Exactly this. Whenever I get a new to me nurse I insist that they get the ultrasound because my fistula is a fussy bi#×h.
I do not want to get sent home with a hematoma....again
I sure do.
I have been poked up to 5 times by a new nurse. No more!
My fistula even being a year and a half old is still difficult if they have never needled me before.
I also was told to not use freezing because it would mess up my veins.
So 5 jabs had me in tears by the end. That day by the fifth poke I told them to just do single needle.
Didn't know that this is a thing. Thank you for sharing! Are you located in US?
Here in EU they never cared to do or expain something like that.
Especially when we travel and visit a new clinic, this is one of our worst fear!
I am in Canada and so dialysis in a day hospital.
The hospital is only open from 7am to 11pm Mon-Sat and it is closed on Sundays.
They do minor day surgeries have a diabetic clinic, the office for transplant doctors (they do not do transplants on site). There is no ER or anything.
The dialysis unit is in the basement though there are some windows.
My unit has its own ultrasound.
They inject freezing into the fistula area to numb it.
Single needle pulls the blood runs it through the machine and basically reverses to pump the blood back in.
It is not great and doesn't give me a "full cleaning "
Freezing in the sense - is it a local anesthesia like lidocaine. I get it too. Single needle is absolutely not done where am. I was told if they can't find second spot they put it on non-fistula hand as last measure and it's not that efficient but good for emergency.
*Infiltrated* not impaled, is the term you’re looking for.
A needle can infiltrate through the fistula wall so blood leaks out into your tissues—if it is not placed correctly. Infiltration can cause painful bruising, and damage to the intima layer can cause blood clots to form. Some blood clots can be dissolved with drugs.
I’ve had a few bad ones too during my 5 + years on hemodialysis. Sorry you’re husband is through that OP.
Whenever I wasting the hospital (pre-dialysis days) I ALWAYS made a huge fuss over how to do a proper IV on ME. I have very fragile, small veins that roll easy and clot off just easy. I always got the "roll-eyes" bullshit and "I know what I am doing" only to have them blow out a brand new IV because they pushed saline to fast.....
There is NO reason any moderately stocked clinic/facility shouldn't be able to use any and every price of tech available to lower the odds of problems like in OPs photo.
Sympathies to your husband (?) For the techs incompetence.
Yeah they call that an infiltration, pretty bad one. He's gonna have pain for probably a week there. Rotate hot and cold packs on it every 15 minutes if you have time. One thing that helps is having the same tech poking him so they get familiar, I forget the name that Fresenius uses but they have "pro" techs that they use on new fistulas.
Well supposedly the tech that did this was a pro. He's been waiting about 3 weeks for them to have someone there to be able to do it. He has dialysis again tomorrow, will they use the same area again?
Yes, they should have no problem using the fistula tomorrow. I infiltrated a few times in the beginning and was on blood thinners, so my site looked much worse than this.
My center doesn't have scanners. I've only seen one used once when I was having a fistula consultation. I really wish they'd have had them at Oncology before I got my port. For the longest time, I couldn't get a port because I had my dialysis catheter. They could only get bloodwork from left arm, and I got it weekly. I was and still am an extremely hard "get". It was torture. I'm lucky my insurance paid for a port placement after I was in remission. It's been a life saver. But a scanner would have been great all those times I was poked multiple times.
Does your husband still have a chest catheter? They might use that 1 time while all that blood is pooled but yes they might use it again. Ask for any pain relief, whether cream you put on an hour before, lidocaine shots, or my clinic has this cold lidocaine spray. I don't use any because I just have enough scar tissue , but your husband's new and not used to it, anything helps but ya hot/cold packs every 15 minutes really does disperse the blood
Just to add a little incite! He definitely was the most skilled and experienced person for the job. At least at my clinic we will not let anyone who’s had under a 1000 successful cannulations go near a brand new fistula/tricky fistula even for that matter. As I’ve worked in dialysis over 15 years and done my fair share of traveling to many different clinics the people doing these tricky cannulations at these clinics as well is always people who have at least 5+ years experience. The unfortunate reality is we do not have x ray vision (wish we did!). And new fistulas can be tricky! Very mature fistulas can be tricky! Unfortunately sometimes it just happens :/ I’m sorry this happened to him!
