)
Wow! I am getting more and more scared of travelling but now that my fistula finally has stopped blowing (they fixed it with the last fistulogram) I am getting ready to go to mornings to have the buttonhole taught to me. I am still scared to stick myself but as soon as the catheter comes out I can finally learn (I hope!)
I've been telling you for months Angie, after you learn to stick yourself you will never let anyone stick you again. :)
Great guide Epo! :)
Amber, Angie et al,
It is important to let only have one person develop buttonhole sites. It does sometimes pose some scheduling concerns, because that means the same person always needs to be available to stick you, at least for a few weeks.
This is why you should begin sticking yourself with sharps, and be the only one to stick yourself while developing the buttonholes.
You are the only person who will consistently be there.
What happens when you travel down state-side and dialyze at a clinic who's never heard of it? They typically associate buttonhole with "lifesites" and will sometimes not let you dialyze there. I've run into this multiple times in California.
The trick I found was to simply tell them I stick myself, and that I bring my own supplies (don't even mention buttonhole). Then take your own needles with you (ship them ahead of time or put in checked baggage obviously) and stick yourself.
Otherwise your buttonholes won't get used, and you'll have someone with God knows how much experience sticking your fistula with a sharp.
Not a good place to be in my not-so-humble opinion.
My $.02 (worth much less when adjusted for inflation) <G>
Have you thought more about doing it yourself angie?How would I learn to do it myself? I need to be taught first! I don't want to just experiement on myself :'( :-\ :-[
I am really scared to learn and I think the nurses are scared to teach us.
Hey epo, did you really need to caps the "sharp"? We're trying not to scare the poor girl lol
The nurse I had said that my fistula is so hard and rolls. Well that sounds to me just like my veins normally as when they are poked with needles a lot they get hard.
Angie. You take charge. You call and cancel the catheter removal. You tell them "I'm taking charge of my health care like everyone is telling me to do and I do not feel comfortable taking out the catheter until my fistula works for 2 months without a problem". If you don't have an infection then leave it in. OR you will be putting it right back in. You can run out of catheter sites too ya know.VERy good advice! Thanks Rerun!! :2thumbsup; :2thumbsup; I will be calling my Neph direct Monday before I go to dialysis! Thanks!
Also, you can bargen with them. Tell them when you learn button hole you will get your catheter out.
The tourniquet is always used. And the nurse on Friday did stabilize it between 2 fingers but still it blew twice (goose egg). Had to use my catheter. Which is why I am going to call the Neph. I asked the nurse and she said "it might just be a fluke" but what would she have done if I didn't have my catheter? She said they would just put one back in if they really needed to. Well I kinda want to prevent the hassle!! >:(The nurse I had said that my fistula is so hard and rolls. Well that sounds to me just like my veins normally as when they are poked with needles a lot they get hard.
Veins that roll are not anything out of the ordinary. They should stabilize the vein between two fingers before they stick it. That is SOP (Standard Operating Procedure). Maybe a tourniquet should be used too. I use it above my venous site and never a miss. Just remember to remove it after the stick ... or the vein might just clot.
Angie. You take charge. You call and cancel the catheter removal. You tell them "I'm taking charge of my health care like everyone is telling me to do and I do not feel comfortable taking out the catheter until my fistula works for 2 months without a problem". If you don't have an infection then leave it in. OR you will be putting it right back in. You can run out of catheter sites too ya know.VERy good advice! Thanks Rerun!! :2thumbsup; :2thumbsup; I will be calling my Neph direct Monday before I go to dialysis! Thanks!
Also, you can bargen with them. Tell them when you learn button hole you will get your catheter out.The tourniquet is always used. And the nurse on Friday did stabilize it between 2 fingers but still it blew twice (goose egg). Had to use my catheter. Which is why I am going to call the Neph. I asked the nurse and she said "it might just be a fluke" but what would she have done if I didn't have my catheter? She said they would just put one back in if they really needed to. Well I kinda want to prevent the hassle!! >:(The nurse I had said that my fistula is so hard and rolls. Well that sounds to me just like my veins normally as when they are poked with needles a lot they get hard.
