I have been using my fistula now for alittle over 8 months, it is located right above my right wrist. I don’t know the technical terminology to use to ask my question so I will tell you that is ballooning out where they insert the needles most of the time. They insist on using the laddar method when needling. Is the ballooning normal?
Ladder method is good at first start but not for a long time to come. If they continue sticking there you will have to go in for surgery to revise it…simply the ballooning just becomes an aneurysm which can burst later on.
What you want to do is stop ladder technique and start training with buttonhole…that way you will avoid the pitfalls of other access problems.
It’s normal that with stepladdering up and down the same area all the time, you will gradually develop these aneurysms. The problem they cause is that, once they have developed, you can’t really put needles in them anymore, and eventually, you can run out of room on the fistula. As Gus mentioned, these kinds of problems can usually be fixed surgically, but it’s best to avoid them if possible. The buttonhole method does seem to be a solution. When I started home hemo, I had already been on in-centre conventional hemo for 2-1/2 years, and I already had two big aneurysms which kind of limited the territory available for creating 2 buttonhole. But after more than a year of using those buttonhole, there absolutely no sign of any enlargement, and if anything, as measured regularly by a Transonic machine, my flow is better now than when I started the home hemo. Of course, as with all aspects of ESRD treatment, there are never any guarantees about anything.
Pierre
Hi y’all,
This month’s “Topic of the Month” article is on Self-cannulation and the Buttonhole Technique. So, if you want to know a bit more about what we’re all talking about, check it out.
http://www.homedialysis.org/v1/rotating/0506topicofthemonth.shtml.
Oh yes, and don’t forget this video about our own Bill Peckham showing how he inserts his own buttonholes…as I recall, Bill stated that this video is incomplete but you can already still see much by just watching it…
http://www.worldfamousedit.com/kidney/Needles_0517.mov
Later down the road I hope to see more patients show their own home made videos to show how they do theirs! 
…Even an inexpensive webCam will do! If you you plan to get a webcam I recommend the following brand/Model…
http://www.logitech.com/index.cfm/products/details/US/EN,CRID=2204,CONTENTID=10628