Name of the thing in front of fistula

[horsie63]

For the life of me I can’t remember what the thing that helps pain by using blunt needles… button hole or something. I want to bring it up at my vein mapping on Sept 7 .

[Beachgirl32]

I don’t do hemo but I recall when my mom had to it awhile there was a buttonhole technique

The buttonhole technique is a way to "cannulate," which means "to insert dialysis needles." Instead of sharp, pointed needles, dull needles are placed into the exact same holes on your fistula every time you have dialysis. Inserting the needles in the same holes creates a "tunneled track" for the needle.

[horsie63 in reply to Beachgirl32]

That’s exactly what I’m looking for. Thank you.

[Bassetmommer]

here is the article on the technique: kidney.org/atoz/content/but....

Also, you can use a topical numbing cream to stop any pain.

[Ziggydoodah in reply to Bassetmommer]

Hi BassetmommerI have been on Haemodialysis for about 16 months. I have buttonholes but unfortunately I am in a lot of pain, when the needles go in. I have asked about the numbing cream and it has a mixed response from the renal nurses. Some are for it, if it controls the pain. Others are totally against it. After a while it causes the buttonholes to go "mushy". Believe I would use the numbing pain in a flash. However the experienced nurses are all saying..under no circumstances.

[Bassetmommer in reply to Ziggydoodah]

The issue with buttonholes is they are more open to infection because there is a direct path to the artery and vein. Although they close at the top, there is less protection. Still I would think that before your insert the needles, you are supposed to wipe off the cream and sterilize the fistula. Maybe they do not want to bother. Remember, it is your arm.

[Ziggydoodah in reply to Bassetmommer]

Yes they do sterilise the area etc. I believe the issue over time causes issues to the fistula. Well that's what they say. I might just try it to see if it does make any difference. That's for your reply

[checkman]

Using lidocaine cream to help pain IS NOT up to any nurse. It's just their "opinion". You do what you want to do. I am also a "port only" person. I will never get another fistula as long as I am on HD. I've had 2 and these techs gave me aneurysms as big as golf balls and they both just stopped working. They would infiltrate and once gave me an infection that turned into the size of a softball on my arm, full of pus, gross. I know someone who let themselves get 8, yes EIGHT fistulas all over their body because they listened to these "medical professionals" and did not use their own judgment—just crazy man. I also stopped letting them change my dressing. I have had SEVERAL infections with a port, either getting the port replaced or being on IV antibiotics. I started changing my own dressing, and voila no more infections. People need to trust their gut and use their own judgment after doing some research, of course.

[cs65 NKF Ambassador]

I believe that when buttonholing was mentioned to me as an option, they also said the holes would have to be opened with a sharp each time because scar tissue would grow over them. I said no and opted instead for Emla cream, which I would apply an hour before the treatment. You cover it with plastic wrap until you get to dialysis, then take off the wrap and wash your hands and the fistula with soap and water. The cream has already worked to numb the area, so it's ok to wash it off. Then the nurse/tech will disinfect your fistula before inserting the needles. All of this is important to prevent infections. I also recall that buttonholing is not offered to new dialysis patients, only patients who have been on dialysis quite a while and have a limited area of the fistula actually usable. After using the Emla cream for quite a while, you may find you don't even need it since the fistula has scarred over enough. When you begin dialysis, they use smaller needles to start with and gradually adjust you to the medium and larger ones.

[horsie63 in reply to cs65]

What is EMLA cream? Different from lidocaine?

[cs65 NKF Ambassador in reply to horsie63]

It's the same as lidocaine cream. Just ask your nurse for it.

[lovemesomeflowers]

We can't get the numbing cream now, was told the company went out of buisness.I am sure there must be other brands out there. I have used it on my fistula for 2 years it does help with the needle stick pain.We may start with a spray?

[Porter20]

Are you talking about butterfly needles? It makes a stick less painful for large amounts of blood?

I ask at every stick!