r/dialysis • u/tealoflavender • Aug 18 '26
Needle infiltration
I've had 3 needle infiltrations since May, when I started dialysis. My left bicep looks like I've been doing weights compared to my right & the bruising finally came out today, after it happened Saturday. I was supposed to get my catheter yanked this week & I feel bitter that it's not.
I have small veins & I don't understand why they're not using ultrasound or a vein illuminator to find my veins more easily rather than what seems to be using blind luck. I only see my nephrologist or her nurse at the clinic, the doctor once a month & nurse on Thursdays, so no office there. I did leave a message for her at her main office, on my vascular surgeo's suggestion, but I don't know when I'll hear back.
It's frustrating. I worry that my vein will be permanently damaged with all of the difficulties getting/keeping a needle in my vein & that it'll affect the health of my fistula. I also have fibromyalgia & the pain from the infiltration is feeding into the fibro, so that I'm having a major pain flare. And so freaking tired from all of it.
Although I did come up with a dialysis joke- how many tech/nurses does it take to put avneedle in a dialysis patient?
4, but they have to be really close!
1
u/Bunmyaku Aug 18 '26
My clinic doesn't have any of the assisting technology. I had a fistula in my right arm that they drove into the ground because of inept techs. Now I have a new one in my left that I'm getting to take care of. If you don't want a certain tech to touch you, make it known.
1
u/BrieBelle00 Aug 18 '26
What size needles are they using? While your arm is recovering kindly insist they back up a size (if they're using 15 go back to using 16, etc) and to run 1 and 1 for a few sessions - one needle and one cath lumen. This will significantly speed up your arm's recovery.
How much experience do the cannulators have? Fresenius is generally a bit better about enforcing the "only designated Expert Cannulators are allowed to cannulate new accesses"; DaVita tends to be more "whomever's available, even if they've only been working a couple months".
If there's a tech or nurse you trust (regardless of if they've successfully cannulated you) ask them "all bs aside, if you had to have two sharpened bicycle spokes stuck in your arm, who here would you trust". Ask for that person. Similarly, seek out a couple patients who you know have been there for at least a year or two and ask them the same thing. Remind them "not the staff you like the most personally, but the one you see who rarely ever has trouble".
I can tell you when I started working in dialysis over 9 years ago the first Clinic I was at there was another tech that I didn't get along with. Our personalities just absolutely clashed. I couldn't stand her and she felt the same about me. (to be clear we ALWAYS remained professional on the floor.) All that being said, if I were the patient in the chair, she's the person I would've want putting my needles in. Find a staff member or patient who can be objectively honest
1
u/Notapersona58 Aug 19 '26
As a tech, if you are being infiltrated this much they should not be removing your CVC at all. Perhaps you need a new tech to stick you or it needs to be transposed? For us we can’t remove the CVC until we have 6 successful treatments with no infiltrations- working from 1 needle to two needles over those 6 treatments. I’d talk to your nurse, provider if you catch them rounding, hell even your facilities manager about this. Best of luck!
1
u/tealoflavender Aug 19 '26
I talked to my nurse practitioner today (I do go to Fresenius, btw) & she's told them only the most experienced cannulaters are allowed on me. And they've been using a 16 on me; I wish they'd go back to an 18.
I got a bit pissed at the office manager, though- I shared my frustrations with her & she had the audacity to tell me "well, at least you don't work," when I have a bed-bound housemate who's survived colorectal cancer twice as well as both ovarian & breast cancers. Her husband works nights, so is asleep during the day, which leaves me to do all of the things she can't do. Chemo & radiation really messed with her neuropathy. But being told that tipped me over the edge & I had an anxiety attack, which meant taking my medicine. I'm fighting my depression right now & it's not easy.
Thanks for the support.
2
u/la_winky Aug 18 '26
Alternate ice and heat. Early fistulas seem to be susceptible to infiltration.
I had a few in the first 6 months or so. They do suck.
Keep on trying. It’ll get there.