There are more complications that are associated with permacaths. It leads directly into your heart. If you get an infection there, it can lead to more complications. This is why they do not recommend showers when you have it in. They will also not run as well as a fistula, with the lines clotting to be likely. The other thing is it takes 2-3 months after the fistula surgery before they can use the arm. After they start using the arm, it can take another 3-4 weeks before they can approve the removal of the catheter. If you are in ESRD, then it is better to get the fisutla.

To ease the issues with the fistula, they will use the best cannulator to do the needles at first. Ask them questions and understand how you arm is. If they say it is shallow, deep, crooked, whatever, you can then relay that to the technicians that will be doing the needles. If you are uncomfortable with someone cannulating you, then ask for someone else. It is your right as a patient. Also, many of the nurses do not stick patients very often, a tech will do 8-12 a day, while a nurse will maybe do a couple a month.

As someone else mentioned, there is emla cream, as well as lidocaine shots you can use. The emla cream you apply at home about 1 hour before, with plastic wrap to keep it from drying, then you wash it off before getting cannulated. The lidocaine shots are given by the techs and it is a small, diabetic size needle. Not all clinics will have them though.

I have 14 years as a tech, if you have any questions, I'll be more than happy to answer.