I met with the Surgeon on Tuesday and he said "No Buttonhole" needles, so I'm back on sharps. Which is fine by me, I was having trouble placing the buttonhole correctly, and I got the distinct impression the nurses were going to keep me at the clinic training longer because I couldn't place them. I probably could have gone home the second week, if we hadn't messed around with buttonhole needles.

For those who don't know, a "buttonhole" or "constant site cannulation" is formed by using sharps in the same exact spot for about 7 days. The sharp needle eventually creates a "scar tunnel", then the patient switches to buttonhole needles which are dull. These buttonhole needles slide down the scar tunnel and push a flap open on the vein. The problem is you need to place the needle in the exact same spot, at the exact same angle over and over again, which is hard to replicate when you are just starting to self-cannulate. My surgeon feels that buttonhole weakens the vein in that spot and then if he needs to go in and repair it, there is nothing to sew to, so he must attach a graft to bypass the weak area. Also, he feels that if something goes wrong during use of the buttonhole, it won't clot properly (because the area is weak) and there is nothing there to stop the blood from rushing down the scar tunnel and out my body. He says it's very dangerous.

Labels: buttonhole, constant site cannulation