New Fistula - advice on pain please

[rose1999]

Hi, my Dad (aged 79) is due to have a fistula next month - he has a catheter into his chest at the moment - He is in the UK and has hemo in hospital (i.e. not at home).  He is worrying because he sees how much pain some of the other patients have when the needles are inserted.  I've read on here about Lidocain and wondered if it is available in the UK, or is there an equivalent - does anyone know please? I'm sure the answer is on here somewhere but there is such a lot of info, I have tried to find it but can't so sorry if I'm asking something I should be able to find the answer to.  He is also worried about bleeding when the needles are removed and how best to stop it.  Can anyone offer advice on either?  I know he can ask at the hospital but different nurses give different answers and YOU are the experts so we really value your advice.
Thanks ever so much. Rose

[goofynina]

I am sorry, i dont know if licocain is avaliable in the UK or not but there are other creams such as Emla Cream that you might want to look into, but sometimes those may not be as effective as you'd like them to be.   I have to admit, i used to use lidocain and i think (well they say) that the pain from the shot of lidocain is much worse than the actual needle just being put into you.  I never tried it but i have been told by another patient who used to use the lidocain and now does not cuz the pain isnt as bad.  As far as the bleeding, when they take you off, they will apply pressure until the bleeding has stopped and they will bandage him up.  It is best after dialysis, not to do anything strainueous (sp) cuz the scab can come loose and it can start bleeding again.  I hope that helps you in some way, please do not hesitate to ask questions, if it has been asked before, we can easily give you the link as to where to find your answers    Good luck to you and your dad. 

[boxman55]

I use a spray called ethyl chloride aerosol it freezes the location right before they insert the needles. It normally takes 3-4 months before the fistula is ready to be used so you and your Dad will have plenty of time to get used to things and ask the nurses and techs all your questions. As far as needle removal every clinic is probably differant but mine uses a pressure bandaid called a Sureseal, this bandaid goes on the moment the needle is pulled (it has clotting medicine) and gauze over that, then pressure for as long as it takes to stop bleeding. 5-10 minutes on average. The catheter is painless and if the needles are inserted correctly they should be also once they are in. Good luck to your Father...Boxman

[ssticker]

One nurse told me that over time using lidocain will damage the skin.
I agree w/goofynina-the lidocain injection itself is painful, for me it was more so than the cannulation itself, so I just go with the needles.
The first time I stuck myself I was so focused on getting the needles in that afterwards I realized I hadn't felt any pain.
So maybe mentally focusing on something else would help.
And everyone's threshold for pain is different.

[ssticker]

Some people at my unit use the Emla cream.
They apply it at home about an hour before and cover it with clear plastic food wrap.
That gives it time to take effect.

[Ang]

i  use  the  emlar  cream  also  known  as lignocaine,  usually  put it  on  2 hours  before  treatment, only  works  well  if  nurses  hit  the  exact  spot,  or  theres  bound  to  be  some  pain.  if  i  put  to much  on  after  a  while  my  arm  starts  to  go red  on  the  2  spots,  good  luck  with  it  all

[rose1999]

Thanks everyone, you are all so kind and helpful.  I've looked at the Emla cream and I'll discuss it with Dad's surgeon when we see him in a couple of weeks.  It's really good to get advice from people who have actually experienced these  things.  He's a bit scared by it all as he only started dialysis 6 months ago and, at his age, it's a big shock to his system.
Thank to you all for your support.
Love
Rose

[angellady07]

Rose, I hope the cream helps your father. I'm sending positive thoughts your way.

[Meinuk]

You can get EMLA cream at Boots.  You just need to remember to put the cream on well before you have the needlestick.  (in my family we have a bunch of needle phobes, and we keep a supply of EMLA at home for every jab.)

Also, can you talk to the unit about establishing buttonholes for your fathers fistula?  I have to say that there is almost no pain when I use my new button holes.

Good Luck!

[rose1999]

Thanks everyone for the advice and good wishes.  Do they do buttonholes in the UK?  I have read a bit about them on here but don't really know much about them.  I will ask the consultant when we go to the access clinic in a couple of weeks but if anyone has any suggestions of the best place (on here or another site) for info then that would be great.
Thanks again for all the support, you're a wonderful bunch of people, I am so glad I found you.
Rose xx