Buttonhole bothers

I wrote about my problems with buttonholes a few days back.

I changed both my access sites recently. Everything went well for a few weeks. But the pain is back. This morning, an hour before the session completed, the pain was there in both sites. I really don't know what to make of this.

Buttonholes have been touted as the best thing since sliced bread. My experience was great for the first year or so. But I have had problems since then. For a few days everything seems all right. But sure enough, after this initial period of comfort, cannulation is scary. The pain seems to be there throughout. The actual process of cannulation is not that much of a problem probably because of the anesthetic (xylocaine) that I inject. But a few hours into dialysis and the pain slowly starts increasing. And when the needles are removed after dialysis, the pain is at its worst.

I have read on the home dialysis forums that it might be a good idea to have two sets of buttonhole sites and you basically alternate between the two every other day. This gives time for the sites to heal. Sounds promising. I must try this. The only question I have is for the creation of a buttonhole site, you need to cannulate at the same site every day. How can this be done? If I must cannulate at the same site every day so that the tunnel forms, how can two sites be created at the same time? I will ask this question on the forum and try and get some answers.

It is amazing how different bodies react to the same thing in different ways. I have yet to hear of anyone with problems with buttonholes. Then why am I having so many problems? I do not know anyone else that needs an anesthetic too. The whole purpose of using buttonholes is that you can avoid the pain that is associated with cannulation.

There are some people who do not use an anesthetic in center too inspite of having sharp needles used on them. This is a real shock to me. Here I am using an anesthetic even for buttonholes and there are these bravehearts that don't use an anesthetic even while using sharps! Do they have such numb arms that the sharp needles don't pain? Or do they like the pain?!

Whatever it is, I don't like any pain at all. My tech once told me that I should try to avoid using the anesthetic because it is not good to use it over a long period of time. The sites around my buttonholes also start becoming black with prolonged use. The area becomes quite ghastly to look at!

I however couldn't care less about this. I need the anesthetic and I use it.

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