Gawd Angie
I have this vision of a nurse standing back and aiming for your arm like she is holding a dart and you are the dart board!!!
Seriously do they wiggle(swivel) the blunt back and forward a little as they go in. That is what I have to do as I am lightly pushing. Sometimes I also pull it nearly all the way out and then it goes in much easier.
You must be getting p…d off with it all.
Well, crikey, I have this image of the captain of the PT boat in Apocalypse Now looking down at his stomach and saying “Spear…” as it’s protruding from front to back…
You’re the only one in your shoes, so you have to do the call,
Best of Luck and what ever happens, you be the one that chooses it…
A Traveler
[QUOTE=beachy;13091]Gawd Angie
I have this vision of a nurse standing back and aiming for your arm like she is holding a dart and you are the dart board!!!
Seriously do they wiggle(swivel) the blunt back and forward a little as they go in. That is what I have to do as I am lightly pushing. Sometimes I also pull it nearly all the way out and then it goes in much easier.
You must be getting p…d off with it all.[/QUOTE]Well the one nurse wiggles it and it won’t go in no matter what. They seem to always miss the actual fistula and the needle is under my skin beside the fistula or above it or pushing it but not penetrating it. THe one nurse Becky pushes really hard and it eventually goes in. Seems that the hole is very VERY small and I heal really REALLY fast. The other nurse said she feels bad for me but knows that is the ONLY way it goes in… 
Seems I am a unique case??
They have to push very VERY hard no matter what or who does it. Only the one nurse, Becky, has the guts to push really REALLY hard to cannulate my arm… I will do it myself when it is not so HARD to cannulate… I mean how in the WORLD will I be able to do this with one hand and not being able to hold my fistula still like I have to for them??? Some one had told me before that it should be like putting in an earring. Let me tell you, this is NOTHING like an earring! I have earrings and have worn earrings for 20 years! This is in NO WAY like putting in an earring!!
AngiesKidney:
I have a similar problem with my arterial buttonholes. No matter how hard I push - the fistula collapses under the dull needle. I have tried all sorts of techniques but nothing works. So, for my arterial sites (I have two) I use the sharp. So long as there is no oozing during my treatment, I have been told - it is OK. I use dulls for my two venus buttonholes - and I agree, it is not like a pierced earring hole.
I’d say that it might be time for you to take the bull by the tail and do it yourself. Once you get the hang of it - you will do great. Four months is a long enough time to have those sites developed. It just may be that you will have to use sharps for a longer period of time. I have been doing my own cannulation for over 2 years and my arterial buttonholes continue to resist the dull needles. Do you have more than one site for each arterial and venus? Do you have trouble using dulls on your venus site(s)? Trust that you will be able to do your own cannulation and ask for support from your unit staff.
Judy
Hi Angie
Just a thought but what if the nurse hold your fistula still for you and you try doing the cannulating? Or has that already been done?
[QUOTE=AngiesKidney;13095]Well the one nurse wiggles it and it won’t go in no matter what. They seem to always miss the actual fistula and the needle is under my skin beside the fistula or above it or pushing it but not penetrating it. THe one nurse Becky pushes really hard and it eventually goes in. Seems that the hole is very VERY small and I heal really REALLY fast. The other nurse said she feels bad for me but knows that is the ONLY way it goes in… Seems I am a unique case??
They have to push very VERY hard no matter what or who does it. Only the one nurse, Becky, has the guts to push really REALLY hard to cannulate my arm… I will do it myself when it is not so HARD to cannulate… I mean how in the WORLD will I be able to do this with one hand and not being able to hold my fistula still like I have to for them??? Some one had told me before that it should be like putting in an earring. Let me tell you, this is NOTHING like an earring! I have earrings and have worn earrings for 20 years! This is in NO WAY like putting in an earring!![/QUOTE]
[QUOTE=beachy;13098]Hi Angie
Just a thought but what if the nurse hold your fistula still for you and you try doing the cannulating? Or has that already been done?[/QUOTE]
Wow good idea! And considering I just found a nurse who does it how I LIKE and gets it in! Today I had Wendy because Becky wasn’t in! Wendy feels around for it instead of spearing it! She says once she realizes what angle works and all she will work with me so I know what angle works and all and then I will start to cannulate myself! Woohoo!!!
