buttonhole site closes up

[Jane]

Hi,

From time to time one of my BH sites closes up. Is it correct practice to go in with a sharp when this happens to open it back up again? I do know that sometimes the site seems like it is closed at first, because my angle is just a little off. But I have had some days that no matter how hard I try, I can not find the angle, and feel very sure it has closed up.

[Unregistered]

Jane, did you receive my reply?

[Jane]

No, I have not.

[Stuart Mott]

Hi Jane,


Sorry you didn't receive my other message. Before I can answer your question, I need to know the answers to a few questions:
-- How deep is your access (in mm.)?
-- Where is it located?
-- Which type of dialysis do you do, and how often?
-- How much weight do you gain between treatments?


In general, yes, it is okay to use a sharp to help open up a Buttonhole that is hard to cannulate, IF you use "Touch Cannulation," which I covered in one of the webinars. You can find those recordings on the home page (http://www.homedialysis.org). Touch Cannulation means holding the tubing behind the needle, rather than the needle or "wings" themselves. This process guides even a sharp needle into the Buttonhole without damaging it.

[Jane]

Hi,
My access is an upper arm AVF, right at the top. nocturnal 6x. 1.0 average. What is it about touch cannulation that guides needles into the BH without damaging it? I am glad it is correct practice to use a sharp when sites close up as I read where some have said that using a sharp can slice into the side of the tunnel so should not be used. And I read where one person said his sites never close up. I will check out your videos the first chance I get.