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  • New to Dialysis

    I'm new to dialysis, as a matter of fact I had to start hemodialysis in the hospital because of a bad case of pneumonia and my kidneys couldn't handle the strain of the virus. I have a fistula in my left arm and it hurts when they stick me with those needles every time I go to dialysis. I have read about Peritoneal Dialysis and I know this is what I want to do. My question, as far as body image is concerned, how much of the catheter is exposed from the belly? Does it interfere with intimacy?
    Thanks for your help!

  • #2
    There is about a 6 to 7 inch small tube that sticks out from your mid-section. I wear a thin band that hides the tube and it is hardly noticeable. PD is the way to go. I have used in center hemo, through both the perm cath and the fistula and PD at home. PD is very freeing, diet wise, time wise ,and being able to live a nearly normal life.

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    • #3
      i just started dialysis this month i had a fistula but it blew on my first day of dialysis so i had to go to surgery and get a port put in my chest boy i like the fact that i dont have to get stuck with needles they sure do hurt but the ports are only temporary i heard but oh well today is my second day of it hope it all goes well

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      • #4
        AngelaCash I hear that you can get a cream that will numb your arm when they stick you. If you haven't already tried it I would have them give you a prescription for it. You rub it on about an hour before you get stuck and it helps ease the pain. They can also give you a shot of lidocaine before they stick you that might help. I don't get dialysis yet so this is from what I have heard on here.

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        • #5
          Originally posted by cheryl48 View Post
          i just started dialysis this month i had a fistula but it blew on my first day of dialysis so i had to go to surgery and get a port put in my chest boy i like the fact that i dont have to get stuck with needles they sure do hurt but the ports are only temporary i heard but oh well today is my second day of it hope it all goes well
          The perm cath can be used up to a year, if you keep the entry hole from getting infection they will wait till the fistula matures which takes about 6 months. My fistula blew out the night I came home from the hospital. I lost 3 and 1/2 pints of blood and my core temp dropped to 94 degrees. I would have died if the lady that takes care of my house had not stopped in to check on me. The para medics said that technically I was dead for a short period of time.

          The needles they use are larger than the needles for donating blood and the cremes and shots don't work very well at dumbing the pain. Getting stuck with 6 needles per week hurts. Find out if you could do the peritoneal dialysis, that is the easiest and pain free also.

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          • #6
            I just started pd I feel fine and I am hoping for the best I am 66 yr old.

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            • #7
              Hello AngelaCash,

              I've been an HHD patient since starting hemodialysis in July 2012. I made the commitment then to learn how to self cannulate, first starting with 15 gauge blunt dialysis needles with buttonhole access my my fistula. The buttonholes are created through repetitive sticks/treatments with 15 gauge sharp dialysis needles.

              Blunt needles cannot pierce and thus cannot infiltrate a fistula as a sharp can. Blunt needles are placed using "soft touch cannulation", in effect augering while advancing the needle trough the established buttonhole tract and through the flap in the vessel. It took nearly 6 months for me to handle a sharp dialysis needle to establish a new buttonhole site. Since then I have developed roughly 12 different buttonhole sites with 5 in current use.

              I've grown quite comfortable handling sharps and self cannulating. There is huge difference between someone else sticking you or you sticking you. When you stick yourself you can feel everything and adjust to address any discomfort. When you are doing the sticking there is no element of surprise. While all of this isn't completely pain free, the pain is quite manageable/tolerable and you focus on any discomfort as a means to an end - your continued survival. I find picking buttonhole scabs far more uncomfortable, especially when a scab is deeply entrenched. All of the scab must be removed before placing the needle lest it get pushed into your blood stream and subject you to what could be a life threatening blood infection.

              I cannot advocate strongly enough for self-cannulation. If you are willing to remove wood and metal splinters from your skin/tissue, sticking yourself with a dialysis needle is the inverse but with a finely engineered "tool".
              Last edited by stumpr54; 12-04-2015, 09:38 AM.

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              • #8
                I am new t dialysis... Have had two sessions... I am a hemo patient... I have a hard time sitting still for the fours hours....I bring my tablet...I have a book downloaded and also some games...there's a TV to watch... But I still find myself feeling anxious.... This is all... New...and scary... And not how I expected to be spending my days....maybe I need to see a therapist.... I am not sure how to process it all...and even as I type it...I feel ridiculous

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                • #9
                  Originally posted by stumpr54 View Post
                  Hello AngelaCash,

                  I've been an HHD patient since starting hemodialysis in July 2012. I made the commitment then to learn how to self cannulate, first starting with 15 gauge blunt dialysis needles with buttonhole access my my fistula. The buttonholes are created through repetitive sticks/treatments with 15 gauge sharp dialysis needles.

                  Blunt needles cannot pierce and thus cannot infiltrate a fistula as a sharp can. Blunt needles are placed using "soft touch cannulation", in effect augering while advancing the needle trough the established buttonhole tract and through the flap in the vessel. It took nearly 6 months for me to handle a sharp dialysis needle to establish a new buttonhole site. Since then I have developed roughly 12 different buttonhole sites with 5 in current use.

                  I've grown quite comfortable handling sharps and self cannulating. There is huge difference between someone else sticking you or you sticking you. When you stick yourself you can feel everything and adjust to address any discomfort. When you are doing the sticking there is no element of surprise. While all of this isn't completely pain free, the pain is quite manageable/tolerable and you focus on any discomfort as a means to an end - your continued survival. I find picking buttonhole scabs far more uncomfortable, especially when a scab is deeply entrenched. All of the scab must be removed before placing the needle lest it get pushed into your blood stream and subject you to what could be a life threatening blood infection.

