Couple of questions about Emla cream.

[Brianna!]

I started to use the Elma cream yesterday. I wanted to use the spray they had, but my insurance didn't cover it, and the spray is 50 bucks.

How long before you go to dialysis do you put on the cream? They told me a half an hour, but I keep hearing here, you need to put it on like an hour beforehand at least. It still hurt a little, but not nearly as bad as without anything to numb the area, it was better than the spray too! If you put it on longer before you get "stuck" does it work better?

For the saran wrap, how tight do you wrap your arm in it? They just told me to wrap it so it doesn't get on your clothes.

There are no directions on the bottle, I just went by what they told me. The pharmacist even gave me instructions, by what the social worker and nurses told him!

I think those are all my questions.

PS-It didn't infiltrate! I think they figured out how to do it so it doesn't infiltrate. My nurse used to stick me for the venous way up on my arm, where the fistula is narrow. But now they do both of them by the crease in my elbow. And the pressures were fantastic yesterday! My machine alarmed once, but that was because the fistula spasmed or something.

Thanks!

[Darthvadar]

Hi Brianna...

Great to hear that your whole needling experience was better yesterday....

Mum was on haemo, and used Emla... She found that it worked best for her if she used it about an hour before dialysis...

Afraid I can help with your question about the Saran wrap... The packs of Emla available comes with Tegederm Patches... Clear plastic centre with a sticky edge...

Take care...

Darth...

[fc2821]

It has been a'life saver" for me. I haveen using it over two years. I was advised when I first started using it to put it on "at least an hour before dialysis". I have always done so,and been numb when needed. I use "Press an seal" wrap, stays on better than regular plastic wrap as it is adhesive. Hhope this helps you.

[willowtreewren]

Brianna, one time the power was off in our center (when we were training) and Carl had to wait for 2 hours before being needled. The cream still worked. We always give it an hour.

He just wraps the plastic wrap loosely. I like the idea of the self sticking wrap, though.

Aleta

[dwcrawford]

I recently saw a survey of users that said 45 min to 1 1/2 hours works well, but 1 3/4 housr worked best.  I put it on at 9:30 and get stuff about 11.  Works beautifully when you get it on the spot they stick. 

I got a prescription for the spray but haven't been able to find anybody who has it.  It is 34 at walgreen but my insurance pays only 10 of it, whereas they pay 100% for 9 tubes of cream each 3 months.  Its a little more than I need but what the heck.  It's only insurance!   Oops!

[Brianna!]

I recently saw a survey of users that said 45 min to 1 1/2 hours works well, but 1 3/4 housr worked best.  I put it on at 9:30 and get stuff about 11.  Works beautifully when you get it on the spot they stick. 

I got a prescription for the spray but haven't been able to find anybody who has it.  It is 34 at walgreen but my insurance pays only 10 of it, whereas they pay 100% for 9 tubes of cream each 3 months.  Its a little more than I need but what the heck.  It's only insurance!   Oops!

I was supposed to get the spray from Walgreens too, but like I said, it was 50 bucks! And I don't think the insurance paid for any of it. I have to pay like 2 dollars of the cream. So insurance doesn't cover ALL of it. I wonder why my nurses told me to put it on only a half an hour. Yesterday, I put the cream on a little under a hour before I was put on, though.

[dwcrawford]

HEHE, yeah, but keep in mind that nurses only stick... they don't get stuck....I guess it'll be trial and error.

I want to know what that "Press and seal" is.  I have trouble making it stay on.

[fc2821]

HEHE, yeah, but keep in mind that nurses only stick... they don't get stuck....I guess it'll be trial and error.

I want to know that that "Press and seal" is.  I have trouble making it stay on.

       Press and Seal wrap is a plastic wrap for use around the home or particularly in the kitchen.  You can find it in most stores where you find regular plastic wrap.  It is a bit adhesive so it will "cling" to bowls, etc. 

[willowtreewren]

9 tubes of cream each 3 months

Holy Cow! 

Carl makes a tube last 2 - 3 months. He just puts a dab at the place I'm going to stick!

I guess we are awfully frugal, even if it doesn't come out of our pocket.

Then again, different folks have different levels of pain tolerance. I think Carl's must be pretty high. 

[dwcrawford]

they are little bitty tubes and i never know where they plan to stick so it goes from my elbow to my shoulder (not really) (not frugal either -- there's or mine)

[willowtreewren]

Yes, Carl knows exactly where I am going to stick so he can put a pea size amount on each site. When you don't know, you have to plan for an attack on the whole territory! 

Aleta

[murf]

Been using enla for about four years. A few tips: use the cream liberally. Wrap Glad Wrap around it tightly. Leave it on for about an hour and a half. Don't let the nurses take it off until just before the needle - it loses its power once unwrapped.

[marie]

I put mine on an hour before treatment. And I use the Glad Press N Seal so it doesnt move the cream. When I used the cling wrap it would slide all over and the cream wouldnt even be on the holes.

[Brianna!]

Update::
I used the emla cream all last week. Wednessday the arterial didn't hurt at all, but the veneous hurt a tad. But not bad at all! I got some glad press n' seal wrap, and i'm going to try that tomorrow morning.

I've been puting it on only an hour before, and it still hurts a little, so i'll try an hour and a half tomorrow. But I don't mind the sticks at all now.

Thanks for the tips!

Oh ps-They're going to start buttonholes on me! After the holidays are done though.

[tyefly]

  Ok   just one more question.......   when you have buttonholes....( using the cream a hour or so before cannulation )  do you use the cream over the buttonholes or do we pick the scab off and use the elma cream... 

[monrein]

I've never used any cream so I'm just guessing here.  You'd probably put the cream on at home , then wash your arm thoroughly at D, pick your scab and cannulate your buttonholes.   I found the sensation helpful to my needling and doing my own needles hurt way less than anyone else (even the best cannulators) doing them.

Good luck. 

[elaineraecarter]

HI YES I FIND 2 HRS AND PKT INSERT SAYS 2-5 HRS

[Brianna!]

Buttonholes aren't supposed to hurt, so I guess you wouldn't need any cream at all. At least that's what I read. But my center said if I feel more comfortable with the cream, I can still put it on

[marie]

The buttonholes are the best!  That's what they're doing on me. It just pops right in  

[silverhead]

Re: the scabs on buttonholes.  I have found that using the Emla cream beforehand softens the scabs and they just wipe off before cannulation......

[cookie2008]

I have buttonholes and still use the emla cream my arterial isnt bad but my venous still hurts.