Bill Peckham, the author of the excellent patient advocacy and home dialysis blog: dialysis from the sharp end of the needle has been on dialysis since 1990 and home dialysis since 2001 where self-cannulates using the buttonhole method. Last year he posted a video on Youtube that I only came across today. It shows his technique of needle insertion. I have often wondered how patients manage to cannulate themselves at home and this demonstrates it very nicely. I am full of admiration for my patients.
These days I position both needles antegrade, and I use the SteriPic to remove the scabs rather than the 20 gage needle in the video. The one thing I wish I had shown when I made the video is the site preparation.
I always wash my hands and fistula with antimicrobial soap, drying with paper towels. Once I am ready to start cannulating I wipe both sites with an alcohol prep pad before removing the scabs. Once the scabs are removed I wipe with povidone-iodine and wait for it to dry before wiping it away with a fresh alcohol wipe.
I've had my fistule for 23 years and have never had an infection. It can be done.
Awesome! I did PD for 6 months prior to transplant. That was a good choice for me.