EMLA cream

[6yr Vet.]

For six years now i have been on hemo dialysis.i use 15 gage needles in the satelite unit of our local hospital.Now that I am home doing my own treatments at night time I now use 17 gage needles.Last night while stringing my machine I noticed I forgot to apply the Emla cream.I race downstairs and put it on, cover it up to aid in the absorption,then continue with the stringing.It was only half an hour later,it was time to cannulate. My arm ached for about an hour.Oh how I hate forgetting to put on the cream.You are probably wondering how I could forget a step that important to me.My answer to that is........I have just started home nocturnal dialysis.With so many steps and procedures to remember,emla cream has a chance to slip out of my mind.I hope I get it right tonight.sincerely 6yr Vet.

[Epoman]

I moved this topic to the "General Discussion" section. The "Introduce Yourself" section is reserved for introductions only. I hope you understand.

I have been on hemo for over 11 years and I have never used the cream. In fact after so many sticks the area becomes numb and I don't even feel the needles go in. Also at the time when I first started dialysis I don't even think they had that cream. They would give you a shot in the area to numb it if you requested it. But I never did because they told me it was bad for the graft.

[LifeOnHold]

I used that stuff three times.  The first time it worked great, the second time only half of my graft was numb, the third time it didn't work at ALL.

It also turned my skin dead white wherever I put it-- my doctor told me to quit using it because it was damaging my skin.

I used lidocaine for the first 4 years (I've been on hemo almost 10 years now-- was on PD for 3 years). but a nurse I trusted got me to try needle insertion without it-- and I discovered that it hurt exactly the same with or without lidocaine... the lidocaine had never worked in the first place!

Most patients in my unit who use EMLA eventually stop using it-- whether it's because they no longer need it or because their insurance won't pay for it, I don't know.

But however you get your needles in, all that counts is that you are able to deal with it.   

[O in]

does emla cream  act like a local?  never heard of it in nz
o in

[Epoman]

does emla cream  act like a local?  never heard of it in nz
o in

http://www.skinsite.com/info_emla_cream.htm

EMLA CREAM:

I. Definition:

EMLA Cream is a topical anesthetic. In other words, it is a cream that numbs the skin and decreases the sensation of pain.

II. Reasons For Use:

To lessen the discomfort from medical procedures.
 
III. How To Use:

- EMLA Cream must be applied two hours before the procedure to the area that the doctor plans to treat.
- Before applying EMLA Cream, wash the skin in the area that the doctor plans to treat with warm soapy water and a wash cloth.
- Rub the skin gently for a few minutes with the wash cloth to remove all dirt and oil from the skin.
- The cream should be applied very thick (about 1\4 inch thick) to the site of the procedure. You also need to apply the cream to   the skin 1/2 inch past the area to be treated.
- Cover the area with saran-wrap being careful not to press on the cream in order for it to remain thick.
- Secure the edges of saran-wrap with medical tape to avoid leakage.

IV. Treatment Results:

The skin will remain numb for at least one hour after the removal of the saran-wrap.

[angieskidney]

2 hours my ass!!

Where did you get that info Epoman? Not to complain but I have been using Emla for a year and no way you need to put it on 2 frickan hours ahead of time! If I did that my whole BODY would be numb!!

It works and I swear by it! Maybe because MY dialysis unit does not even HAVE those needles that numb you like you Americans do. In Canada it is either go out and buy the Emla or feel like an orange being stabbed with a straw .. uh .. 2 straws ...

Rerun was asking me about it so I made a vid. I originally posted it over here until I did a search to make sure it was easy to find. Since this thread is called Emla however, it just made more sense to post it here instead and put a referring link in my other post.

Hope you all appreciate it those who are interested in trying Emla out.

Of course once I learn Buttonhole I will try to go without as then they switch you to "blunt" needles once the paths are established and I won't need the numbing.

I will make a vid on Monday before dialysis. No need to waste now just for a vid to "Illustrate" lol  

EMLA Video: http://angieskidney.com/Video/EmlaVid.wmv (7.72Mb)

A word of advice: DO NOT use the CHEAP wrap to cover and hold in the cream on your arm. The cheap wrap only rips all over, does NOT keep the cream from evaporating, and is pure HELL to get off your arm at dialysis prior to cannulation. If you use the cheap wrap you might as well not buy the cream in the first place. It is expensive and you WANT it to WORK!

It is an expensive way to be pain-free but worth it. I buy more than one tube so that I can put it as medical expenses on my disability income statement every month

Enjoy!

[Rerun]

That really helps!  Thanks Angie.  I asked for EMLA cream but my Pharmacy uses a generic when it can, so I got "Fougera" Lidocaine and Prilocaine Cream.  I will try it on Thursday. 

             

[angieskidney]

That really helps!  Thanks Angie.  I asked for EMLA cream but my Pharmacy uses a generic when it can, so I got "Fougera" Lidocaine and Prilocaine Cream.  I will try it on Thursday. 

             

Cool! Does it have just as much Lidocaine and Prilocaine in it as Emla? (2.5% each?)

[Sara]

Joe uses the generic EMLA cream too, and it works well for him.   

[AlasdairUK]

I stopped using the cream after a few goes. I never remember to put in on in time and when i did it works a bit, but I can still feel the needle. So for the amount of effort involved for not too much of a reduction in pain is not worth it for me.

It also seems to irritate my skin and cause it to be more sensitive than it already is. Once you get over the mental block of needing the cream and realize that it does not hurt that much. Maybe I'm lucky and have good nurses who stick me so there is less pain.

[angieskidney]

Topicaine® – This clear gel must be applied in a thick layer 30 minutes to 1 hour before dialysis, and covered with a dressing. One study found that over-the-counter Topicaine worked faster than EMLA®, ELA-Max®, and tetracaine ointment, and it is often cheaper.

I read that at Kidney School. Has anyone ever tried this instead of Emla cream??

[tubes]

i use lidocaine ointment 5%.
i have it on about a minute then the nurse sticks me. 
i like the stuff, works for me.