I Hate The Needles!!!!!!!!!!!!!!!!!!

[Panda_9]

Yes definitely dont apply pressure until the needle is out!! Its not hard to do, you just have to be quick about it. Whip it out, and apply pressure immediately.
I have had buttonholes (using the same site each time) for only 8 months, and I can tell you now that I have almost no pain at all.It doesnt even hurt when I put the local in! Once the buttonholes develop, you stick the local needle just down the hole a little bit, then veer off into the side of it and push the local in very slowly. I only use about 0.2ml per site, so its very little. Once you have been doing this for a while the pain is minimal. I have no pain inserting the cannulas, and no pain removing them. Sharps do hurt though, as its hard to localise the entire site. Which is why I definitely would go the buttonhole method. I dont know what the infection risks are, but if you follow all the appropriate cleaning measures you should be fine. I havent had an infection since Ive been doing it. Of course, if you notice any signs of infection...redness....pain, etc....you must seek treatment immediately, and DONT dialyse until you do!!!!

[Rerun]

I thought the WHOLE point of  buttonhole technique was "no pain."  Why are you using numbing medicine?

[Panda_9]

Because you do get some sensation when cannulating. Id rather have none. It doesn't hurt really, but thats my choice. I use so little local that I mostly don't feel it. I have a huge scar as well so I guess if I stick it into scar tissue I cant feel it as much. On occasion, I cant get the blunts in, and when you try to push, it does hurt. So thats another reason lol Its hard to explain, its more like a friction feeling with buttonholes. Where as with sharps, it just plain hurts!
I will probably try not to use it eventually, I dunno. It comes in our pre packed dressing packs, so I figure I may as well use it.

[angieskidney]

I plan on learning the button hole technique. I am still new at this. I was on PD for years but since July they have used my permcath for hemo in clinic. But last week they started using my fistula they have been trying to work since the start of this year and are using the 17 ga and are switching to the 15ga this wed (I dialysize m/w/f). I am nervous and since I am in the evening shift (I was on the same shift with Jaime before he died) they say I will have to be switched to the day shift to learn the buttonhole technique since there is no one to teach me at the evenings.

I like learning all I can here because I learn more about what I have been asking for months now more here than anywhere else I have been!! Thank you

[Rerun]

Don't jump from 17gu to 15gu.  There is also a 16 gu.  Use that for awhile.

[Bajanne]

I just recently cleared a big hurdle for me.  For the last 3 sessions I did not take lidocaine.  I find that the lidocaine needle, while it doesn't hurt that much to go in, it stings terribly when the medication goes in.  I started with a nurse that I trust to put in right first time.  That went well.  The next session another nurse did it.  Then yesterday, another one did it as well.  I think if I tell them what I am expecting, then they do their best not to foul up.

[susie q]

I had my first needle yesterday..
one needle.. one line
no freezing   
wasn't as bad as I thought it would be..
Can't wait to get rid of the cath.   

[Bajanne]

Great, susi q!  You go, girl!  Hope it continues to go well with you.

[kitkatz]

I hate the needles when they hit a nerve in the arm, other wise they are NOT supposed to hurt once they are in the fistula or graft.  Other wise I would have to run away every time they stick me!

[scyankee]

angieskidney,
   DON'T increase the size of your needle until YOU feel ready to do so.
  I have been on hemo for 8 months. I have very small veins and my upper arm fistula does not seem to be
developing. May never get enlarged. Anyway, I am still on only size 17 needles. Tried # 16 and that was a
BIG mistake.  Depending on your development, maybe you will be able to go lower and with higher blood flow
rate.  I can't, probably never will be able to go faster.  I have constant pain in my entire arm during dialysis
that after about 2 hrs I need them to turn down the flow rate.
  I find if I put the cream on every 15 minutes for 1.25 hrs before treatment it helps with the needles.
  Good luck.
  SCYankee

[angieskidney]

I had my first needle yesterday..
one needle.. one line
no freezing   
wasn't as bad as I thought it would be..
Can't wait to get rid of the cath.   

I just started the same way 2 weeks ago on a wed and then last wed started 2 needles. Those are the smaller ones. This wed they are starting me on the 15ga and I am nervous from some of the stories I have heard... the Emla cream works best if you wrap your arm in cling wrap.

angieskidney,
   DON'T increase the size of your needle until YOU feel ready to do so.
  I have been on hemo for 8 months. I have very small veins and my upper arm fistula does not seem to be
developing. May never get enlarged. Anyway, I am still on only size 17 needles. Tried # 16 and that was a
BIG mistake.  Depending on your development, maybe you will be able to go lower and with higher blood flow
rate.  I can't, probably never will be able to go faster.  I have constant pain in my entire arm during dialysis
that after about 2 hrs I need them to turn down the flow rate.
  I find if I put the cream on every 15 minutes for 1.25 hrs before treatment it helps with the needles.
  Good luck.
  SCYankee

I have no choice. I mean .. they say I can turn it down but if I do I have learned from experience that they write "non-compliant" on your paper which effects if you will get a transplant or not (in canada).

