Horrible pain when being stuck!!

[chattyKathy1959]

I am new at being stuck...this was my third time since my fistula has been revised several times! This is horrible for me! I have had a catheter since June 2011 and my fistula is now ready but the pain is unbearable!  They told me to get a numbing cream, does it work? I asked my MD for a script, I'm praying it helps!! My nurse told me they have to go deep and that's why it's so painful...I sure would keep my catheter if it wasn't so dangerous!!

[YLGuy]

Put the cream on at least 1 hour before.  I put the cream on as soon as I get out of the shower.  I then put a tiny piece of Saran Wrap on each dollop of cream and a piece of tape over that.  I have buttonholes and the cream makes the scab so soft that it pretty much comes right off.

[tiredandthirsty]

i started on hemo two and a half weeks ago.  i was mortified as well and went in the first day without the cream.  it did hurt a little but it went away after a while.  but i still got a prescription from the neph for an EMLA cream and in my opinion it does make a difference.  it is not a silver bullet, so there will be some pain, but i believe it is less than what it would be without the cream.  i have been using it for all treatment so far.  it works for me, it might as well work for you.  no harm in trying :-)

[Whamo]

At my kidney center they give me a shot of lydocaine before they put in the big boys.  Once, my nurse forgot, and the pain was incredible. 

[dialysisadvocate]

I am not sure about this but I have heard pros and cons about giving lidocaine prior to sticking -- can't remember - maybe someone else knows.
Also, my father had severe pain when certain staff cannulated -- others were less painful...
Opinion of Roberta Mikles - www.qualitysafepatientcare.com

[deniferfer]

I'm not on hemo but I use the numbing cream when I get my bloodwork done and it works.  i would leave it on longer if they have to go deep like you said to it can numb all the way.

[Hazmat35]

I've been on "D" for 2 years, and I use the Lidocane cream at least 1 1/2 hour before I start my treatments.  I know that once or twice I forgot to use the cream, and HOLY COW was it painful.  14 ga needles are nothing to joke about. 

In the hospital by our house, if you are there for a stay, and have your treatment done there, they use an aerosol can spray, just before they stick you.  It works instantly.  Our center won't let us use it because of the "toxins" in the aerosol can effecting other patients. 

The cream works great!  put it on, then put a small piece of plastic wrap over it.  It helps it absorb into your skin and also protects your clothes from getting messy and greasy.  Then, just before Dialysis, wash it off! 

My Neph writes me a script for 60 grams once a month.  That would be for 2 x 30 gram tubes.  One tube lasts me about 2 months.  He writes the extra because of my copay.  I can get 60 grams for the same price as 30 grams but get twice the cream. 

[cattlekid]

Have you thought about having buttonholes established?  Once the buttonholes are ready, there is little to no pain (at least for me) as you are inserting the blunt needle into the same track over and over again, like an earring hole. 

[mogee]

When I had a fistula the cannulation needle would occasionally hit a nerve.  Is this what  is happening to you?

[Hazmat35]

Have you thought about having buttonholes established?  Once the buttonholes are ready, there is little to no pain (at least for me) as you are inserting the blunt needle into the same track over and over again, like an earring hole.

I have button holes, but still get the pain.  I think that it is more PHYSCO-CEMATIC than anything.  i have an INCREDIBLE fear of needles.  So, I still use the cream. 

[Cordelia]

I was going to get this cream awhile ago but my nurse pretty much discouraged it by saying that it 'introduces' the risk  of infection. Has anybody gotten an infection from using this cream?

[cassandra]

I don't (and never have) use the cream, but the lidocain spray, and the nurse said the same. I don't even react to nonsense. If you clean it, and sterilize it properly as you are supposed to, there is no more risk of infection, as without the cream/spray.
I've been using it for 15 yrs now, and never had an infection.
Of the people around me that use the cream I've also never heard of an infection.
The only infections I've heard of were with people who went 'cold turkey', but were unlucky with not having been sterilised properly or something like that.
So I needle myself, and super sterilize.

love Cas

[Cordelia]

Thanks, Cas, for the clarification.       

[Restorer]

My fistula is in my upper-inner arm - very sensitive skin. I have buttonholes. If I forget the cream, it's VERY painful.

I wash my hands and my arm before I put the cream on, and then I wash my hands and arm again when I get to the dialysis unit. I really doubt there's much additional chance of infection if you do that. I seem to be the oddball at my unit though. I never see anyone other patients washing their hands or accesses.

[Hazmat35]

After I put the cream on over my button holes, I cover with a layer of plastic wrap, and tape it down with some tape that I get from the center. 

I leave the cream on for about 2 hours, and when they call me for my appointment, I go to the Wash station where we are suppose to wash our hands and weigh our selves, I take off the wrap and wash off the cream with a damp towel and pat it dry.  Very easy, on takes a couple of seconds.  Some of our other patients, don't wash the cream off, they let the Technicians do it, and they dont' seem to mind to much. 

[rfranzi]

I started switching from the chest catheter to the needles last week. Had my first day with two needles yesterday. My fistula is near my wrist. They try to space the needles two inches apart, so it is near the wrist and the middle of the lower half of the arm. I am lucky the scar is tiny, but the artery (?) is a bit narrow near the wrist and that hurts the most. I got the cream and put it on at least an hour before and wrap the arm in saran wrap. I wash it off when I get to the center. When I get there, they give me lydocaine shots before the needle. I have also asked for a moderate amount of painkilers for the initial times, as much as it takes. My doc gave me 5 percocet last week. It hurt this weekend, so the on call doc gave me something less strong but still helpful to get me through the weekend, as per their policy, they couldn't prescribe narcotics while my neph was on vacation. Anyways, it was okay, it was all I needed. But I did need something. I have no shame in asking for the cream, the shots, the painkiller (which I take before I go in) - whatever it takes to minimize the discomfort. It is tough enough to adjust to dialysis. I do believe and I guess this is what's keeping me going, is that I believe it will become less tender over time. That my fistula will get stronger (or they will go in there and make it stronger) and that scar tissue will develop around the access point and it will hurt less as it gets routine. I keep telling myself, this is the tough part. If I can get through this, it should get better. Right?

[tiredandthirsty]

My fistula is near my wrist. They try to space the needles two inches apart, so it is near the wrist and the middle of the lower half of the arm. I am lucky the scar is tiny, but the artery (?) is a bit narrow near the wrist and that hurts the most.

this is exactly my situation.  i have the fistula at the same spot and the lower needle hurts the most.  it does get "easier" as time progresses.  i mean i have been on D for just over three months now and at this point, it hurts less than it did the first week.  i do use lidocaine cream regularly although sometimes i think it does not help at all and sometimes it does.  Hang in there.