Dialysis in center question

[Riverwhispering]

I know I'm being a baby about this but I need to know....... I will be starting in center dialysis soon and I have a big fear of pain from needles.  I hear the dialysis needles are huge suckers and that they have a cream they use to numb the area for sticking.  With little needles for IVs in the past I've had some nurses blow the vain and end up with a major bruise and quite a bit of pain when they are sticking me. 

How do you all go three times a week and get stuck with these huge needle and not stress out?   I get so stressed just thinking about it I'm sure I'll be in tears before they even try to insert them.   Help me get over this please... I'm freaking out over this. 

[cattlekid]

So I was doing in-center hemo for nine months with a catheter.  I would see people screaming and crying when getting stuck with the needles.  Then I started asking questions when it was time for me to get my fistula (I waited until all my living donors crapped out of testing).  I chose to go the buttonhole route.  I also went from in-center to NxStage at home.  So I am sticking myself - personally, I feel much less pain sticking myself because I am the one in charge of where the big honking needle goes.  I would also recommend buttonholes even if you are in-center because you are using a blunt needle after the buttonholes are established.  So now, a month in when doing it at home, I barely feel the needle stick at all. 

[Riverwhispering]

Screaming and Crying..... OMG LOL

[HILINE]

it depends on the tech who sticks you, they start off with small needles and work up, I don't use cream, I won't let a certain tech stick me or my dog if I had one

[Katonsdad]

As they are sticking me a find a vocal point. I think intensely of the 5 minutes after I am stuck and
it helps. sort of putting myself past that point. Acenter I went to in Ca. used ladocaine but the stick hurt just as muc h.

Katonsdad

[Pharvey]

I used Lido for a while, but the sting seemed worse than the actual needle stick to me. 

Do you have an established fistula?  If so, I did not find any bruising, etc like I had in the past from IV's and blood draws. 

I agree that finding a point to look at the first several times is a good plan.  I tried to look at the needle early on and found that to be a mistake for me.  Now after 2 years if I am not looking, many times I don't even feel the stick.  I assume this is because the nerve endings have deadened in certain spots on the fistula.   

Also, it is true that certain techs seem to be more painful when inserting needles.  Unfortunately the only to find out which ones is to go through it.

I think you will find, like most things, that the apprehension and fear associated with the unknown is worse than the reality! Good Luck!

[Riki]

I use Emla cream.  I put it on about an hour before going in and it numbs the skin quite well.  It's normally just the initial going through the skin that you feel pain from anyway, unless they make a mistake, which does happen on occasion. I don't remember the last time I was infiltrated.

I don't look at the needles.  I tend to look at the floor when they're putting them in, even though I can't feel them.  Once they are in, I will look, though.

Fistulas are different than regular veins.  They are bigger, and sometimes they are easier to see than regular veins.  I know that my top site is very easy to see, even without a tourniquet.

I do agree that learning to put the needles in yourself is probably best, because you would be doing it every time, and you'd know exactly where to go.  I'm not able to do this due to my eye sight, but I am able to tell the nurses where to put the needles.  It's only a rare occasion when I am wrong about that.  Knowing the best place to go is good when you're traveling too, because then you're able to tell whoever is putting your needles in the right place to go, and you lessen the risk of infiltration.

[lmunchkin]

I agree with Riki about fistulas are probably the easiest to stick.  Most are very big, like my J's.  I would have to be "blind" to miss it (no pun intended).

I think the post about picking a spot or something away from the sticking you, would probably work.  But you do have to look when they remove them so as to hold site with guaze to stop bleeding.

You will get use to it over time.  I know that doesnt help you in your delema.

God Bless,
lmunchkin
 

[Riki]

I don't have a problem looking when they take them out.  I just it just cuz it seems easier that way. *L*  I do find that they hurt more coming out than going in.

[cassandra]

Since years, and years I use Xyloncaine 10 mg Spray (cos they let me use it at a DC in Holland), and I find it an awfull lot less painfull than without the spray. Its not painless, but definetely less (as I found out on another holiday when I forgot to take it with me, and had to buy it £3,50 a bottle for a month use (3x a week). I spray it on the fistula where they will (I tell the 'tech' where to go) stick the needles. I find it the discovery of the century myself. You have to leave it a few minutes to 'soak' in though, but a lot less hassle the Emlea creme. lol

[Gerald Lively]

You guys are giving me the "willies".  Eeeh Gad!  Sticking yourself. - - upchuck!!

[Hazmat35]

I do in center Hemo, I have Button-Holes and I use the LIDO cream. 

I have an INTENSE fear of needles, so now that they have the Button Holes estabilished, I develop a lot of "scar" tissue in between sessions.  So when they go to stick me with the blunt needles, it is sometimes EXTREMELY hard for them to get past it. 

So, the numbing cream helps me there, as well as "mentally".  I know that the cream is on, so there is NO pain from the needles.  At least, that is what I keep telling myself. 

[willowtreewren]

You guys are giving me the "willies".  Eeeh Gad!  Sticking yourself. - - upchuck!!

