For the last week or so, I’ve been having pain in my arterial site towards the end of my 7 hour session - after around five or five and half hours. I wasn’t able to sleep because of this pain. Last night however, the pain was quite severe within about 3 hours of starting dialysis. I injected some lignocaine into the area and then also took an IV painkiller - Trammadol. I was able to go on for another hour. After this the pain returned. I closed dialysis.
The area is quite sore. Last nigh, while cannulating, I did not get the correct spot and had to push and pull before the needle went in. I am not sure if the pain was due to that.
The question I had is do the buttonhole sites need to be changed after some time? Has anyone experienced similar pain? Do you think I should change the arterial sites? I have a pair of buttonhole sites and alternate each pair every other day. Both my arterial sites have ben paining and it has been a struggle during the cannulation almost all days.
Sorry to hear that you’re having Buttonhole pain. You reported this last May, too, only then it was in the middle of a treatment. Did anything help it then? Gus thought maybe it sounded like a carpal tunnel or tendonitis problem. Does that seem to fit, or is it definitely the Buttonhole itself?
I’ve emailed your question to my go-to Buttonhole cannulation experts, and will let you know if they come up with any ideas for you.
Still waiting to hear back from folks. But you certainly don’t have to use Buttonholes. Or, in your case, since you seem to get ~6 months of pain-free use out of a new set, you could start new ones the moment one of them starts to bother you, and have the advantage of them while they do last–less chance of aneurysm and less pain (while they work). Or not–it’s really up to you.
I can only speak from experience (I have been using button holes for close to 4 years now)…
The only time I have had arterial pain/soreness was when my fistula was stenosed. (A narrowing through the fistula). While it is suggested that this should not occur with the buttonhole technique, it does over time.
I hope this issue is resolved for you in short order. While dealing with dialysis can be matter of fact (just something we do), it becomes more of an issue when it is uncomfortable and causing discomfort.
Have you tried running your blood pump at a lower flow for a few (maybe 3 consequetive txts?), just to give your arm a rest? I believe you do noctural. While I realize your clearance would be less, (in the short term you could monitor your diet more then usual), maybe if there is some internal inflammation/irritation it would decrease the pain???