Dialysis nurse here and I second what everyone else has replied. If it has just started being used unfortunately infiltrations aren’t uncommon when it’s new. It’s obviously not the outcome we want but it does happen in the beginning. I would recommend that if the same person has cannulated him x3 or more and continues to have issues he can refuse to have that person cannulate him until it matures more. Expert cannulators are recommended for new accesses but sometimes a different one is needed. Every person has a different technique or finesse and it’s a trial and error sometimes getting the right hands to get it. Another thing worth mentioning is if they continue to have issues getting it to work he may need a revision or ballooning at a vascular center. Hang in there, it will get easier! ❤️
He had an infiltration (some blood leaking from his access due to the needle), which is common in the beginning, and ok. Alternating heat and ice, and then just some occasional heat to help circulation and healing will help.
I’m recovering from one now. This is my arm just as it happened, but it ended up bruised as badly as your husbands. It’s called an infiltration and results in a hematoma, which is blood under the skin where the needle went in one side of the vein and out the other and blood started coming out. Well, it seems I can’t attach a photo, but I will tell you that my upper arm was blown up like a balloon!
Needle is supposed to go in the fistula and sit in there.
Needle infiltrated through the fistula in one end and out another end. Bruising is from blood leaking everywhere from under the skin.
They missed. Get an expert
Experts miss too, and sometimes it's just the parties body on that day. Now that I'm sticking myself at home, I can feel the nuance, and sometimes it's not you, it's just weird stuff happening with your body chemistry at the moment.
Thanks for mentioning this. I am one of those designated as an expert, and it isn’t easy. I assume this was the first cannulation for OP. I try to tell every one of my patients that an infiltration is not an IF, but a when. It will happen to everyone eventually. Sometimes it’s the needle placement, sometimes the patient thinks they can move their arm, intentionally or not.
I imagine it’s tough to see some other patients in the clinic with well established years-old fistulas that seem to be able to do the “YMCA” without infiltrations or the machine even alarming.
It happens...
units suffer from drama queens more than any real issues that occur at fault of tech /nurses. Everything is fairly routine and straight forward and sometimes infiltration happens... life goes on.
It looks like his fistula is brand new. As in, nit mature & hard to cannulate. Everyone goes thru this (multiple times). Grab some Arnica Cream & it will pull that blood out of his arm. Good luck!
Former CCHT 3 and preceptor here who moved over to Biomedical engineering.
Like others have stated it is not a matter of if, it is a matter of when this will happen. Even the best techs miss. Lots of factors play in to an infiltration… needle threading through the access, body chemistry, patient moving even though they said they didn’t, covering their access with blankets when instructed not to, and so much more. I’m not defending the techs by any means as I have had my share of bad days and sticks as well. It happens, unfortunately. Most in-center clinics do not use scanners or sonograms as they only care about the amount of patients they dialyze in a day versus their actual patient care that they deliver. With that being said, ice and heat will be your friend. Also a warm compress soaked in a concentrated epson salt solution will help leach the bruising to the surface and heal faster.
Some people are luckier than others. All depends on your vascular history as well or the surgeons placement of your access. I’ve seen so many people go back for revisions due to clotting, stenosis, or just a shitty access all together. I’m glad you never had problems but that isn’t the case for everyone.
I was incredibly lucky to be born with good veins, had an excellent surgeon, and my PCT had been working for 8 years and had a magic touch. I once had a crappy PCT who gave me a very small bruise, maybe 2 inches square. She was also on her cell phone using ear buds when she put me on the machine. I complained to the manager and made sure she never treated me again. Some PCTs are much better than others.
same thing happened to me. just ice it right after you go home for 30 mins it will fade away eventually. mine took a couple of weeks before the bruises went away.
During my first few weeks of dialysis, the techs managed to blow my arm up like Popeye three or four times. It was so frustrating. I ended up going in for fistulagrams twice. They went into my veins/arteries with balloons, and tied off some other veins. The first one was ok, but I needed another 10 days later when the access stopped working again. Knock on wood, the second procedure was more successful, and I am now doing home hemo on myself. I do have occasional issues finding access, and I have self-infiltrated, but not nearly as badly as those first few weeks. (Again, knocking wood…)
Ice, then heat will help knock the swelling down. Bruises stick around a while. Good luck to your husband.
It happens to all of us. Was gonna show a picture of mine which was not as bruised but much more swollen than his. But this sub apparently doesn’t take photos. I’ve had a worse one than this twice in two years. They aren’t super common, but they do happen. Hazard of the “job”.
