Will buttonholes close up requiring going in with a sharp if they are not used for two days in a row?
Once the buttonholes are established, the scabs just have to be removed after not dialyzing for 2 days. My husband only had to use sharp needles to establish his buttonholes, which took about 1 or 2 weeks.
I meant once the buttonholes are established, should 2 days go by without doing a tx, will the bhs close up and sharps be needed to open them again??
It might happen occasionally that the dull needle might be harder to get in, but no, a buttonhole doesn’t usually close up after 2 days. My experience has been that when the dull needle won’t go in, it’s because I’ve inadvertently started it out a little deeper in the buttonhole - sometimes because I’ve left some scab just under the skin where it goes in at an angle, and it gets deflected off the track a bit.
Pierre
I agree on that, the tunnel is still there…it happened to me once that the scab has fallen off and the skin looked smooth and closed but I can still see a dull mark there…weak closed surface that even the buttonhole needle was able to break it open…
Well they shouldn’t …but mine often do!!! I usually seem to manage a week or so cannulating fine, then have a couple of successive sessions where it takes either a couple of blunts to get going; a sharp to start one off, then switch to a blunt after stopping the bleeding for minute :roll: ; or run one blunt, one sharp (for a shorter evening run) ; or even give up & come back next day!! I have thrown up to 10 cannulas in the bin just to get on! :roll:
- Bear
A home patient was telling us the problem he had. He only dialyzed 5 days in a row instead of six. He had just established his buttonholes and had done first tx with the bh needles. That first time with the dull needles, they went in with no problem. But after the 2 day break, he could not get the bh needles to go in. He tried every way to twist the bh needles, pull out and reangle them, but could not get them in. Said he felt pain and that it was like hitting a wall no matter which way he angled the needles. So, not knowing what else to do, he went in with sharps. He has had a subsequent tx and the bhs still will not go in, so he went in with sharps again. What is the remedy?
Also, let me add, he got the scabs off very clean, before going in.
Heather,
I just look at the tunnel as being like my pierced ear tunnels. They would take a while to close up totally, but if i went earringless for more than a couple of days it would require a bit more effort to get them back in. I can feel a nerve sometimes going in with the arterial if it doesn’t slip in easily but so far so good. I do know some people, who like Bear have difficulty sometimes as there is too much resistence . One fellow uses sharps in his buttonhole every time because of this, hmmm. :?
Oh dear 
…I hope he straps his arm down if he’s doing nocturnal !!! :o
Hi Beachy,
With new pierced earrings they warn you to be sure to wear the earrings everyday or the holes can close up. I wonder if bhs react something like this.
Bear, I see your post came in the same time as mine. I am going to have dinner now, but will get back to your post later as I want to reread it to see exactly what it is that you do.
Oh I see another post of Bear’s has come in and that was my other question- if one is doing nocturnal and can’t get the dull needles in and must go with sharps, how does one secure the needles so that he doesn’t infiltrate?
I’ve dialyzed overnight with a sharp needle in one of the buttonholes several times. I had no problems. Of course, it might depend on what the fistula is like. I prefer not to have to do this of course, but sometimes you have to do what you have to do.
Pierre
Pierre wrote:
It might happen occasionally that the dull needle might be harder to get in, but no, a buttonhole doesn’t usually close up after 2 days. My experience has been that when the dull needle won’t go in, it’s because I’ve inadvertently started it out a little deeper in the buttonhole - sometimes because I’ve left some scab just under the skin where it goes in at an angle, and it gets deflected off the track a bit.
So, in this situation, do you feel pain and find it impossible to find the tunnel? Feels like hitting scar tissue? Is this when you go in with a sharp? Can one damage the sides of the tunnel with the sharp?
gus wrote:
agree on that, the tunnel is still there…it happened to me once that the scab has fallen off and the skin looked smooth and closed but I can still see a dull mark there…weak closed surface that even the buttonhole needle was able to break it open…
Not sure what you mean here. The gentleman we spoke to said he was able to get the dull needle part way in, but could not go past a certain point without pain. So, it’s like the tunnel is there but it is obstructed or closed up part way in.
The Bear wrote:
Well they shouldn’t …but mine often do!!! I usually seem to manage a week or so cannulating fine, then have a couple of successive sessions where it takes either a couple of blunts to get going; a sharp to start one off, then switch to a blunt after stopping the bleeding for minute ; or run one blunt, one sharp (for a shorter evening run) ; or even give up & come back next day!! I have thrown up to 10 cannulas in the bin just to get on!
Think I read where you spoke about this situation before, Bear. Whew, you have quite a system. Why the 10 cannulas? If the dull doesn’t work and you switch to a sharp and maybe back to a dull how does that equal 10–yikes!!!
Pierre wrote:
I’ve dialyzed overnight with a sharp needle in one of the buttonholes several times. I had no problems. Of course, it might depend on what the fistula is like. I prefer not to have to do this of course, but sometimes you have to do what you have to do.
No extra taping to secure it or did you keep your arm extra still? Were you able to get in with the bh needles the next night?
No one stated what your training nurse told you to do in such a case???
Ah, that’s on a particularly bad go 
…try blunt #1…take out to see if clotted:no. GO to blunt #2, still no go…anyway, occasionally, after opening with a sharp, stopping (well mostly) the bleeding then trying a blunt or two again and still not getting it in, I’ve had to revert to a sharp & keep it in. Maybe 10’s an exaggeration, but one time it was close. :roll:
I think quite often you get thru the scar tissue O.K., only to encounter resistence from the fistula, the vein wall. I think this is when a little prick (no not me :lol: ) is required and where a sharp will get it & then you revert to a blunt & it’ll go in. I have put a blunt in with a nice stream still squishing out :shock: - dramatic, but it worked!
- Bear
Ah!!! I’ve just remembered the “10 cannulas” days!! - I tried & persevered thru a few, then gave up, went out to the living room, had a cuppa & a snack, then came back after an hour or more & tried again! Twice I did this - once I got in O.K. eventually & once my arm was so sore I knew I wasn’t going to get any sleep, so gave up & came back for a daytime sesh…& got in fine! :roll: