my mother is a hemo patient with an upper arm fistula. the nurses at her dialysis center can't seem to get access but the doctor's at the hospital don't have any problem. i've heard referance to the "two arm" technique but can't find any info on the web. Does any one have any advice for me? This nurse insists that my mom needs a cathader, but i don't see why when her fistula is perfectly healthy. I hate to say this, but it seems like she just wants my mother to have the cathader to make her life easier. there has to be something that this woman can change in her approach to my mother's access in order to get results without needless surgery. any advice would be appreciated. Thank You.

I would try speaking with someone else in the dialysis center. Hopefully there is more than one nurse or technician in the facility. Someone else may be a better cannulator. Also, sometimes at the hospital they are trying to access the fistula with a smaller needle than in the dialysis clinic. Your Mom may need them try a 17 gauge and then advance. How long has she had the fistula and did they have her exercising it?

A fistula is the preferred access if it works. I would keep at it for the long term benefit.

hmm.. seems I can't log in

Anyway, wanted to reply .. I feel for you goodson as I am in the same boat! No one in my dialysis unit can cannulate me and I am marrying someone where I will have to move! If I do move I am sooo worried no one will be able to cannulate me there as well and it is in a spot where I don't think I will be able to cannulate myself neither! I have buttonholes started Dec 8th 2006 but still today when I went to dialysis March 14th 2007 they still couldn't cannulate and had to use a sharp on the arterial (usually that one is fine and the venous is difficult!)..

I really feel for you! It seems that not all dialysis units have well trained nurses / techs in cannulation and I have heard that a lot of units actually prefer catheters so they don't have to deal with difficult cannulations!

Even so, an AV Fistula is a LOT better than a catheter (even though some people do have to resort to them)! Try researching as much as you can online about why AV Fistulas are better than catheters and maybe print the info out and show it to your unit. It will be harder for them to push a catheter on your mom if you are armed with that information!

Good luck!

- Angieskidney.com

Most nurses here would much rather have a fistula or graft patient than a catheter. Catheters are more trouble than cannulation.

I think the comeback of the buttonhole technique is a great start in increasing the life of fistulas. But, not many nurses have the training to start or follow thru with buttonholes. As buttonholes become more common, i think the companies will offer more widespread training for nurses on them.