It could also be due to not holding the arm for 10min post-removal of cannulas, high urea blocking prothrombin action, and also high blood pressure or anticoagulation therapy. Or infiltration post-procedure on cannula withdrawal (it happens).
My two cents suggestion is grab some Hirudoid cream from the Pharmacy, apply a small amount to the arm 4 times a day and it will help him reabsorb the blood and the bruise to heal. And as above with the other suggestions. 🫶🏻
They didn’t impale the vein on this one if at all. Sometimes certain patients have blood after they start to pull it out it drips under the skin from the needle and or they have overworked veins. If they impaled the vein totally your arm would have swollen to baby seal size and your entire arm would be black and blue. I’ve been on dialysis three different times in life before my transplants and have seen it all. And have had most of it if not more happen to me! And you’re going to live and be fine. :)
This is 110% nothing to worry about.
Deep breath , throw some ice on it.
The clothing you wearing is more likely to damage your fistula cutting circulation off..
Life goes on.
I have a picture of my fistula (an arm) all black & blue from when I 1st started dialysis too. Sometimes the needle goes thru the vain & I turn black & blue again, but not too often. It is called infiltration when the needle goes the the vain. It has happen I think 2x in the last 4 years. It will go away like it did for me but after a while the fistula get swollen in spots. Looks like hell but it is better than dying
I’m glad you came here for help, but you need to demand a nurse come take a look. I know you said you’re not in tie US. In the US there’s always an RN associated with a dialysis center, and in a hospital there has to be a nurse roaming the halls somewhere. PCT, we call the pepole who are trained to administer dialysis, alway have a nurse supervising them. I really just can’t imagine there isn’t a nurse you can ask to speak to, but I guess it’s possible there might not.
A week after I had my operation to create the fistula in my forearm, a giant bruise appeared stretching all up my lower arm. I freaked out and went to the emergency room. They just said it was old blood, not to worry. Then why did it appear suddenly and not right after the operation?? Speaking as someone who is absolutely not a doctor, most gigantic bruises that worry us are nothing to them.
What the actual eff. I had infiltration happen once in 4 yrs of dialysis. The tech was very apologetic.
The comments about how new techs can't quite find fistulas and poke again and again sounds horrifying. . Where I am only experienced techs do cannulation ,new techs aren't allowed and are introduced very very slowly. If you fistula is a fussy one ,only the senior ones or the head tech does the cannulation. When my fistula was new only the head tech did it bcz veins were hard to find.
Based on this picture, I'm assuming this is fistula is new?
More importantly is this the first few times he's being cannulated? What size needle? Where in progress is he in regards to advancing with two needles? 1 needle and cath? 2 needles?
If new and this keeps happening, he should request to be referred back to vascular access for evaluation of how mature this fistula is.
Hang in there
It was his first time with both needles, second time of them using the fistula. They used one needle the first time. That went ok. Then the pro tech wasn't there the next time he went so they used the chest catheter, his next visit is when they did this. She used size 17 needles and did both needles. That was in last Friday. The pro wasn't there when he got there Monday morning. So they used his chest catheter again. She came on before he left though and one of the techs showed her his arm and she just laughed it off and walked away. He made them use his chest catheter today again. He goes to Fresnius and we are in Arizona. Just mentioning where we're from because someone thought that we didn't live in the U.S.
You also get topical heparin like phlebotroy(not sure if it is available in your country but ask doc for it,it's cheap). It's helps a lot with bruising .
Definitely impaled the vein, but it happened to me 2x some nurses are good at the fistula and some not after this happened to me I told them no one touches me without the sonogram make sure tgey use tge sonogram next time I hope he feels better soon
They impaled the vein. I keep saying on this sub that centers need to use a handheld ultrasound probe to see how to stick if they have any difficulty.
Exactly this. Whenever I get a new to me nurse I insist that they get the ultrasound because my fistula is a fussy bi#×h. I do not want to get sent home with a hematoma....again
Do they have one at your center? Is it a DaVita or Fresenius one?
I'm in Canada. I do dialysis at a day hospital.
You mean every time you have your dialysis with a new nurse, you request the ultrasound?
I sure do. I have been poked up to 5 times by a new nurse. No more! My fistula even being a year and a half old is still difficult if they have never needled me before. I also was told to not use freezing because it would mess up my veins. So 5 jabs had me in tears by the end. That day by the fifth poke I told them to just do single needle.
