Was wondering you folk over there in the Northern hemisphere care for your buttonholes particularly straight after dialysis?
I have heard a few horror stories of late of fistula infection and am interested to hear how long you leave you buttonholes covered after the cannulas are removed and whether any antiseptic cream is applied before or after the covering is removed? Also how long do you leave the sites before showering etc??
I usually just leave the “tip stops” on for around 4 hours and then have no cream or real protection on but I am hearing in some other renal units they are suggesting dialyzors apply something like "Medi honey"post dialysis.
[quote=beachy;14019]Was wondering you folk over there in the Northern hemisphere care for your buttonholes particularly straight after dialysis?
Interesting question, I do have been doing something different than maybe what most home patients do and my clinic didn’t suggest what I do, its something I took into account to have extra protection…
I have heard a few horror stories of late of fistula infection and am interested to hear how long you leave you buttonholes covered after the cannulas are removed and whether any antiseptic cream is applied before or after the covering is removed? Also how long do you leave the sites before showering etc??
Before dialysis, wash fistula, then use alcohol, betadine, and Sterigel for tunnels. After dialysis, once the buttonholes clot I add a dash of NeoSporin on top of each buttonhole. Then place my bandage on it, not too tight. leave on overnight and remove in the morning. Showering takes place next day, 7-12 hours apart from treatment time.
I usually just leave the “tip stops” on for around 4 hours and then have no cream or real protection on but I am hearing in some other renal units they are suggesting dialysors apply something like "Medi honey"post dialysis.
Any ideas anyone?
Well, I think you should use extra protection. What I am doing(Neosporin) was not included in training, it was included by my decision.
When I was doing buttonhole (the nurses have decided to give up on mine now) I would leave the gauze on maybe too long as when I take it off it bleeds because it pulls the scab off. I put a stop bleed bandage on it after that. I shower when I have a scab (hole closed to infection possibilities) but I notice in the shower the scab gets soft so I have wondered about this myself.
i worry about fistula infection because I have known 2 people my age who have died. One to possible fistula infection and another to a clot that got dislodged when he fell and went to his brain. I clot fast and I heal fast so I didn’t use any creams on my buttonholes when I was doing them because I was afraid of the buttonholes closing up. Now that I am back to the sharps and ladder technique I don’t have to worry about that anymore. Should I be using a cream on my fistula now?
This is a very interesting topic! Thanks for posting it!
For me, the blood clots quite fast. I’m doing nocturnal. So, once I remove the needles, I put a little Neosporin powder and a piece of gauze and then use torniquets to hold the gauze in place with some pressure.
After about 15 minutes, I remove all t his and put 2 waterproof band aids. I then h ave a shower. Water does go in however but less than if I don’t put anything.
After the shower I remove the band aids and leave it open.
Caring for buttonholes still seems to be a bit of a grey area with a fair bit of 'suck it and see" approach, particularly down here. I have heard It has even been banned in one training hospital due to the high rate of infection. Apparently one home dialyzor was picking the scabs of with his fingernails. I mean REALLY some people have got rocks for brains!
Kamal
I would be a bit cautious about getting water on your buttonholes so soon after you have taken the needles out. I would also worry about drying the arm with a towel that wasn’t fresh every time.(Please correct me if I am wrong, Dori)
The way I look at it, the tunnels develop tissue along the track similar to pierced earring holes, so the tunnel is fairly exposed all the way to the vein which can allow bugs to have a nice environment. A scab does form over the surface but needs at least a few hours to harden. I would assume with the step ladder technique there would be no defined tunnel.
I do a fair bit of swimming but leave it around 7 to 8 hours at least.
If I have a shower straight after dialysis I always have my arm horizontal away from the water spraying onto it. Just my thoughts.
Hi ya beachy…ever since Jessie started buttonholes and sel-cannulation he’s been using Medi-Honey…not avaliable here in Canada…it was sent to him by Dr John Agar of Australia…Jess puts a dab on after he removes the blunts…never had a prob thus far
Nice to hear from you. I had bought some Medi-Honey after talking to our guru but wasn’t sure when exactly to use it. I guess I could just dab a bit on the “tip stops” (band aids) I use as I am removing the cannulas .
Nice to hear from you. I had bought some Medi-Honey after talking to our guru but wasn’t sure when exactly to use it. I guess I could just dab a bit on the “tip stops” (band aids) I use as I am removing the cannulas .
Hope you and Jessie are doing well.
Cheers[/QUOTE]
...I wish I'd known/read this before last October!!!
Before losing my fistula…since when I’ve had a permacath for 7 months (all bar a day);
another for 2 weeks - infected; a femoral for 9 days; now a trans-lumbar cath!!..and still
waiting to get a new fistula we can actually use !
thing are cool with Jessie…and yes that’s the way he’s doing it …just a dab on the band aid is all what’s needed… Jessie just got a call to-day from London (Canada) and he’s “finally” on the transplant list… we are all very happy to get over that hurddel …we are prepared to wait but pray that it will not be too too long…we’ve been through this before with Jessie’s mom Anne so it’s not new… Jessie should be starting training for home dialysis very soon in Toronto