Sometimes I feel not listened to. I wish my favourite nurse was at my unit more than just every couple months for a week only. I miss her. She is very nice. Her name is Jeannine (Not sure if I spelled it right) & she always makes me smile. All the nurses seem pretty reliant but I still can't help feeling rushed. 3 times with each step ... is that the same for everyone else??

[Joe Paul]

I think the larger needle's in a short period of time is the "norm". Remember the more blood thru the machine, the better for you. I started dialysis April this year, was at 15 gauge within 1-1/2 months time.
If the nurse's told you ahead of time about the larger needle's, thats kind of mean, that works on your nerve's. At the clinic I go to, they changed me up, and didn't tell me, I was the one who noticed, that was by the color of the "flap's" on the needle. We all hate needle's, but I can't recall the difference in the 17 to the 15, thank God it only hurts till they are in.

[angieskidney]

I think the larger needle's in a short period of time is the "norm". Remember the more blood thru the machine, the better for you. I started dialysis April this year, was at 15 gauge within 1-1/2 months time.
If the nurse's told you ahead of time about the larger needle's, thats kind of mean, that works on your nerve's. At the clinic I go to, they changed me up, and didn't tell me, I was the one who noticed, that was by the color of the "flap's" on the needle. We all hate needle's, but I can't recall the difference in the 17 to the 15, thank God it only hurts till they are in.

I asked to be told. I wanted to see the difference. I mean I have been going thru all sorts of stuff since I was 9 years old so for me .. I would rather just know. It doesn't make me more nervous by knowing. Infact for me it relaxes me to know ahead of time what to expect. I am a very realistic person. Sure they are bigger but I think my AV Fistula will be able to handle it by looking at it.

The nurse was NOT being mean ... you see .. the first nurse would NOT talk about it with me but the 2nd nurse did because I asked. It must be hard being a nurse when different people want different things. And everyone reacts differently.

[kevno]

Old Tread same news "I Hate Those Bloody Needles!!!!!!!!!!!!!!!!!!!!!"

Well what Sister Shirley said when she came back off her holiday she did Got caught out, was ot expecting it. Been using both lines since about March. She got a needle in my fistula today. Been very quiet, thinking she had forgot what she had said. But I'm not that lucky

I know My lines are failing, plus it is suppose to be for my own good "Ha!"  Will never get used to being needled To many bad memories from when I was a child on haemo, being held down and so on, what I have said before. Now thinking about Thursday, if, what she did before was tell all the nurses that I was not to use both lines, but to have at least one needle in. Been let off having needles because I was moving around so much with the pain in my leg. But the pain is going and the needles are coming back

[Rerun]

Kevno you can do it.  Just let them get them in and taped down and then just block it out of your mind.  Take some drugs before you go in!

[kitkatz]

Kevno, you CAN do it.  Tell the inner children to go somewhere nice for a holiday in your mind while you are on dialysis.  They do not have to be there when you get stuck.  You, the big brave adult can do the sticks just fine.   I have had to do this several times in my own life to get through things.  I know you can do it.  Like Rerun said. Stick it, tape it down, and lots of drugs!

[Rerun]

Kevno it seems like you are the type who would LIKE being held down by nurses!!!   

[Panda_9]

You could try some valium or something like that  I find it helps take your mind off things.

[kevno]

Tried must be nearly everything. Drugs, seen Doctors, professors about the phobia. I know it is stupid but, thats why I went onto CAPD and not Haemo. A Doc said I would never have to go on haemo, how wrong he was. Been on haemo for six years now. Most of the time I have got away with my lines. But the time for the lines has now run out. But my fistula is, in a word crap. It was done in 1980, Stopped because I got ESP 2000, the surgeons had a go at restarting it one year later! a cut from my wrist to the top of my arm 44 staples, and only a 2 inch stretch of the fistula is working. Ha! well, we see what happens Thursday I hope I can deal with it a bit better than last time the Nurses tried needles with me, only having two hours of dialysis. Getting out of the chair and not even letting a Nurse try to get an needle in I knew the time was coming, it has come around so quick! I got caught out on Tuesday, was not expecting it, she did it so fast. On Thursday will be ready for the needle. Plus already thinking about having an needle.

Getting held down by the Nurses might be good. There are a few fit ones. But the only trouble I would be fighting them off Old Rerun

[Panda_9]

I find if I harp about things that worry me, it makes it worse. Even talking about it too much makes it worse. I have developed a really bad problem in association with the quality of the dialysis water, plus a few other things. I really have to make myself ignore it, otherwise it just overrules my life. I have started seeing a psychologist once a week which helps alot. Just talking to her (about everything and anything) gives me that little push to stay on dialysis for the that week. 

[kevno]

I have gone to three psychologist two were Doctors and the last one a Professor. I did get needled today well one needle, but I got put on as soon as I got to the unit otherwise I would get anxious about the needle and got for a walk to try t calm down a bit. Too many bad memories, too many to get rid of, from being six years old. When the Doctors found out too late I had Reflux. Having a doctor try time and time again to get a vein for a IVP. The Nurses holding me down, too my Mum stepping in to stop the Doctor from trying again. Then telling that Doctor to leave me alone and get a more competent Doctor To being on Haemo when I was ten. Had four years I can not remember much about, on so much Valium. But still had my arm strapped to a board to keep it straight. Plus a nurse to hold my arm down. Even now I have to hold the top of my arm when I am being needled.

[stauffenberg]

There are so many problems with fistulas breaking down, taking time to mature, getting infiltrated, and developing recirculation difficulties that I don't know why the medical profession thinks they are the only answer for long term hemodialysis.  This does not even begin to address the problems patients have with the physical pain of being needled and the general uselessness of anaesthetics to address those problems.  Why not do what I did during all the years of dialysis, which is insist on being dialysed through a central line, a catheter inserted in the chest?  This way there is absolutely no pain in being attached to the machine or removed from it, attachment and removal are much quicker, you can move both arms freely during dialysis, and your body-image is not damaged by one or more ugly fistulas. 

Of course the average nephrologist will tell you that a central line is unsuitable for long-term dialysis, but this is based on outdated experience with the older models, which used to become infected so often that the patient had to suffer unacceptably many bouts of septicemia.  But with the new models this is not an issue, and the line generally never becomes clotted or needs to be changed.  Even if it does, it can quickly and painlessly be replaced over a guide wire, without making a new hole in the chest for insertion.  The only difficulty for the patient is that you have to be careful not to get the line infected, which means never getting it wet, so when you take a bath you have to wrap it up carefully in a baggie and secure it with tape.  I used his method of dialysis from 1996 to 2005 and had to have the line changed for infection only three times, which no nephrologist will ever believe could be true, but in my case it was.  I think anyone could achieve the same result or better, simply by keeping the exit site dry.  The few times the line got infected were my own fault in filling the bathtub too full and splashing water onto the line.

[Rerun]

Stauffenberg that makes me feel a lot better.  The last time they put in a catheter in my chest (May) I told them it is not coming out.  I'm not a piece of Tupperware.  So, it is in and doing okay.   It has some "Proud flesh" around it, but it is not infected.  But, it weeps and boy does that smell.  Of course my chest is not too far from my nose!  There is a doctor on dialysis at my unit and he just has a catheter too.  So, when they start giving me crap about using my fistula I tell them "When Doc over there starts using his, I'll use mine."   

[Zach]

Stauffenberg that makes me feel a lot better.  The last time they put in a catheter in my chest (May) I told them it is not coming out.  I'm not a piece of Tupperware.  So, it is in and doing okay.   It has some "Proud flesh" around it, but it is not infected.  But, it weeps and boy does that smell.  Of course my chest is not too far from my nose!  There is a doctor on dialysis at my unit and he just has a catheter too.  So, when they start giving me crap about using my fistula I tell them "When Doc over there starts using his, I'll use mine."   

Sorry Rerun, but with all due respect, do you actually feel a lot better because stauffenberg says so?  Did you read his description of his own dialysis experience?

I spent eight years on dialysis, during which I was unable to work and endured a kind of living death, during which my existence was plagued with hypersomnia, constant nausea and vomiting, itching, difficulty concentrating, and exhaustion -- despite my rigid adherence to the renal diet and 15 hours of hemodialysis a week.

From this experience you want to take his advise?  The symptoms he describes sound a lot like inadequate dialysis --- through a  catheter inserted in the chest.

I care too much about you to not speak up ... and yes in public, too.
He's just spewing more hog wash.         

[Panda_9]

I would prefer a fistula to a permacath. I totally hated having those things. stauffenberg, what one person experiences is usually not the same as another. I can tell you now that in my experience, getting a catheter inserted is not pain free, and it also wasnt pain free when I got it dressed every dialysis. It was a pain to stop it from getting wet, and it itched so much I made it bleed. I couldnt wait to get that thing pulled out.

Im no expert, but if I am right there are more risks associated with using a catheter for dialysis. They are mostly only used temporarily here, and Im sure its for good reason. They are probably more expensive too.