I Hate Dialysis Message Board
Dialysis Discussion => Dialysis: General Discussion => Topic started by: sullidog on March 26, 2010, 03:29:37 PM
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As most of you know I've been battling with my center to not remove fluid from me. Well my doctor wrote a new order to stop fluid removal again even minimum because I was crashing even in minimum. Today my tech told me there's not an option to turn off fluid removal altogether that they would just have to give me back what minimum takes off. Is this true about dialysis machines? or are they trying to give me a fib. I'm not sure the brand of machines we use but it's a newer machine most of the centers have these same type that you see in youtube videos.
Troy
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On our machines there has to be a minimum amount of fluid removed to help dialyze. Here the amount is at least .6
Drink extra fluid before you dialyze. If you still crash you may be below what your actual dryweight should be.
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Yes on our machines we can turn the UF (fluid) off , so that it continues to clean the blood but doesnt pull any fluid off. They have done this for me several times when i have been on the verge of crashing. If they insist they cant then you are just going to have to drink a bit more and go in over your dry weight :(
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But the machine still takes some fluid.
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You have any idea how much we'd like to have your problem? I for one would love to be able to drink more without getting fluid overloaded!
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Jenna had to have no fluid removed as she was urinating fine and was not retaining fluid. The techs told me the default required some base amount removed, so each time I had to insist that the charge nurse manually override the default. If I didn't Jenna was really sick, and then they'd load her up saline.
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depends on the machine,but should be able to overide,but get you ibw checked out
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Maybe have them give you a couple hundred cc's of saline and then they will have something to pull off. Plus the water crossing the membrane helps transfer toxins.
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...my doctor wrote a new order to stop fluid removal again even minimum because I was crashing even in minimum. Today my tech told me there's not an option to turn off fluid removal altogether that they would just have to give me back what minimum takes off. Is this true about dialysis machines? or are they trying to give me a fib...
Let's assume that your tech is not lying. Ask what that minimum rate is (for example, the minimum might be 100 ml every half-hour) and have that much saline given back to you at half-hour intervals. I KNOW this can be done because my brother gets 100ml saline flushes every half-hour which add to his fluid volume. Don't let them wait until the end and give it back all at once.
Here's a basic comment, that tech should have gotten the charge nurse involved to determine how they were going to provide you treatment as prescribed by your doctor. Your tech's answer cannot be the final word - the DOCTOR prescribes your treatment.
:boxing;
Best of luck with this!
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Thanks for the replies.
I think the minimal is .300
As far as asking the charge nurses, our techs like to do their own thing, and our center allows this to go on.
Troy
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Our 4008's you can set a UF target of 0 which means no fluid off, but in practice what happens is that there's a minimum recommended to cover the washback(sometimes called rinseback) to cover the saline that goes in. Our unit uses 0.5 (500mil) as a default, though I have 0.4 because that works better for me. When new patients come in to our unit with orders for no fluid removal they still set the 500 - which is basically nothing.
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As a tech i am on the other side of the discussion here. Our machines which are the 2008K's we have a minimum amount of fluid or UF goal we have to enter into the machine to get it to work, usually it is 300 ml and hour. We also have patients that have a high urine out put ertc and we do the fluid replacement. But instead of dumping all the saline into the body at the end, we give it throughout the run and patients go out about what they came in at, give or take 0.1kg but it usually pretty close. If you are crashing at a minimum uf then it sounds like you have to may have gained weight and need your "dry" adjusted. If that is not it, then request fluid replacement throughout the run, if the techs won't abide by this, then go above their heads. In the end it is your body and your right, stand up for it.
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I finally won this battle! I went to my neph about it and he said that yes they have to do minamum but they have to give you fluid back. My neph really chewed them out when he found out that this wasn't happening the way he wrote the order.
Troy