A two-part buttonhole question

[Desert Dancer]

It was really smooth sailing with my buttonholes for the first couple of months, but now it's been months since I've been able to get my blunts in on the first shot.  There have been nights I've gone through 6 or 7 packs of needles before giving up and deciding to sharp stick (although now I've sharp stuck so often - maybe every 2nd or 3rd cannulation - that I give up a lot sooner now).  There's nothing quite like trying to shove a 15ga blunt through a closed buttonhole. 

I can't figure out what I'm doing that's causing my buttonholes to heal up so quickly. Have you ever heard someone complain about healing quickly? Me neither. I'm convinced it must be something in my diet, like fish. I know whenever I eat a lot of fish my hair and fingernails grow like crazy. I told Andy I'm going to Google 'foods that heal' and avoid everything on the list.

Does anyone else have this problem? There doesn't seem to be any rhyme or reason to it. Sometimes I'll go three days and get right in, other times I'll be right on schedule and still have to sharp stick.

My other question is about the tourniquet. Reading texasstyle's post on a BP cuff on the fistula arm got me to thinking about it. Sometimes it will take me a half-hour or longer to cannulate, and up until recently I used to leave on the tourniquet the whole time I was cannulating. Then a couple weeks back it struck me that the tourniquet and a BP cuff have the same effect on my fistula, so maybe that wasn't such a good idea. So I started having Andy remove it and re-do it throughout the process, and I take it off the instant I get into my second buttonhole.

Does that seem like reasonable thinking to you? What does everyone else do with their tourniquet if they're having cannulation issues?

[del]

I have heard of people who heal really quickly which makes buttonholing difficult.  Hubby's "usually" go in with no problem but there are times we have to use a sharp - sometimes 3 or 4 times in a row and then it will be okay again.  Hubby doesn't use a tourniquet on his arm.  He just holds it with his hand while I needle or I hold it and he needles.

[kitkatz]

I have never used a tourniquet. The tech uses his hand to press on the fistula to put the needle into the buttonhole. My buttonholes do heal quickly, too.  After a weekend I can be a hard stick.

[rsudock]

The blunt needles rarely worked on my buttonholes. I healed way to quiclkly. I agree that leaving the tourniquet on that long is worrisome. Have Andy apply pressure to your fistula with his hand that way he can left off more not to put more strain on your access.

Hope this gets worked out!

xo,
R

[boswife]

strongly agree not to leave tourniquet on through the process. OUr nurses were real stirct about that so im thinking it's important.  They worried about clotting etc....  Also, is your fistula moving or rolling?  I know that active people have found that their fistula moves and makes it harder to find the tunnel.  We one time had to use a sharp for 2 days, but since then it has been ok.  One lady told us to twist it a bit to find the tunnel and that worked. Hope you get it solved.  Awful to have to look forward to that struggle each day 

[tyefly]

I have a upper arm fistula and .. well fat on my arm..... LOL      I have to use a 1.25 inch buttonhole needle to do my venous....    I use tape to get my access tight... I place tape close to my access and pull my skin so that its tight... I do this in three different directions....  this makes it easier to get in with out a indentation as you are pushing the needle in .... I hope this make since..... If I dont do this then I end up just pushing and pushing and the fat just sinks in..... hard to get the needle in....  It was suggested that I use a sharp and just cut my way in again and again.... No way... I have nice tunnels ... tight tunnels... they just need to be tighten up when placing the needles..... try this..

[brandi1leigh]

My buttonholes do heal quickly, too.  After a weekend I can be a hard stick.

This is the exact sentence I was going to write.  I tell the staff that quick healing is my one superpower. Sometimes I'll go for weeks with no problems, and then suddenly on a Monday the track has closed so they have to use sharps again. Glad to know it's not just me.

[BillSharp]

I'm a fast healer, also. Only one tech at my D center can cannulate me well, and if she takes a day off, the others often have to use a sharp. Woe unto me when I travel and have to have an unfamiliar tech do me. But, it's all just part of the process, one of the little things we have to get through in our quest to stay alive..

[Desert Dancer]

I'm glad to know it's not just me! (Though I'm sorry anyone has to go through this.)

It never even occurred to me to not use a tourniquet; my nurses told me if I started off using one when creating the buttonholes, then I had to continue using one or the door into the fistula would not be in the same place.  Lord knows it's hard enough to find the door as it is - I try so hard to position my arm precisely the same way every time, and still I have to roll my wrist from side to side a millimeter at a time, searching, searching, searching... it doesn't help that my fistula likes to roll and shift, as well.

I KNEW leaving the damned tourniquet on was bad. Why didn't that occur to me months ago?

It's so frustrating. Sometimes my arm feels like pounded raw meat and I'm just ready to give up. 

[del]

Desert, hubby puts pressure on his fistula and I hold the fistula in place while I am needling - keeps it from moving.

[Desert Dancer]

  to everyone for your responses! It opened my eyes to a whole lot of ways of doing this that I hadn't thought of myself.

I guess Andy and I have gotten into such a groove that we hadn't really considered that he might need to take a more active role in the cannulation itself. We work together like clockwork right up to - and after - but the cannulation itself has always been all mine for some reason; it just shook out that way. 

(Don't get me wrong, I couldn't get through them without him. It's amazing how much love and encouragement can shine through a face mask after a fifth failed attempt.)

I think maybe we will tinker around with all of these suggestions and find a winning combo. I'm certainly going to have him hold my fistula in place so it doesn't roll away from the blunt.

[cookie2008]

My buttonholes give my hubby a problem it rolls, so if the first blunt don't go in I turn my hand over and the blunt goes in. I have an upper arm fistula.  And we use a tourniquet.