One of the most stressful aspects of end-stage renal disease (permanent kidney failure), aside from the stress of an incurable chronic disease itself is the dialysis needle sticks. There have been times that I’ve had to endure up to eight misguided sticks with a 14- or 15-guage needle. These needles are as big as nails, seriously, and they hurt like blazes going in and coming out. Especially after five or six near misses.
A few weeks ago I developed an aneurysm in my fistula that western medicine can neither adequately explain, prevent, nor treat. My Chinese medicine practitioner, predictably, knew just what to do. Aneurysms form when the tissue of a blood vessel weakens and subsequently expand. I suspect one of the reasons the walls of my blood vessel weakened was because of so many misguided needle sticks and repeated sticks in the same location.
Help is on the way in the form of Herbert Zeman’s device he calls a “vein contrast enhancer.” Zeman’s invention uses a camera with light emitting diodes (LEDs) to illuminate the skin at a near-infrared wavelength that is readily absorbed by blood, resulting in a clear image rendering the exact location of veins. The image is enhanced in a PC and projected through a “hot mirror” onto the skin, ensuring accuracy to within 0.06mm.
Herbert Zeman’s vein camera
Zeman’s vein camera, while not specifically designed for dialysis needle placement, would eliminate missed needle sticks and will undergo medical trails at a Tennessee hospital later this year. Because all of its parts fit in a shoebox, the device is highly portable and can fit on an intravenous drip stand.
One way to make cannulation less stressfull is to do it yourself. I am eternally grateful to the nurse who talked me into placing my own needles when I started dialysis 14 years ago. Over the years I infiltrated myself twice, not a bad record but since switching to the buttonhole method three years ago I haven’t infiltrated myself once. I have seen people of all ages and manual dexterity learn to self needle so I am of the opinion that anyone could learn to put in their own needles. Once you learn to self needle, much of the stress of dialysis is eliminated.
http://www.homedialysis.org is a website that has good information on self needling with the buttonhole method; the site includes a discussion board frequented by home dialysis patients, many whom self needle. The site also has good information on the benefits of more frequent dialysis which is available in some areas to people on home hemodialysis.
Thanks for posting information about Zeman’s vein camera. I can see it helping to identify the best location for a fistula in someone about to start dialysis. Right now dye is commonly used to look at the veins but the dye can decrease the function of already compromised kidneys.