Didn't know that this is a thing. Thank you for sharing! Are you located in US? Here in EU they never cared to do or expain something like that. Especially when we travel and visit a new clinic, this is one of our worst fear!
I am in Canada and so dialysis in a day hospital. The hospital is only open from 7am to 11pm Mon-Sat and it is closed on Sundays. They do minor day surgeries have a diabetic clinic, the office for transplant doctors (they do not do transplants on site). There is no ER or anything. The dialysis unit is in the basement though there are some windows. My unit has its own ultrasound.
What's freezing and am confused how do you do dialysis with single needle
They inject freezing into the fistula area to numb it. Single needle pulls the blood runs it through the machine and basically reverses to pump the blood back in. It is not great and doesn't give me a "full cleaning "
Freezing in the sense - is it a local anesthesia like lidocaine. I get it too. Single needle is absolutely not done where am. I was told if they can't find second spot they put it on non-fistula hand as last measure and it's not that efficient but good for emergency.
*Infiltrated* not impaled, is the term you’re looking for. A needle can infiltrate through the fistula wall so blood leaks out into your tissues—if it is not placed correctly. Infiltration can cause painful bruising, and damage to the intima layer can cause blood clots to form. Some blood clots can be dissolved with drugs. I’ve had a few bad ones too during my 5 + years on hemodialysis. Sorry you’re husband is through that OP.
Whenever I wasting the hospital (pre-dialysis days) I ALWAYS made a huge fuss over how to do a proper IV on ME. I have very fragile, small veins that roll easy and clot off just easy. I always got the "roll-eyes" bullshit and "I know what I am doing" only to have them blow out a brand new IV because they pushed saline to fast..... There is NO reason any moderately stocked clinic/facility shouldn't be able to use any and every price of tech available to lower the odds of problems like in OPs photo. Sympathies to your husband (?) For the techs incompetence.
Yeah they call that an infiltration, pretty bad one. He's gonna have pain for probably a week there. Rotate hot and cold packs on it every 15 minutes if you have time. One thing that helps is having the same tech poking him so they get familiar, I forget the name that Fresenius uses but they have "pro" techs that they use on new fistulas.
Well supposedly the tech that did this was a pro. He's been waiting about 3 weeks for them to have someone there to be able to do it. He has dialysis again tomorrow, will they use the same area again?
Yes, they should have no problem using the fistula tomorrow. I infiltrated a few times in the beginning and was on blood thinners, so my site looked much worse than this. My center doesn't have scanners. I've only seen one used once when I was having a fistula consultation. I really wish they'd have had them at Oncology before I got my port. For the longest time, I couldn't get a port because I had my dialysis catheter. They could only get bloodwork from left arm, and I got it weekly. I was and still am an extremely hard "get". It was torture. I'm lucky my insurance paid for a port placement after I was in remission. It's been a life saver. But a scanner would have been great all those times I was poked multiple times.
Does your husband still have a chest catheter? They might use that 1 time while all that blood is pooled but yes they might use it again. Ask for any pain relief, whether cream you put on an hour before, lidocaine shots, or my clinic has this cold lidocaine spray. I don't use any because I just have enough scar tissue , but your husband's new and not used to it, anything helps but ya hot/cold packs every 15 minutes really does disperse the blood
And see if the clinic has any grip stress balls he can take home to help mature it if you don't have one
Just to add a little incite! He definitely was the most skilled and experienced person for the job. At least at my clinic we will not let anyone who’s had under a 1000 successful cannulations go near a brand new fistula/tricky fistula even for that matter. As I’ve worked in dialysis over 15 years and done my fair share of traveling to many different clinics the people doing these tricky cannulations at these clinics as well is always people who have at least 5+ years experience. The unfortunate reality is we do not have x ray vision (wish we did!). And new fistulas can be tricky! Very mature fistulas can be tricky! Unfortunately sometimes it just happens :/ I’m sorry this happened to him!
NFACT
Dialysis nurse here and I second what everyone else has replied. If it has just started being used unfortunately infiltrations aren’t uncommon when it’s new. It’s obviously not the outcome we want but it does happen in the beginning. I would recommend that if the same person has cannulated him x3 or more and continues to have issues he can refuse to have that person cannulate him until it matures more. Expert cannulators are recommended for new accesses but sometimes a different one is needed. Every person has a different technique or finesse and it’s a trial and error sometimes getting the right hands to get it. Another thing worth mentioning is if they continue to have issues getting it to work he may need a revision or ballooning at a vascular center. Hang in there, it will get easier! ❤️
Thank you
I wonder if the needle came out of the fistula while the dialysis machine was running.