 

Gerald, this reminded me that the first time (and for several times after) I stuck Carl, I was truly about to throw up! It was VERY stressful. But it got to be so routine! And when I was gone for a week and Carl took his NxStage machine back to the center for treatments, they just handed him the needles the first day and he stuck himself. We did not use buttonholes as his VS and neph were not in favor of using them.

There you have it! 

Aleta

[Hazmat35]

Did you get a Fistula yet? 

Don't worry!  If there is any bigger baby in the world afraid of needles than ME, I'd love to meet them.  Just the though of needles made me woozy.  Getting a normal blood test, I would have to lay down on a cot or on a gurny in the hospital, because I would pass out!  JUST A NORMAL BLOOD TEST mind you!  But, since I've started Dialysis, the nurses and social workers have helped me get past it for the most part. 

Do some breathing exercises (in through the nose, out the mouth), and try to regulate your breathing in and out.  It actually helps and cools you down.  Focus on something else, like TV or somehting going on outside the window if possible, and don't think about what is going on (while they are inserting the needles), and concentrate on your breathing.  And in about 60 seconds it will all be done! 

If you use the LIDO cream, and put it on about 11/2 hours before your treatment, and cover it with plastic wrap, you won't feel anything but some pressure.  It really works great! 

Trust me, after 1 1/2 years of getting stuck, I'm still laughed at, at my center, by the nurses for being such a big baby!  But I don't care, I'm working though it!  I NEVER look at the needles or what is going on, and they all know better than to tell me what they are doing.  They just do it, QUICKLY, and get it over!  Then, they tell we what they did, and why they did it! 

Good luck! Don't worry, it is NOT as bad as you think it is going to be!  Go visit your center, and ask them if you can hang out for a while, and get used to the place, and all the goings on.  Then it won't be so new to you at first. 

[pdpatty]

When the surgeon put in my fistula,he must have cut some nerves in the arm and they have not grown back together because I feel no pain in the area of the stick. If they go too far up or too deep ,that hurts but if they get the right spot,no one can make me say `ouch'. Just lucky ,I guess.

[Hazmat35]

Since years, and years I use Xyloncaine 10 mg Spray (cos they let me use it at a DC in Holland), and I find it an awfull lot less painfull than without the spray. Its not painless, but definetely less (as I found out on another holiday when I forgot to take it with me, and had to buy it £3,50 a bottle for a month use (3x a week). I spray it on the fistula where they will (I tell the 'tech' where to go) stick the needles. I find it the discovery of the century myself. You have to leave it a few minutes to 'soak' in though, but a lot less hassle the Emlea creme. lol

After I had my Fistula put in, and the VERY 1st time I did Dialysis, my doctor had me do a hospital stay for 3 days.  In the hospital, they did Dialysis, each of those 3 days, and they used the SPRAY on the Fistula area.  It seemed to work really well.  But, at the center, if you don't have anything to use, they won't supply it.  They don't like you to use the spray, either.  Just the cream or nothing. 

[Riverwhispering]

Last time i saw my doctor (6 weeks ago) he said something about wanting me to stay in the hospital for 3 days when they start me on dialysis to monitor me and I told him that can't happen because i have critters that need to be fed and let out and no one to do it if i'm gone.  I see my doctor on Friday so I'm going to be asking him a bunch of questions now that you all have given me things to ask him like the cream and other things that have been brought up.   

[Rain]

Get emla cream.  I use it every time. I put in on, then tape plastic wrap over the site about 45 -1 hour before.

So when  I needle myself I can't feel a thing.

[cassandra]

dear Hazmat did they tell you why they don't want you to use the spray?

[amanda100wilson]

I agree, Emla cream does the trick.  Maybe you could go to a therapist to teach you some relaxation techniques to help you.

[GraphicBass]

Biggest thing that worked for me was to not expect it to hurt badly, just like a regular injection. Don't enlarge negative expectations.

Other than that, breathe deeply before and during and focus your mind on something pleasant. Bring a photo book or album and focus your eyes on something pleasant as well.

Then realize it will al be over in a few seconds.

[thegrammalady]

 

Trust me, after 1 1/2 years of getting stuck, I'm still laughed at, at my center, by the nurses for being such a big baby!  But I don't care, I'm working though it!  I NEVER look at the needles or what is going on, and they all know better than to tell me what they are doing.  They just do it, QUICKLY, and get it over!  Then, they tell we what they did, and why they did it! 
.

laugh at you? they should be ashamed of themselves and should know better. next time ask them if they would like to sit down and you'll stick them.  i wouldn't let a tech who though a fear of needles was funny near me. and you don't have to. i've been stuck without anything and it isn't pleasant. i use cream or lidocane. lamaz breathing works wonders for little needle sticks.

[fearless]

If you have had a fistula created, do your exercises to strengthen it and don't let them stick it before it's ready.  The surgeon who put it is should be able to tell them when it's ready.  Don't let anyone but the most experienced person be the one to cannulate your new fistula.  Have them use just one needle in conjunction with your catheter (if you have one).  This will help to continue to strengthen the fistula.

Then, when the fistula is ready for both needles- trust your cannulator and focus on the light outside the window or inside your heart!