Infiltrated at my first in center visit...

[carol1987]

Oh well... first time at my center and i was infiltrated and no Dialysis today!


waiting to hear from my Neph to see if i can wait until thursday to try again...

The arterial went in great one poke ... hardly felt it.  Then they tried to place the venious  and that is where my fistula is deep.... missed... wiggled it and then it started to swell a bit.   tried it higher up.. no go.  I then asked how many more tries till we say no  go for the day.    The charge nurse  then tried higher up...  thought she got it... they start the machine and I begin to swell. 
They gave me ice took out the needles and  thats it for the day....

It is just a bit sore right now and i am sure it will be ugly later on...
I have to call my vascular surgeon and let him know... this is what he was afraid of...  I really don't want the surgery to raise it....hopefully  if i do need the surgery they will let me just stop Dialysis for a bit instead of getting a catheter......

[boswife]

dang it!!  im so sorry.  Hoping for some good news next round..   

[carol1987]

Thanks boswife!  I am so happy that i had those first "good" experiences in the hospital last week... so I am not as upset.
and reading here helped me to know what infiltration is and that you do just stop trying some days....

[gothiclovemonkey]

i had a ton of problems with infultration when i first started, which lasted about a year ( i really think it may have just been the center i was going to) I ended up getting a cath, but that was mainly because all the infultrates and proceedures i was having done ended up causing me to get MRSA in my fistula... over the course of one year i had about 17 proceedures done to "correct" my fistula. It is very ugly lol Good news, since i started at a new clinic last year, ive only been infultrated 2 times! Both were probably from me coughing too much lol
They typically want to try to restick at LEAST once around here, but i usually just say no... Unless its going to be the sat to tues stretch, then i might let them try once more. When I first started, I actually let them try more, but to be quite honest about it, just letting them do the initial stick is stressful enough...
One bit of advice, ALWAYS make sure when they go to give ur heprin to make sure they pull BACK before the inject, to make sure its not infultrated!!!! That is the WORST! The stuff stays in your tissue forever (well, weeks...) and sooooooore!

[Riki]

They push saline here.. I don't think I've ever had heparin pushed, just had whatever was on the machine. They push it slow, because if they push it fast, I will yell at them. *L*  If they push 10cc of saline and it's infiltrated, my arm just blows up like a balloon.  If they push it slow, I'll know if it's infiltrated by the feel, that way there is less swelling, because there's less fluid pushed into the tissues

[carol1987]

wow gothic... 17 procedures!!  well so far since starting D i have had a fistula gram and looks likely that I will have to
get the op to raise the fistula...
so you let them  try twice ... that sounds reasonable...
I will make sure it is not infultrating before heparin!! got it

Riki does "push saline" mean that is how the test the line??? make sure you are on good??? I ill make sure they push slowly!!!

Thank you both... it is so helpful to know what to say, do , ask right away.

[FindingNeverland]

Ouch, sorry to hear that. I had trouble with infiltrations when I first started using my fistula, luckily back then I had a catheter for back up but if anything were to happen now I don't have it anymore... they do tend to get annoying, I'm not worried though because my fistula is much stronger and more mature now so its become very easy to stick.

[carol1987]

Lets just say i was not too confident when the tech felt my arm and said... "you don't even have a back up catheter"
hmmmm perhaps i should have suggested she find someone else try to get it at that point!!

so what are the odds of them getting it on Thursday with all of this bruising etc?

should i even let them try twice???

[boswife]

we're not REAL experienced, as hubby on for only a year and a few months, but, the one time he was infiltrated,  he still did fine the next visit.  He was really brused, but that didnt seem to make it harder .  Hope it will be fine..

[YLGuy]

OUCH!  I would definately ask that the charge nurse try it from the get go next time.