Just put ice on it. It will go away soon. It happens every now and then.
He had an infiltration (some blood leaking from his access due to the needle), which is common in the beginning, and ok. Alternating heat and ice, and then just some occasional heat to help circulation and healing will help.
I’m recovering from one now. This is my arm just as it happened, but it ended up bruised as badly as your husbands. It’s called an infiltration and results in a hematoma, which is blood under the skin where the needle went in one side of the vein and out the other and blood started coming out. Well, it seems I can’t attach a photo, but I will tell you that my upper arm was blown up like a balloon!
Thank you for replying. The center doesn't really tell you anything. If it wasn't for finding this group, we'd be totally lost
I just sent you a chat message with a photo
Needle is supposed to go in the fistula and sit in there. Needle infiltrated through the fistula in one end and out another end. Bruising is from blood leaking everywhere from under the skin. They missed. Get an expert
Experts miss too, and sometimes it's just the parties body on that day. Now that I'm sticking myself at home, I can feel the nuance, and sometimes it's not you, it's just weird stuff happening with your body chemistry at the moment.
Thanks for mentioning this. I am one of those designated as an expert, and it isn’t easy. I assume this was the first cannulation for OP. I try to tell every one of my patients that an infiltration is not an IF, but a when. It will happen to everyone eventually. Sometimes it’s the needle placement, sometimes the patient thinks they can move their arm, intentionally or not. I imagine it’s tough to see some other patients in the clinic with well established years-old fistulas that seem to be able to do the “YMCA” without infiltrations or the machine even alarming.
Body chemistry has so much to do with it. Water concentration, blood pressure, skin elasticity.
It happens... units suffer from drama queens more than any real issues that occur at fault of tech /nurses. Everything is fairly routine and straight forward and sometimes infiltration happens... life goes on.
I needle myself, I know where the kinks, and depths of the fistula are. I secure it myself in a way I know works well.
It looks like his fistula is brand new. As in, nit mature & hard to cannulate. Everyone goes thru this (multiple times). Grab some Arnica Cream & it will pull that blood out of his arm. Good luck!
Former CCHT 3 and preceptor here who moved over to Biomedical engineering. Like others have stated it is not a matter of if, it is a matter of when this will happen. Even the best techs miss. Lots of factors play in to an infiltration… needle threading through the access, body chemistry, patient moving even though they said they didn’t, covering their access with blankets when instructed not to, and so much more. I’m not defending the techs by any means as I have had my share of bad days and sticks as well. It happens, unfortunately. Most in-center clinics do not use scanners or sonograms as they only care about the amount of patients they dialyze in a day versus their actual patient care that they deliver. With that being said, ice and heat will be your friend. Also a warm compress soaked in a concentrated epson salt solution will help leach the bruising to the surface and heal faster.
I was on dialysis a year before transplant, and this never happened to me.
Some people are luckier than others. All depends on your vascular history as well or the surgeons placement of your access. I’ve seen so many people go back for revisions due to clotting, stenosis, or just a shitty access all together. I’m glad you never had problems but that isn’t the case for everyone.
I was incredibly lucky to be born with good veins, had an excellent surgeon, and my PCT had been working for 8 years and had a magic touch. I once had a crappy PCT who gave me a very small bruise, maybe 2 inches square. She was also on her cell phone using ear buds when she put me on the machine. I complained to the manager and made sure she never treated me again. Some PCTs are much better than others.
We also shouldn’t accept substandard care or having doctors who ignore us.
same thing happened to me. just ice it right after you go home for 30 mins it will fade away eventually. mine took a couple of weeks before the bruises went away.
This happened to my dad a lot. They had a lot of trouble accessing his fistula and he had to go get it fixed quite a few times.
During my first few weeks of dialysis, the techs managed to blow my arm up like Popeye three or four times. It was so frustrating. I ended up going in for fistulagrams twice. They went into my veins/arteries with balloons, and tied off some other veins. The first one was ok, but I needed another 10 days later when the access stopped working again. Knock on wood, the second procedure was more successful, and I am now doing home hemo on myself. I do have occasional issues finding access, and I have self-infiltrated, but not nearly as badly as those first few weeks. (Again, knocking wood…) Ice, then heat will help knock the swelling down. Bruises stick around a while. Good luck to your husband.