That’s awesome, Angie, I’m so thrilled to hear it!
I have a LUAF and my fistula rolls quite a bit at the venous site…
at the risk of being obvious or over simplified, i hold the wings with my thumb and index finger and use my fore or middle finger to immobilize the fistula toward the ‘needle’ …it therefore puts the fistula in between my forefinger (the direction of the roll) and the fistula needle.
if that is helpful, good luck.
[QUOTE=Dori Schatell;13106]That’s awesome, Angie, I’m so thrilled to hear it![/QUOTE]Today Wendy Cannulated me AGAIN and again she had little troubles! She said the trick is to do it slowly and feel around for the holes because she said that I have LOTS of holes from everyone using sharps when they get impatient and don’t want to take the time to find the hole!! How about that? I had a FEELING that was the situation but the others wouldn’t listen to my worries and told me it is nothing and that this just happens and to just accept it! I am glad I finally found a nurse there who will listen to me and take me seriously!!
She said she won’t be there on Wed but will be there Friday. She said that to wait til there are a few good cannulations and then she will guide me while I learn to cannulate myself!
Ooooh I am soooo nervous now that it will finally become a reality!!!
Any words of wisdom ? Simple advice that I won’t forget in my state of nerviousness when the time comes?
Way to go Angie.
I know you will be amazed the millisecond you have a try just how easy it is to have a go at doing it yourself.
The best advice I can give is just don’t dwell on what you are about to do, just breathe deep, calm yourself and then go for it. Don’t stuff around and start thinking about the task , that is when you lose faith in yourself. You have nothing to lose. It will hurt less than what you have already been through I promise.
You know what sensation to feel for and once you have had a try, even if the nurse guides your hand you will be so STOKED that you made that leap . There will be no going back!! It is such a buzz to have a go whatever the outcome.
Thinking of you.
[QUOTE=AngiesKidney;13120]Today Wendy Cannulated me AGAIN and again she had little troubles! She said the trick is to do it slowly and feel around for the holes because she said that I have LOTS of holes from everyone using sharps when they get impatient and don’t want to take the time to find the hole!! How about that? I had a FEELING that was the situation but the others wouldn’t listen to my worries and told me it is nothing and that this just happens and to just accept it! I am glad I finally found a nurse there who will listen to me and take me seriously!!
She said she won’t be there on Wed but will be there Friday. She said that to wait til there are a few good cannulations and then she will guide me while I learn to cannulate myself!
Ooooh I am soooo nervous now that it will finally become a reality!!!
Any words of wisdom ? Simple advice that I won’t forget in my state of nerviousness when the time comes?[/QUOTE]
The following was the first post to my blog Tasty Kidney Pie. I wrote it last June. I’m coming up on my one year anniiversary with Nx Stage. The link is http://blog.360.yahoo.com/blog-ZOinGoMlc6Ob0cYOq_REylepo7tocLwF6N_bBg6HWyEn0A–?cq=1&l=101&u=104&mx=104&lmt=5
[Since May I have been hemodialyzing at home by myself. To achieve this level of freedom and health I had to face one enormous obstacle. I had to stick the large dialysis needles into my vein so that the blood can be exposed to the artificial kidney.
The first time I had to stick, I held the surgically sharp tip with my right hand just above the bulging vein in my left bicep. I just held it there. After some time I tried to imagine my hand moving forward at the correct angle. I tried not to think about the razor sharp metal slicing layers of skin until I felt a “pop,” the feeling described to me when the needle bursts through the vein wall allowing blood to flash into the connected tubing. I was instructed that at that point I would know when to stop pushing. “But, how would I know?” “What would keep me from continuing right on through the opposite wall skewering the Triceps brachii like some tender piece of marinated tenderloin?” The answer given was that I would just know, which was comforting, not!