Veins that roll are not anything out of the ordinary. They should stabilize the vein between two fingers before they stick it. That is SOP (Standard Operating Procedure). Maybe a tourniquet should be used too. I use it above my venous site and never a miss. Just remember to remove it after the stick ... or the vein might just clot.
And I really feel they should take me seriously about the Buttonhole and not keep putting me off since my fistula is not going to be as easy to poke in the long run with how I develop scar tissue ... I really feel they do not take me seriously at all because of my young age :-[
Did you know that the buttonhole method was developed by accident?
Well it doesn't seem like anyone listens to me but I have finally gotten ahold of the new social worker who seems MIA. They have scheduled me for the catheter removal this Tuesday and have told me they "think" there is no opening for me to learn buttonhole .. so now I have gotten the new social worker involved saying how I feel like I don't matter and I want answers and don't want my catheter removed yet. I will see what will develop from this in this short of time. They keep telling me, "if you need it in again it is not hard to get it back in". Ya but what if I am at dialysis, need dialysis, and they need to use the catheter but it is out? Sometimes I wonder where their brains are!
I think she is also going to look into the buttonhole scheduling for me.
Well it doesn't seem like anyone listens to me but I have finally gotten ahold of the new social worker who seems MIA. They have scheduled me for the catheter removal this Tuesday and have told me they "think" there is no opening for me to learn buttonhole .. so now I have gotten the new social worker involved saying how I feel like I don't matter and I want answers and don't want my catheter removed yet. I will see what will develop from this in this short of time. They keep telling me, "if you need it in again it is not hard to get it back in". Ya but what if I am at dialysis, need dialysis, and they need to use the catheter but it is out? Sometimes I wonder where their brains are!
I think she is also going to look into the buttonhole scheduling for me.
Everything you need to know to start a buttonhole on your own.
http://www.homedialysis.org/v1/types/buttonhole.shtml
haha I found that site 2 days ago and put it on my own forums ;) lolWell it doesn't seem like anyone listens to me but I have finally gotten ahold of the new social worker who seems MIA. They have scheduled me for the catheter removal this Tuesday and have told me they "think" there is no opening for me to learn buttonhole .. so now I have gotten the new social worker involved saying how I feel like I don't matter and I want answers and don't want my catheter removed yet. I will see what will develop from this in this short of time. They keep telling me, "if you need it in again it is not hard to get it back in". Ya but what if I am at dialysis, need dialysis, and they need to use the catheter but it is out? Sometimes I wonder where their brains are!
I think she is also going to look into the buttonhole scheduling for me.
Everything you need to know to start a buttonhole on your own.
http://www.homedialysis.org/v1/types/buttonhole.shtml
Yeah she can start the buttonhole using sharps, but what happens when she needs the "Blunt" needles and they do not order them for her? :( She needs to RAISE HELL bottomline. DEMAND IT!I need Epoman to come to my unit and raise hell for me ;) :clap;
Yeah she can start the buttonhole using sharps, but what happens when she needs the "Blunt" needles and they do not order them for her? :( She needs to RAISE HELL bottomline. DEMAND IT!
For me I just need the nurse that does buttonhole to start it. For some reason my dialysis unit seems to disorganized lately and I don't know what has changed. I even talked to the Kidney Foundation executive director since they are in the same building and she said to talk to the renal social worker .. who hasn't been around for 2 months and is on vacation this week ...Yeah she can start the buttonhole using sharps, but what happens when she needs the "Blunt" needles and they do not order them for her? :( She needs to RAISE HELL bottomline. DEMAND IT!
Well from what I have gathered the unit already carries the blunts so it would be merely a formality of having the doctor order it to be used. Wouldn't it?
I spoke to my unit about buttonhole tonight. They said they do not do it nor recommend it either. They don't get blunt needles from their supplier and I was also told that the very reason they don't buttonhole is due toYes but for me it is best. Why? Because I have done extensive research myself and they have limited spots to stick me so sadly they are already sticking my arterial in the same spot and lately it is leaking because they are sticking it into scar tissue (that is right .. 14 months of Hemo and only had the fistula since May and already have scar tissue that leaks when the needle is cannulated through it). I don't know if that is normal but I am worried because they don't have many options for the arterial. This is why I want buttonhole. If they are gonna cannulate me in the SAME spot almost every time then they might as well do it right!! Right??