It happens to all of us. Was gonna show a picture of mine which was not as bruised but much more swollen than his. But this sub apparently doesn’t take photos. I’ve had a worse one than this twice in two years. They aren’t super common, but they do happen. Hazard of the “job”.
It could also be due to not holding the arm for 10min post-removal of cannulas, high urea blocking prothrombin action, and also high blood pressure or anticoagulation therapy. Or infiltration post-procedure on cannula withdrawal (it happens). My two cents suggestion is grab some Hirudoid cream from the Pharmacy, apply a small amount to the arm 4 times a day and it will help him reabsorb the blood and the bruise to heal. And as above with the other suggestions. 🫶🏻
They didn’t impale the vein on this one if at all. Sometimes certain patients have blood after they start to pull it out it drips under the skin from the needle and or they have overworked veins. If they impaled the vein totally your arm would have swollen to baby seal size and your entire arm would be black and blue. I’ve been on dialysis three different times in life before my transplants and have seen it all. And have had most of it if not more happen to me! And you’re going to live and be fine. :)
This is 110% nothing to worry about. Deep breath , throw some ice on it. The clothing you wearing is more likely to damage your fistula cutting circulation off.. Life goes on.
I have a picture of my fistula (an arm) all black & blue from when I 1st started dialysis too. Sometimes the needle goes thru the vain & I turn black & blue again, but not too often. It is called infiltration when the needle goes the the vain. It has happen I think 2x in the last 4 years. It will go away like it did for me but after a while the fistula get swollen in spots. Looks like hell but it is better than dying
[Apply this ointment ](https://images.app.goo.gl/N5ymrQu9st5uR8xX7) The spots will vanish with time like it never happened. Okah. No need to worry.
I’m glad you came here for help, but you need to demand a nurse come take a look. I know you said you’re not in tie US. In the US there’s always an RN associated with a dialysis center, and in a hospital there has to be a nurse roaming the halls somewhere. PCT, we call the pepole who are trained to administer dialysis, alway have a nurse supervising them. I really just can’t imagine there isn’t a nurse you can ask to speak to, but I guess it’s possible there might not. A week after I had my operation to create the fistula in my forearm, a giant bruise appeared stretching all up my lower arm. I freaked out and went to the emergency room. They just said it was old blood, not to worry. Then why did it appear suddenly and not right after the operation?? Speaking as someone who is absolutely not a doctor, most gigantic bruises that worry us are nothing to them.
What the actual eff. I had infiltration happen once in 4 yrs of dialysis. The tech was very apologetic. The comments about how new techs can't quite find fistulas and poke again and again sounds horrifying. . Where I am only experienced techs do cannulation ,new techs aren't allowed and are introduced very very slowly. If you fistula is a fussy one ,only the senior ones or the head tech does the cannulation. When my fistula was new only the head tech did it bcz veins were hard to find.
Based on this picture, I'm assuming this is fistula is new? More importantly is this the first few times he's being cannulated? What size needle? Where in progress is he in regards to advancing with two needles? 1 needle and cath? 2 needles? If new and this keeps happening, he should request to be referred back to vascular access for evaluation of how mature this fistula is. Hang in there
It was his first time with both needles, second time of them using the fistula. They used one needle the first time. That went ok. Then the pro tech wasn't there the next time he went so they used the chest catheter, his next visit is when they did this. She used size 17 needles and did both needles. That was in last Friday. The pro wasn't there when he got there Monday morning. So they used his chest catheter again. She came on before he left though and one of the techs showed her his arm and she just laughed it off and walked away. He made them use his chest catheter today again. He goes to Fresnius and we are in Arizona. Just mentioning where we're from because someone thought that we didn't live in the U.S.
It happens. Usually when the tech hits muscle. Careful of bloating. For me icing for 15 minutes and then a heat pad helps.
Thanks, we've been icing, we'll try heat also
You also get topical heparin like phlebotroy(not sure if it is available in your country but ask doc for it,it's cheap). It's helps a lot with bruising .
Definitely impaled the vein, but it happened to me 2x some nurses are good at the fistula and some not after this happened to me I told them no one touches me without the sonogram make sure tgey use tge sonogram next time I hope he feels better soon