After a few more very long seconds of what on the outside must have looked like a Zen meditation trance but on the inside I knew what was really going on - panic and a mental image of me throwing the needle out of my hand and lifting my butt of the seat and hauling it on out of there. Instead, I took my leap of faith. I thrusted my extended fingers forward while my left big toe searched for a table leg to wrap around to calm itself all the while I silently screamed, “I do not like this “Sam I am.” I do not like big needles in my ham.” But before I could butcher any more Seuss it was over. Some magical force stopped my forward motion leaving the needle right in the middle of my vein. I sighed. My arterial bloodline was secured. After a few moments of quiet celebration I reached for another needle to secure my venous bloodline. When both lines were set and the machine was on, I leaned back into my chair exhausted but smiling. . . I had scaled the Mountain and found that my life was better for it. Six out of seven days I scale that same mountain but each day the slope flattens just a bit.
For added inspirational emphasis cue ](http://www.firstgiving.com/riverdudes06)Marvin[ now . . .
There ain’t no mountain high enough to keep me away from my Drea, Kobe and Nia.
“. . . Ain’t no mountain high
Ain’t no valley low
Ain’t no river wide enough, baby
If you need me, call me
No matter where you are
No matter how far
Just call my name
I’ll be there in a hurry
You don’t have to worry
'Cause baby,
There ain’t no mountain high enough
Ain’t no valley low enough
Ain’t no river wide enough
To keep me from getting to you
Remember the day
I set you free
I told you
You could always count on me
From that day on I made a vow
I’ll be there when you want me
Some way,some how
'Cause baby,
There ain’t no mountain high enough
Ain’t no valley low enough
Ain’t no river wide enough
No wind, no rain
My love is alive
Way down in my heart
Lyrics by Nickolas Ashford/Valerie Simpson; performed by Marvin Gaye and Tammy Terrell](http://www.firstgiving.com/riverdudes06)
[QUOTE=beachy;13121]Way to go Angie.
I know you will be amazed the millisecond you have a try just how easy it is to have a go at doing it yourself.
The best advice I can give is just don’t dwell on what you are about to do, just breathe deep, calm yourself and then go for it. Don’t stuff around and start thinking about the task , that is when you lose faith in yourself. You have nothing to lose. It will hurt less than what you have already been through I promise.
You know what sensation to feel for and once you have had a try, even if the nurse guides your hand you will be so STOKED that you made that leap . There will be no going back!! It is such a buzz to have a go whatever the outcome.
Thinking of you.[/QUOTE]
So much for my plans … even Wendy could not cannulate me and my fistula is only getting worse … NOT better 
Friday they had to use sharps on both buttonholes and then Monday they had trouble and had to use sharps again and then yesterday (Wed) Wendy who has always been able to cannulate me without any trouble as if my fistula is easy could not even cannulate me!!
So again … a sharp but at least she got the arterial in with a blunt needle! But the Venous she actually has to start a brand new hole! This is the 3rd hole for the Venous! So when the Nephrologist came by (he comes only once a month) I got on his case and he finally said I could see the surgeon for a Fistulagram! The nurses were all saying I didn’t need to see one because sharps go in no problem and the Nephrologist was asking if I wanted to just give up on buttonhole and just do the ladder technique and I said no way!! I explained to him my whole reason for going with buttonhole in the first place is because when they were doing the ladder technique they were doing the arterial in the SAME SPOT ALL THE TIME anyway! So unless I wanted my fistula RUINED I followed the advice of Bill Halcomb (most know him as Epoman) and pushed for Buttonhole. I honestly thought it would go a LOT SMOOTHER than this however …
So I have a new buttonhole for the venous but there is no where else to start a new one for the arterial (the whole reason we went for the buttonholes … you’d have to see my fistula to understand why … there is a very sharp curve and my fistula is so short … and very snakey and dips and heals especially fast and clots and everything you can think of … happens to mine.)
I am trying to work up the courage to do this new buttonhole myself but since I have no clue how to cannulate myself … doing it for the first time with a SHARP scares the hell outta me!!
Any new advice?
My Fistula looks like this (I know … not the best pic … but no matter what angle the pic was taken, no one could see what the problem was with my fistula … so that is why all the labelling)
Hi Angie
Fantastic pictures! (Only a fellow dialysta can appreciate the trouble you must have gone through)
I have been having trouble with my arterial buttonhole lately as it seems to have moved around the place (don’t know whether that is my fault or the veins) and I have begun using sharps in a new spot just under the old to create a new buttonhole as i can’t feel my vein anywhere else . I thought stuff this sticking a local in and just went straight in with a sharp and was amazed that it didn’t hurt at all really!
i was really p’d off after cruising with those buttonholes for so long. I really feel for what you have to put up with.