1) The risk of infection being that much greater.
2) By using the same spot over and over, the fistula develops large welts and the skin becomes harder.
3) There is a possiblity of poorer blood flow i.e. trickling blood through the veins.
I'm not saying anyone is right or wrong cos I don't know, but those are the reasons I was given for not doing buttonhole in my unit.
I spoke to my unit about buttonhole tonight. They said they do not do it nor recommend it either. They don't get blunt needles from their supplier and I was also told that the very reason they don't buttonhole is due to
1) The risk of infection being that much greater.
2) By using the same spot over and over, the fistula develops large welts and the skin becomes harder.
3) There is a possiblity of poorer blood flow i.e. trickling blood through the veins.
I'm not saying anyone is right or wrong cos I don't know, but those are the reasons I was given for not doing buttonhole in my unit.
I printed off the information from the link that you gave us Epoman and took it into my unit. A different nurse to the one I spoke to previously said that her and one other were going to another unit to be trained on buttonhole technique!!!
Methinks that maybe there is a communication problem at my unit!
I watched the video links and boy they were really enough to put me off especially Gus, have you guys seen the size of his fistula arm? What a mess it is, at least it looks that way to me. And in Bill's film, why was he taking BP on his fistula arm? My unit always take BP from my right arm ie my non-fistula arm.He is using the cuff not to take pressure but to act as a ternequet (is that how it is spelled??). He wouldn't be able to tie one on.
I finally started Buttonhole on Friday! But my fistula kept having spasms. I figure this is the best place of any to ask .. WHY does that happen???
here is a pic of my fistula looking from my shoulder down:
As you can see, it is nothing like Gus' or Bill's in the video. I don't want my arm to end up looking like theirs if that is what happens when you button hole!
I thought the pic was small, have changed it now.
I can't help being a bit vain guys. I still care about how I look and have some pride in my appearance regardless of dialysis.
I don't understand why people would stick their needles in the same place each time- My techs always rotate to help with the bumps plus to prevent an aneurysm.
... If you are on home hemo, they want you to have at least 2 buttonhole sites for arterial and venous to give a bit of time for the vein to heal since we go 6 days a week. ...
Cool thanks for the info. Well I guess I'll see how they do with this guy at my center since he'll be the first one. One interesting thing I found out is that even after the buttonholes are started it will always be one of the staff that does the sticking.
Hello! I am a new home hemodialysis patient after being in clinic for almost a year. I began training for home hemo on 2/4/2008. On that day, we started sites for the buttonholes. It has now been 5 weeks using the sharps. I attempted on a couple of occasions to use the blunt needles, but each time they could not pierce through the fistula, no matter how hard I push it. I am going to try again with the blunts tonight, here's hoping for success!cherpep -- For Marvin's buttonholes, the nurse established it with sharps for five days. Then, I took over with blunts. We didn't have any problems with blunts (used them almost six months) until he had to go back in-center for six weeks (antibiotics on the machine). Then, the in-center nurses allowed me to cannulate, but I had some trouble. I think it was switching from six days a week to only three. It was like his track wanted to close up between treatments (the Tuesday treatments were the worst -- having to go since the Sat. before without a stick). I found myself putting a little more pressure as I was sticking, and, usually, I could get it to go in. However, I did have to revert to sharps a couple of times. We were told that you had to be very, very careful with the sharps because they could damage the track (going in or coming out). When I stick him with a sharp, I "thread" the needle (after I get a blood flash and I'm inserting it all the way in) very, very, very carefully and very, very, very slowly. Hope this helps.
I do have a couple of questions - has anyone else ever experienced this difficulty? Also, are there problems in using the cutting needles on the same insertion sight for a long period of time?
Thanks in advance for your help.
I am going to get some emla and try that. Sticks have been too painful lately. I have been trying to tuff it out but I guess I am a woose.