                  I cannot advocate strongly enough for self-cannulation. If you are willing to remove wood and metal splinters from your skin/tissue, sticking yourself with a dialysis needle is the inverse but with a finely engineered "tool".
                  I was going to ask you about buttonholes and how they are made. When you do HHD, how long are you hooked up to the machine? The reason for these questions is that I know someday my peritoneal membrane will stop working because it gets thicker over time and eventually won't let the waste products do the ion exchange. Then I plan on doing HHD. I am only going back to a Hemo center as a last resort. Too much suffering happens there, old people that can barely move etc...

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                  • #10
                    Originally posted by ocalasweetthing View Post
                    I am new t dialysis... Have had two sessions... I am a hemo patient... I have a hard time sitting still for the fours hours....I bring my tablet...I have a book downloaded and also some games...there's a TV to watch... But I still find myself feeling anxious.... This is all... New...and scary... And not how I expected to be spending my days....maybe I need to see a therapist.... I am not sure how to process it all...and even as I type it...I feel ridiculous
                    Have a serious talk with your centers social worker and nephrologist. I started at a center and quickly went to the peritoneal dialysis. I hook myself up to the cycler (small machine) 3-4 nights per week when I go to sleep and in the morning the process is all done.

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                    • #11
                      Hello Loganwon,

                      You should have sent me a Message to reply directly about your very valid questions about button holes and HHD. I've been quite busy and just today checked out the Recent Posts to find your questions to my post of 12-3-15.

                      I think I answered you question about the process for creating buttonholes in my 12-3-15 post: "The buttonholes are created through repetitive sticks/treatments with 15 gauge sharp dialysis needles." When you start hemodialysis through HHD training (vastly preferred), your arteriovenous fistula will be cannulated with 17 ga sharp dialysis needles for 5 or so treatments. You then progress to 16 gage sharp dialysis needles for 5 or so treatments. You then progress to 15 ga sharp dialysis needles for 7 to 10 treatments before attempts are made to cannulate your fistula with 15 ga blunt dialysis needles. The site cannulation that is done through this entire period is done on the same two sites.

                      It is very unlikely that any in-center dialysis facility will follow this protocol as button hole access is universally discouraged up to the point of banned in these settings. If you are an HHD patient and seek treatment in an in-center facility, they will generally allow you to "do your own thing", e.g. prep and cannulate your access, connect and disconnect from the dialysis machine. They will set up the machine and monitor your vitals and address any alarm conditions.

                      I conduct HHD treatments in the great comfort of my "dialysis room", essentially a spare bedroom in my home. The room is equipped with desktop computer, home theater system, day bed, the NxStage System 1 Cycler, NxStage Pureflow SL, and about two weeks of HHD supplies. Bulk supplies are kept in our basement. The HHD treatments consist of both short daily treatments and nocturnal treatments.

                      I am "hooked up to the machine" for 2 to 3 hours for a short daily treatment and roughly 8 hours for a nocturnal treatment. During these treatments, I have my roughly 36" of blood lines secured to my arm and across my chest connecting me to the cycler. I have the full range of motion with my right (access) arm and can do everything with this arm that I could normally do while not connected to the cycler, e.g. type, write, read, play guitar, assemble and disassemble, etc. Between the two pieces of paper tape holding each dialysis needle in place and the elastic Velcro straps holding the lines to my forearm, my only limitations are the short distance that I can move away from the cycler. I can sit, stand or lay down without constraint.

                      I have been an HHD patient from the start. I never missed any work (full time) to support training or treatments. I have traveled extensively for business and pleasure while an HHD patient, never missing my 5X 4X alternating weekly treatment schedule. I especially look forward to the NFL season, when I can conduct a short daily treatment watching the Green Bay Packers or other game on Sundays.

                      In preparation for HHD, you will need to have an arteriovenous fistula placed, find a dialysis center that offers home hemodialysis, and lastly and most importantly, you will need a care partner to join you in training and be there at home when you conduct your treatments.

                      The role that my spouse plays in my HHD treatments is quite minimal. I do all the machine prep and set up, cannulate my access and hook up and disconnect at the beginning and ending of each treatment. My care partner spouse pulls my second needle at the end of treatment so I can then hold pressure on both sites, while she strips the machine and cleans all surfaces and disposes of the cartridge, saline bag and the dialysate SAK, when that is expended. When we treat "on the road", she sets out the bags of premixed dialysate, while I hang them and plumb them in preparation for that evening's nocturnal treatment. There is a bit more to dispose of when treating on the road - the spent premixed dialysate bags. A week's worth of treatments fit into a large plastic garbage bag. The two of use have been at this for 3-1/2 years and we've got a very lean and well oiled machine. All it takes is repetition and the desire to improve where possible.

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                      • #12
                        Thanks for the reply, so you are a Packer Backer? I am a big Detroit Lions fan, I wish we had an NFL team, I swear the Tigers or Red Wings could play better sometimes. Maybe even the Pistons. There is no excuse for Detroit not being a number 1 team. The Ford family owns them, so they have tons of money and a very loyal fan base, a great stadium to play in and they still stink! Anyway thanks for the info, gives me something to think about for the future.

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                        • #13
                          Loganwon: I thought PHD had to be done evey day. Is this not true ? Under what circumstances would you do PHD "every" day vs only 3-4 nights a week?

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