[quote=AngiesKidney;13354]
So again … a sharp but at least she got the arterial in with a blunt needle! But the Venous she actually has to start a brand new hole! This is the 3rd hole for the Venous! So when the Nephrologist came by (he comes only once a month) I got on his case and he finally said I could see the surgeon for a Fistulagram! The nurses were all saying I didn’t need to see one because sharps go in no problem and the Nephrologist was asking if I wanted to just give up on buttonhole and just do the ladder technique and I said no way!! I explained to him my whole reason for going with buttonhole in the first place is because when they were doing the ladder technique they were doing the arterial in the SAME SPOT ALL THE TIME anyway! So unless I wanted my fistula RUINED I followed the advice of Bill Halcomb (most know him as Epoman) and pushed for Buttonhole. I honestly thought it would go a LOT SMOOTHER than this however …
So I have a new buttonhole for the venous but there is no where else to start a new one for the arterial (the whole reason we went for the buttonholes … you’d have to see my fistula to understand why … there is a very sharp curve and my fistula is so short … and very snakey and dips and heals especially fast and clots and everything you can think of … happens to mine.)
I am trying to work up the courage to do this new buttonhole myself but since I have no clue how to cannulate myself … doing it for the first time with a SHARP scares the hell outta me!!
Any new advice?
My Fistula looks like this (I know … not the best pic … but no matter what angle the pic was taken, no one could see what the problem was with my fistula … so that is why all the labelling)
[/quote]
Very nice fistula! Geez, yours looks better than mine, literally mine is VeRry Short(will post pics of mine soon) You seem to have plenty of area to form buttonholes and I think once you take charge on creating them yourself it will be less stressful for you. I remember my first time inserting sharp needles to myself, was sweating hard, biting my lip, and just holding my breathe…the andrenaline rush was WOW! hehehe…Once I accomplished the first try there after everything has gotten easier.
I have seen you do yours in videos you have made (you are THAT Gus right?) and any advice you have for me I will take seriously! 
Just like advice from Dori or Beachy or BillP!
Thx guys!
I am just afraid of infiltrating myself since my arm is sooooo sore now that I can’t feel crap (well I can but what I mean is I can’t feel precisely where the needle is going like I used to be able to …)
Do you know what I mean? Right now it is all swollen where the venous buttonhole is 
It normally doesn’t go up that much like it is right now. I got a huge hill now 
And I know my fistula looks long but it is in a way where there are only more than one spot for the venous and not the arterial. That is why when they were doing the ladder technique the arterial even then was always in the same exact spot
Absolutley, glad you saw the video… 
I have to tell you, I am not Dori nor I am Bill, I am simply Gus and the best adivice you will ever get is believe in yourself. No one gave me advice on cannulation…I learned by watching others do it.
You will not infiltrate yourself, you can feel it before it happens. Its you who is on control… someone else who is cannulating you can’t feel your vessel.
Don’t let them stick you anymore. If you want to use sharps for a while then just use ladder method for a while till you get use to it, after that then go to buttonhole.
Yep I agree , Gus.
Use sharps wherever you think you can get in easiest before worrying about attempting the buttonhole. Unlike Gus, I had no-one to watch and no one apart from Gus and Pierre and a few others on this wonderful forum to talk me through it and for them I am eternally grateful (: It is such an empowering feeling when you get a cannula in, even if it doesn’t get in the first time.
Cheers
Riverdude that is fantastic!!! I love it.
Cheers
[QUOTE=TheRiverdude;13140]The following was the first post to my blog Tasty Kidney Pie. I wrote it last June. I’m coming up on my one year anniiversary with Nx Stage. The link is http://blog.360.yahoo.com/blog-ZOinGoMlc6Ob0cYOq_REylepo7tocLwF6N_bBg6HWyEn0A–?cq=1&l=101&u=104&mx=104&lmt=5
[Since May I have been hemodialyzing at home by myself. To achieve this level of freedom and health I had to face one enormous obstacle. I had to stick the large dialysis needles into my vein so that the blood can be exposed to the artificial kidney.
