My mother is experiencing a great deal of pain when they insert the needles into her fistula.
She says it feels like a burning sensation or her hand is on fire. It will also at times start going up her arm. It continues the whole time the needles are in place. We tested for steel syndrome and that is not the problem. No one knows why this is occurring. Has anyone else had this problem or know what we can do?
Sounds like nerve involvement in or around the tissue surrounding the fistula. If the needle contacts the nerve upon cannulation, it could trigger the burning sensation. The other possibility is that the portion of the needle that is outside of the fistula and in the tissue is contacting a nerve. If the center is using the ladder technique - different cannulation sites, it seems unlikely that the same nerve would be contacted. There are no nerves in the fistula, but the fistula can run along nerves and/or be in contact with them. The fistula shouldn't change its shape or location in response to having a needle in place or wile in use, if flows are adequate. The dialysis machine would alarm chronically if the venous and arterial pressures vary above or below established limits and these changes in pressure could affect the fistula size and shape, increasing the likelihood of nearby nerve involvement. Nerve issues are vexing to treat, much less diagnose.
I am an HHD patient and as such manage most of my own care and treatments with the assistance of my care partner/spouse. I cannulate my fistula via any one of 10 combinations of two of five buttonhole sites that I developed with repeated sticks (and treatment) with 15 gage sharp dialysis needles. I use 15 gage blunt dialysis needles once the site is established (2 to 6 sharp sticks) and feel virtually nothing during the blunt stick (via soft touch cannulation - augering the needle through the tract, past the fistula flap and into the fistula. I feel nothing during treatments that range from 2 to 3 hours daily or 6 to 8 hours nocturnally.
A hot water glove was used in center when they were near a nerve and a burning achy feeling was present. They had repositioned the needle as well which sometimes worked. When the heat helped I bought hand warmers near the site. It would stop. Hope this helps. The tech told me that ice helps other people.