Need advice incredibly fast!

Dear Stuart,
Sorry to be so frantic, but I am in a pickle!
Three weeks ago on Monday my tech cannulated me with a 16G needle for the first time since i began cannulating a couple months ago (with 17G) Our intention on that day was to begin 16G buttonholes. Everything went fine for 2 weeks. There was a little “leaking” on the 5th session. On the Friday at the end of the second week the needle was going in so easily that the tech thought we might try buttonholes on Monday. I know, that was a mistake! The blunt went all the way in but did not go in the vein. We used the sharp. She tried a blunt in the second hole and the same thing happened. So we decided to try again in a week. The next therapy went fine - no bleeding.

Today, Friday, after only one session since the Monday the blunts wouldn’t go in, I was told that we were instructed by management to try the blunts again. Well, the arterial again received the blunt needle all the way to the hilt but didn’t go in. When my tech used the sharp, she couldn’t get any flashback. When she readjusted and got flash back, there was an electric shock feeling, and she couldn’t push blood in or out. I asked her to remove the needle. I wanted to try to cannulate the venous with a sharp to keep it open and then run my therapy with one needle and my catheter. I asked that the doctor be called for permission. But the nurse convinced me that it would be a bad idea because the entire vessel would be “angry” that the arterial needle had irritated it.

Because I have now had two cannulation attempts with blunt needles in a 5-day period, I fear that the vein above my arterial hole has probably been separated from the skin above it (where else would the length of the needle go?) Now also the sharp being stuck in there, probably along the same mistaken track. Is this buttonhole attempt site done for? What should I do?

My fistula is in my left forearm, shallow from wrist to mid-arm, then turning slightly toward my body and going a little but deeper. It sits on top of my arm. I cannot cannulate for about 3-4 inches above my wrist because there is too much pain during treatment. Then, continuing up my arm there is about an inch where it’s good to stick for arterial. Then the vein goes around a little bend, and that’s where we stick for venous. i feel like we stuck in the very best place for buttonholes and now I’m afraid it’s ruined.

My fistula was placed in June of last year. We started using two needles just before Christmas. We only moved up from 17G when i started my buttonhole a few weeks ago. i don’t want my fistula to become distended and developing aneurysms. I was hoping to transition to home hemo with 16G buttonholes, which my doctor has approved.

What do I do when Monday comes? i feel like there’s a track along the top of my fistula above the arterial site due to having three needles inserted there this week. Is two days enough to heal? Why aren’t the blunts going in? Will it just take longer or do I have numerous holes in the vein that aren’t lining up?

UGH! I’m scared! Do we try a new site? toward the wrist or the elbow?

The tech is not using touch cannulation, but seems to have a feel for how the needle is going in (until today). I asked that if the needle was not in the vein when it was half way in to pull it out (because the fistula is shallow and it should be in the vein at that depth) but she seemed to think she was in because she put the needle all the way in.

If I want to try on Monday to cannulate myself, how do i go about picking a spot? Would I be able to hit the buttonhole if the person whose been doing it for three weeks cannot? Is it dangerous to cannulate north of the buttonhole site? Isn’t the track there?

and so many thanks. I am so grateful.

can you give me a update of access one year later, doo still have it