The first time I had to stick, I held the surgically sharp tip with my right hand just above the bulging vein in my left bicep. I just held it there. After some time I tried to imagine my hand moving forward at the correct angle. I tried not to think about the razor sharp metal slicing layers of skin until I felt a “pop,” the feeling described to me when the needle bursts through the vein wall allowing blood to flash into the connected tubing. I was instructed that at that point I would know when to stop pushing. “But, how would I know?” “What would keep me from continuing right on through the opposite wall skewering the Triceps brachii like some tender piece of marinated tenderloin?” The answer given was that I would just know, which was comforting, not!
After a few more very long seconds of what on the outside must have looked like a Zen meditation trance but on the inside I knew what was really going on - panic and a mental image of me throwing the needle out of my hand and lifting my butt of the seat and hauling it on out of there. Instead, I took my leap of faith. I thrusted my extended fingers forward while my left big toe searched for a table leg to wrap around to calm itself all the while I silently screamed, “I do not like this “Sam I am.” I do not like big needles in my ham.” But before I could butcher any more Seuss it was over. Some magical force stopped my forward motion leaving the needle right in the middle of my vein. I sighed. My arterial bloodline was secured. After a few moments of quiet celebration I reached for another needle to secure my venous bloodline. When both lines were set and the machine was on, I leaned back into my chair exhausted but smiling. . . I had scaled the Mountain and found that my life was better for it. Six out of seven days I scale that same mountain but each day the slope flattens just a bit.
For added inspirational emphasis cue ](http://www.firstgiving.com/riverdudes06)Marvin[ now . . .
There ain’t no mountain high enough to keep me away from my Drea, Kobe and Nia.
“. . . Ain’t no mountain high
Ain’t no valley low
Ain’t no river wide enough, baby
If you need me, call me
No matter where you are
No matter how far
Just call my name
I’ll be there in a hurry
You don’t have to worry
'Cause baby,
There ain’t no mountain high enough
Ain’t no valley low enough
Ain’t no river wide enough
To keep me from getting to you
Remember the day
I set you free
I told you
You could always count on me
From that day on I made a vow
I’ll be there when you want me
Some way,some how
'Cause baby,
There ain’t no mountain high enough
Ain’t no valley low enough
Ain’t no river wide enough
No wind, no rain
My love is alive
Way down in my heart
Lyrics by Nickolas Ashford/Valerie Simpson; performed by Marvin Gaye and Tammy Terrell](http://www.firstgiving.com/riverdudes06)[/QUOTE]
[QUOTE=beachy;13363]Yep I agree , Gus.
Use sharps wherever you think you can get in easiest before worrying about attempting the buttonhole. Unlike Gus, I had no-one to watch and no one apart from Gus and Pierre and a few others on this wonderful forum to talk me through it and for them I am eternally grateful (: It is such an empowering feeling when you get a cannula in, even if it doesn’t get in the first time.
Cheers[/QUOTE]
Yes but like I keep repeatedly telling everyone I have buttonholes and have had them since December 8th 2006.
The reason I don’t do the ladder technique is because there is only one spot I can do the artieral becuase of how my fistula is. It takes a very sharp turn that leaves only 1 inch of straight way before that sharp turn. Then there is the button hole for the venous. The venous I can do ladder technique if I have to but it was so troublematic that was why I wanted to go for buttonhole. When I explained my reasoning to the Nephrologist he agreed that buttonhole is way better than ladder technique with how my arm is.
Even though all the nurses don’t think that it is anything they are doin wrong I think it is simply because every single time they go to establish a buttonhole they do NOT have their unit set up to have the same cannulator for 6 times in a row. When ever I demand this they look at me as if I am absolutely insain! I plan to bring this up at the Kidney Foundation.
So this is why, based on all the advice you all have given me, that I figure my best bet for a successful set of buttonholes is for me to cannulate myself right from the beginning but that means cannulating myself with sharps! I was planning on blunts! Not sharps! THis is even more frightening to me!