button hole cannulation fistula pictures home hemodialysis

Home Hemodialysis – 8 Classes Later

As per my calculations, it’s been 2 and a half weeks since I started doing home hemodialysis training (or 8 training classes). According to Rose, my trainer, I’m doing pretty well. She seems to think that I’ll be ready to go at it by myself in 6 weeks, or by the end of February I guess.

The idea of doing dialysis at home and having my days free is pretty exciting to me. It’s a feeling I haven’t felt in a long time. I would have loved to NOT have to train for home hemodialysis and to have just gone straight to transplant. But there has been so many plans to go ahead with transplant and something always seems to come up, be it me getting ill on more than one occasion, or this time with my father having slightly elevated blood pressure levels. It’s becoming more and more apparent to me that perhaps this hitches keep coming a long for a reason. Perhaps I’ll get my transplant…but just not now. I guess the man upstairs isn’t ready to see me get a kidney (or perhaps isn’t ready to see my dad donate one).

Now I seem to be doing pretty well with setting up the dialysis machine and such. That was one of my main worries…the whole damned thing looks so complex and complicated. But the home dialysis training unit created this instruction binder with full page sized pictures each step of the way. It’s really helping and I can pretty much set the machine up without supervision.

The problem that I seem to be having now would have to be cannulating myself. For those who don’t know, cannulating oneself is just fancy for “sticking dialysis needles in my arm”. I have two bumps on my arm which were caused by several nurses sticking needles in it. I’ve been told several times that it’s better to put your needles in yourself as it’ll hurt less, and since you’re the one doing it, you’ll be putting the needle in at the same angle all the time. It’s much better for you. When I was still doing in-centre dialysis, some nurses tried and tried to get me to cannulate myself. It simply wasn’t something that I was interested in. I do consider myself independant, and I like doing things for myself, but this certainly wasn’t one of them. The idea of sticking a needle in my arm didn’t seem to sit well with me. I was also afraid that I’d shove the needle in too far or something and botch my arm up majorly.

Rose is teaching me a cannulation technique called “button-hole”. It basically consists of sticking the needle in the same spot day after day. When you’re ready to dialyze, you clean your arm, soak the scab that has developed over the hole that you stuck the needle in the day before, use a needle to gently pick the scab off, then put your new needle in the exact same spot. Sounds easy enough, but I’m still struggling with it a bit. My needles didn’t used to hurt going in because the nurses used to put them in vaguely the same area. But now that we’re doing the button hole technique, we couldn’t use the same spot that all of the other nurses were using. We have to give that entire area a chance to rest. So, we had to start a new spot. Breaking fresh and uncalloused skin hurts! Plus, these needles aren’t a joke…they’re pretty big!

So today I put my needles in and it wasn’t the best. The bottom one went ok, but the top one didn’t go as well. When I put it in, it hurt more than I know it should have. When we started dialysis, it became apparent that the needle was touching the wall of the fistula or something, because the machine was showing higher than normal venous pressures. So, in the end, Rose had to put another needle in on top. We left the not working needle in and just switched the tubes. we did that for a couple of reasons. One was that the tape that was used to secure that needle was overlapping my bottom needle, and if I removed the non-working one, the good one would probably go with it. Secondly, I had already received some heparin, and if I removed the non working needle, I’d probably bleed forever. Well, perhaps not forever, but for a very long time nonetheless.

When I got home, my arm was pretty sore from all the poking around so I iced it for a while. It feels better now, and I’m sure it’s ready for another poking on Monday.

Below are two pictures of my poor, tortured arm. If you can see the red circles, the one on the far right is a circle that is around my bottom button hole site. The middle circle is my top button hole site. The circle on the left is the new hole that Rose had to poke in me when the middle button hole decided to be fussy. Oh, and I know you’re jealous of my penguin pyjama bottoms. 😉


1 comment on “Home Hemodialysis – 8 Classes Later

  1. I hope your training for home dialysis went well. After 3 years now, there is no way I would ever go back to 3 time a week in a clinic. Keep up the writing.John Melochehttp://dialysisdiary.blogspot.com/


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