Cannulating fistula without topical anesthetic

[RightSide]

Any folks here cannulate their fistula without putting some kind of topical anesthetic (like EMLA Cream) on it first?

I find having to apply the anesthetic cream a bit of an inconvenience--and if cannulation wouldn't hurt too much, I would just as well forgo it.  But those 16 gauge needles look a bit scary, and I wonder if they really hurt.

[RichardMEL]

yep.. though I don't stick myself...

I had local shots the first time then from the 2nd session said no and haven't looked back. No real issue. About 70-80% of the time it doesn't hurt going in, other times it stings a little bit, but really not much. The fistula is hardened after over 3 years so the biggest trouble the nurses have is "tough skin" to get through!

[willowtreewren]

We use the cream, but there are times that Carl forgets to put it on. He is stoic about the sticks. And every once in a while the cream doesn't work that well. He generally has more stinging with the venous stick. It upsets me more than him when he forgets the cream. LOL!

Richard, Carl's fistula has gotten tough, too. Sometimes I really have to lean on it to get the needles in. We use 15 gauge needles.

But his fistula is really well developed. I certainly don't have a hard time finding a spot to stick. 

[jbeany]

My center didn't have cream, only lidocaine shots.  I hate that burning sensation it gives, so I skipped it on my first try, and never used it.  The needles are big, but unless they hit a nerve, it's not really any different than getting your blood drawn.

Try it once without - you can always go back to the cream if it doesn't work for you.

[YLGuy]

15 gauge needles.  I rarely remember to put the cream on.  One side is fine the other definatley is painful for a moment but it is just a moment.

[kitkatz]

I have a graft and have not used anything for years.

[tubes]

I never forget to use my cream. I have been stuck in a different place where I hadnt put any cream. That was because I was infiltrated so I had no choice. I didnt even feel a thing. It was just a lucky stick. Most places do hurt a tad bit even with the cream.

I use 14 gauge needles.  (i need a smiley that screams and runs off and hides) until then, this smiley will have to work. 

~Robert

[Brianna!]

Up until I moved to my new center, they wouldn't let me use anything to numb it. D:

It really doesn't hurt that bad though. Yes the needles are big, but I was expecting horrible, horrible, pain. This one guy at Children's SCREAMED every time they stuck him. And he had been going to dialysis for 4 years. It was kinda funny when he screamed, because all he said was "aiii!" I don't think it hurt him, he was just being dramatic.

I would try it without the cream, and see how you "like" it. And if it's not too bad, then don't use the EMLA cream.

[HubbysPartner]

My husband has never used anything.  He cannulates himself and says it doesn't really hurt.  His fistula has matured well and his buttonholes are well established.  He uses 15 gauge needles.

[dwcrawford]

Several men in my bay/unit use nothing and don't scream.  Us Sissies demand the cream and still curse a little.  Next to largest needle (is that 15?)

Still can't get the spray around here.

[jdwills83]

    emla cream rocks!

[RichardMEL]

We used to have this BIG tough guy in our unit who DEMANDED local injections (he had a hissy fit if he couldn't) and he would scream and cry even then.......

[nursewratchet]

We had spray, or shots at the clinic.  We do however, ask newbies to try one side with and one without.  Most of the patients use nothing at all.  I can count on 1 hand the ones that use a number.  Out of 126 patients.  Their choice though.  The shots can by the way, damage or shorten the life of the access.

[BigSky]

The pain is not too bad.  Its less IMO than waiting out the sting of lidocaine.  There can be a little more pain involved if your fistula is really deep.




If you go with  buttonholes you would have virtually no pain and should not need anything at all to numb it. 

[willowtreewren]

We used to have this BIG tough guy in our unit who DEMANDED local injections (he had a hissy fit if he couldn't) and he would scream and cry even then.......

Richard, I didn't know that my father had moved to Australia! 

[boswife]

Hubby started with the numbing shot but the last 6x used nothing.  He was told it could shorten the life of his fistula and thats all it took..  He said it's better than 'that' sting you get with the other shot.  Him and only ONE other guy at his facility say they're in a club cause they're the only ones who brave it with nothen.  We have a pretty neat group where he goes. 

[Melissa]

I used Lidocaine or the cream for the first year or so because I was too afraid to try without.  Then I visited a unit that would not use anything on me and realized it wasn't that bad.  Compared to some of the headaches I have had it is nothing!  Sometimes it does hurt a little more than I am prepared for though.  I make a face and usually squeak "OW!", but I am being dramatic.  It seems to help for me!!   You should try it, just to see, at least once.  Then you will know what you want to do.

[Brianna!]

Someone said something about the spray. I hate that stuff. It basically freezes your skin, and gives you frost bite. It turns your skin white. For me, it hurts more than the stick itself! I didn't have time to put on the EMLA cream, and I was going to grin and bear it, but they offered to put the spray on me, and I agreed. I forgot how uncomfortable it is!

[pdpatty]

No need  for cream,lower part of fistula is totally numb from the surgery. Feeling has not returned and hope it never does.  When they stick in top needle ,less sting than getting stuck with a sewing needle. AS a matter of fact,that hurts worse than the dialysis needles.

It may be where my fistula is ,it is on right  inner arm just above the elbow.  Notice most are up a bit on arm.

[tyefly]

    I am developing buttonholes   and I was using lidocaine shots and decided to try it with out......  still hurts but it less of a sting that the lidocaine....   but still painfull..... I have tried the cream  several times now and I cant see that the cream works.... I have left in on for hours before my sticks......   I am going to start trying to self cannuate one of these days....but I am not sure how I am going to do that.... its one thing to have some pain when someone else is sticking you  and  I am not sure how I am going to stick my self with the pain involved....  pretty hard to do something to your self when it causes pain....  I am hoping that my buttonholes will develop more and then there will be no pain...??     they have done my buttonholes 7 times now..and they still hurt alot.....  how long does it take......

[Adam_W]

When I first started using my graft, I used EMLA, but once the area started to get numb from use, I stopped using it. I haven't used any since.

Adam

[hurlock1]

My center didn't have cream, only lidocaine shots.  I hate that burning sensation it gives, so I skipped it on my first try, and never used it.  The needles are big, but unless they hit a nerve, it's not really any different than getting your blood drawn.

Try it once without - you can always go back to the cream if it doesn't work for you.

The Center usually doesn't have the cream. For it to do any good, you have to put it on an hour before they stick you. From what I understand the lidocaine shots "Toughen" the fistula. to where it makes it, over time, harder to stick you. With the co-pay with my insurance the emla cream only costs me $10.00 out of pocket. I get two tubes and they last as long as two months. I have button holes and it hurts less when they stick me. I have no reason to prove that I'm a man and can take the pain.  I usually don't have anybody to help me in the morning and for whatever reason, I can't deal with wrapping my arm in cellophane one handed so I cut a little rectangle from a ziplock and tape it on. Sometimes I forget to apply the danged stuff and it doesn't hurt that much, but I have a tendency to jump when I don't use the stuff so I keep putting the cream on every time. (if I remember)

[chiefsfan301]

I have upper arm fistula and only had 27 "D" sessions, started off without using anything and don't really feel the needles (15ga) go in.  I notice the first touch of the needle if I watch, I always watch!

[del]

At Hubby's first hemo treatment when they used his fistula he was asked if he wanted something to numb the pain. He asked what it was and they told him 2 more needles. He said no thanks and he has never used anything for the pain.  He says it didn't really hurt at all just like a burn when they put the needles in.  He has been using buttonholes for over 3 years and he says they are pain free.