[MooseMom]

How common is this problem of having deep veins and needing surgery to lift them?  I've heard a lot about this here on IHD.  After my fistula was placed and before I woke up, my vascular surgeon told my husband that as he was creating the fistula, he went ahead and "lifted" the vein, ie he sewed it onto the underside of my skin (urp).  I don't know for sure, but I would expect this to mean that I won't have this problem of the vein being too deep.  Why aren't fistulas "lifted" like this from the beginning?

[FindingNeverland]

Good question MooseMom. I haven't had that problem, apparently mine is very shallow, the problem was that it was so small, after all I am a teeny tiny person. carol1987, I would ask for someone with more experience.

[gothiclovemonkey]

it might be sore, but they should be able to do the treatment, just might hurt a bit

they dont lift them from the begining because they might do it naturally, then u would have a big ugly really raised, and its kind of dangerous too. mine is HUGE and looks like a snake, and its shaped like an S with a Z under it LOL very curved and lifted very high, they told me a good bump could make me bleed.... and its true, had someone Playfully tap my arm once, and it bled... I bend my arm, i feel the thrill like crazy and my hand goes to sleep... insane.

[carol1987]

Thanks... do they ever give you and medication to take during dialyisis if it is more painful.... if you have a bad  infiltration?  i may need some anxiety med moosemom i am not feeling very brave tonight...

[gothiclovemonkey]

u can ask the dr to prescribe u some anxiety meds...
Some centers can give tylenol and things like that... and some also have a numbing spray but it wont help with the soreness probably... thats more like a bruise...

[Stoday]

If they mess up on one stick you can have dialysis using only the good one.

The single needle method does mean that they have to replace all the tubing and the dialyser, so it costs 'em. I've had that twice when they failed on my venal. If they dig around for too long it can develop a clot.

Gothic — what do you mean by you only let them try twice? What's a try? If they stick the needle fully in and it misses the vein, is that a try? Or is it only a try when it penetrates the vein?

[gothiclovemonkey]

LOL i let them do it once, if they screw up im done. SOMETIMES ill let them try one more attempt, if they mess that up... im not a happy one.
single needle method?

[Riki]

Riki does "push saline" mean that is how the test the line??? make sure you are on good??? I ill make sure they push slowly!!!

Yes, a syringe filled with saline is connected to the end of the line attached to the needle before they stick me.  When the needle is in, they push the saline (slowly, cuz I tell them to go slow).  If I don't feel anything, they go on to the next needle, or connect to the machine, depending on which needle they're on.  if it stings or burns, they take it out.

The centre I go to in Manhattan doesn't do this, and I get nervous when they put me on there because they don't. I've been lucky the few times that they've needled me that nothing bad has happened, but since I have to pay for every little thing they use there, I don't complain.

If they mess up on one stick you can have dialysis using only the good one.

The single needle method does mean that they have to replace all the tubing and the dialyser, so it costs 'em. I've had that twice when they failed on my venal. If they dig around for too long it can develop a clot.

They used the single needle for 2 weeks after I was infiltrated last month.  I found it fascinating, watching the blood going in and out of the chambers (that the nurses called balls. We had quite a few immature jokes made about that).  It looked like they were breathing.  It was very cool.

Gothic — what do you mean by you only let them try twice? What's a try? If they stick the needle fully in and it misses the vein, is that a try? Or is it only a try when it penetrates the vein?

They're only allowed to stick me twice per site.  After that, someone else can try, again only 2 stick per site.  If they still can't get it, they either do single needle, or I go home and they fit me in the next day.  In my case, they usually do get one, so single needle is usually the option.

[cookie2008]

When I had my fistula raised it took 2 months to heal, so they put in a permacath for my treatments.  By time it was healed we were home doing nxstage and my nurse came to the house put them in with no problem the first day, second day my hubby put them in no problem and he has been doing it since.  Raising my fistula was the best thing they did.

[carol1987]

Awesome cookie!!  I am hoping to heal and not have to get a catheter.... I was feeling good before we started Dialysis last week....  My creatnine actually went from 7.6 to a 5.4 on the day I was admitted to the hospital for my first session.  Either way... i am hoping raising it will work for me as it did for you!!