I have to surrender a successful buttohole

[dieterschien]

Over the past five years I have only used one access (buttonhole). I must travel for two weeks to a center in New York that doesn't support buttonhole, so I go to ropeladder. My problem is my home center will not start new buttonholes upon my return ( which they consider).
My center promoted this method, so well its all I know.
Fistula has a limited life, so let it live as it has WELL

[PatDowns]

Over the past five years I have only used one access (buttonhole). I must travel for two weeks to a center in New York that doesn't support buttonhole, so I go to ropeladder. My problem is my home center will not start new buttonholes upon my return ( which they consider).
My center promoted this method, so well its all I know.
Fistula has a limited life, so let it live as it has WELL

Can you elaborate?    Why can you not go to a different dialysis center?  There are numerous ones in NYC.  If you self-cannulate, take needles with you.  Also, what reason was given you can't start a second set of buttonholes?  This all sounds quite sketchy.

EDIT:

You can go to this web site to find facilities near where you will be staying in NYC - http://www.dialysisfinder.com/

Then, go to "Dialysis Compare" to see how well the facilities are doing on certain benchmark outcomes - http://www.medicare.gov/dialysisfacilitycompare/

[dieterschien]

The location is in the Catskill (closes to Mothers) , and I am dependent on a 20 minute ride each way (cause I don't drive) another reason why I can't do self cannulate (visually impaired).
Since starting at this center they have changed positions about buttonholes ( why  I can't restart only maintain.
I haven't been able to visit the NY center due to available space.
I haven't seen my Mother in 3 years 

[iKAZ3D]

This is not useful, but I must point out that the thread title is misspelled so it says I have to surrender a successful BUTTOHOLE. Missing an 'n' in there. If I didn't see that 'o', I would've been very, very, worried. XD 

[Rerun]

BUTTHOLE?  Are they making you a new one??

                 

[bevvy5]

I've never asked about this as Greg's never had an issue with his buttonholes - or buttholes but that's another topic - lol.

Is the issue you don't self-cannulate?  If you do, couldn't take needles and just make sure you cannulate, then remove the needles just to keep the track open?

Seems like a step back to go from a good buttonhole to sharps, but that's JMHO.

Either way, have a good trip.

[Desert Dancer]

Simply take blunts with you and don't take no for an answer. When I visited NJ last May they did not have any blunts as they have no patients with buttonholes. I brought my own and there was no problem.

As far as your center changing their policy on buttonholes, it's not THEIR decision. It's YOUR body. And honestly, you may not even need to create new ones, just re-open the ones you have if you don't take blunts with you. You are not a child and they cannot force you to ladder if you don't want to do that.

[YLGuy]

I was going to travel but did not.  When I was making plans my tech told me to bring my own blunt needles just in case the center I was going to use did not have them.  One thing is that I can self-cannulate so I was planning on inserting my own needles.

[PatDowns]

The location is in the Catskill (closes to Mothers) , and I am dependent on a 20 minute ride each way (cause I don't drive) another reason why I can't do self cannulate (visually impaired).
Since starting at this center they have changed positions about buttonholes ( why  I can't restart only maintain.
I haven't been able to visit the NY center due to available space.
I haven't seen my Mother in 3 years

I hate to hear that you have been put in this situation.  However, your access is your Life line!  Please do all you can to perserve it, especially when it has been working so well.  If it is an individual who will be taking you to the dialysis center, explain the importance of the access to your health.  Maybe (s)he will be understanding and sympathetic, and willing to drive a bit further to a clinic knowledgeable about using buttonholes.  If not, is there a way to access public transportation and a taxi to get to another center?   This is such a vital issue to not give in on - especially when the buttonhole technique has served you so well over the years.

As for your home clinic - what reason did they give for no longer promoting buttonholes?  Are they experiencing high infection rates?  If this is the case, give the facility adminstrator (or whoever made the decision) copies of these links to articles by Stuart Mott, one of the most experienced vascular access nurses when it comes to the buttonhole technique:

http://www.hemodoc.com/2012/07/the-genius-of-stuart-mott-solving-buttonhole-infections.html

http://www.esrdnet15.org/qi/ff/buttonholeprocedure.pdf

I hope these issues get resolved in your best interest. - PatDowns


 

[lmunchkin]

I know most here favor Buttonholes.  It is as I understand the best method to use.  That being said, I have always done the ladder method, and have had no problems with that method.  The only difference as far as appearance you have more sticks on the fistula (.....) like a ladder instead of (. .) from buttonholes.

My husbands fistual  . . . . .              
Those who do buttonhole fistulas   . .            

No problems with the ladder thus far!  But you do what works best for you.  Don't give in & stand your ground respectfully!

God Bless,
lmunchkin

[dieterschien]

Thank you all for the words. Fortunately  I will not have to give up buttonhole, unfortunately I will not travel due to other health reasons. I hope to look at travel plans late fall.

[bevvy5]

I'm sorry to hear that.  I hope that you feel well enough to go visit your mom soon.