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Dialysis Discussion => Dialysis: General Discussion => Topic started by: texasstyle on September 09, 2010, 11:58:57 PM

Title: K too high, in ER
Post by: texasstyle on September 09, 2010, 11:58:57 PM
My husband was in chest pain very badly the last couple days. Finally got tim to ER 12:30 am this morning. Admitted. His k was 6.6. They will dialyize him there tomorrow morning. They gave potassium binder I think in this super giant sized syringe in his IV. they said he was not in a-fib? What can I expect will happen to him while in the  hosp? Never had this before lol. I feel safe because I know he's exactly where he should be. Maybe this will be the wake up call he needs to stop fighting off going that 3rd day a week.
Title: Re: K too high, in ER
Post by: MooseMom on September 10, 2010, 12:14:43 AM
Well, I hope that what will happen to him in the hospital is lowering of his potassium and getting out of danger!  You're right...he's exactly where he should be.  Is he pretty strict with his diet, or does he cheat too much?
Title: Re: K too high, in ER
Post by: RichardMEL on September 10, 2010, 01:37:10 AM
TS he's been in the hosp before for high K hasn't he? Maybe it will be the wake up call, but probably not. If he gets through this OK he might think "oh well no problem I can just go to ER and get fixed up"  and avoid the issue (yes, I know that is STUPID but that is what *some* men might actually do!!!  :urcrazy;).

Potassium can build up quickly - this is one of the main reasons most people do 3 sessions - much longer between sessions and your K will go up too much - as he has found.

I hope he will be OK and *does* wake up!

 :cuddle; :cuddle; :cuddle; :cuddle; :cuddle;
Title: Re: K too high, in ER
Post by: texasstyle on September 10, 2010, 03:57:35 AM
No, hasn't been in before with high K issues and admitted. He did have on his labs 6.9 on K no too long ago, but he drank an emergency  binder at home and I think after while it came back down. He's been pretty good about his diet I have to say. He's learned the high k foods to avoid etc... I think it's time he's gotten very strict with it. Eating too many LOW potassuim foods can make it high as you know. That renal diet is such a pain in the neck. I'm tired (as usual). Richard, I need a cup of coffee from that coffee machine! lol
Title: Re: K too high, in ER
Post by: M3Riddler on September 10, 2010, 04:10:43 AM
My husband was in chest pain very badly the last couple days. Finally got tim to ER 12:30 am this morning. Admitted. His k was 6.6. They will dialyize him there tomorrow morning. They gave potassium binder I think in this super giant sized syringe in his IV. they said he was not in a-fib? What can I expect will happen to him while in the  hosp? Never had this before lol. I feel safe because I know he's exactly where he should be. Maybe this will be the wake up call he needs to stop fighting off going that 3rd day a week.

They probably gave your husband sodium bicarbonate. Im very suprised they did not dialyze him that day - expecially with the chest pain symptoms he was having....
Title: Re: K too high, in ER
Post by: RichardMEL on September 10, 2010, 05:23:07 AM
small irony: coffee does contain a reasonable amount of potassium. d'oh! Still I have my morning brew with the boys at work during the week. It's a routine!!!
Title: Re: K too high, in ER
Post by: texasstyle on September 10, 2010, 06:47:57 AM
update! they can't get his BP raised. They can't find the exact cause of the chest pains. Dr. this morning said possiibilty of perotenitis (heart infection), clot in the lungs. they just don't  know. They are giving him contrast dye test this morning to help determine things. Dr. said kidneys patients don't normally get this done but it is in his best interst to find out what's going on. will dialize right after. Apperently they also gave him an emergency dialysis last night at 3am. Cardio, Neph, and some Pulmonary specialists will all be working on this today. I PRAY  he does not have an infection in his heart. (has CHF already) PRAY they get BP up. Last night it was  74/40something?. She also said is his condition of course he can't rid any of these posions or toxins out. I feel like the world has just fallen apart. I'm shaking. What the hell just happened in a day??? I am alone here. My Aunt is coming by this afternon and we are going over. I know this morning he will be out of the room most of it. My dad is in the semi-area from Florida at least but they came into take care of my step brother who is dying of cancer. He is in very bad shape and worsening by the day. Man, when it rains it piur doesn't it?????? I've never been so worried about Mike as I am now. Thanks everyone for being there.
Title: Re: K too high, in ER
Post by: billybags on September 10, 2010, 08:29:45 AM
Whoo, texasstyle every thing seems to be happening at once, that's how the cookie crumbles. One thing Mike is in the right place and it sounds like they are testing him for every thing possible. Hang in there they will get him sorted. Poor thing I bet you don't know whether you are coming or going. It is horrible when they are in hospital, you go home and just cant wait to get back. Try to unwind a bit, make sure you get some thing to eat, look after your self. Thinking of you both.
Title: Re: K too high, in ER
Post by: Rerun on September 10, 2010, 08:46:48 AM
Hang in therre.  He is in good hands it sounds like.

               :grouphug;
Title: Re: K too high, in ER
Post by: MooseMom on September 10, 2010, 09:15:21 AM
Oh goodness...what the hell happened?  There seems to be several issues here...oh, please keep us updated.  Just remember you have a whole team of doctors in your corner.  I do hope they sort this out very soon and you both can go home.  What a frightening time!
Title: Re: K too high, in ER
Post by: thegrammalady on September 10, 2010, 09:19:30 AM
 :grouphug;   :grouphug;   :grouphug;
Title: Re: K too high, in ER
Post by: texasstyle on September 10, 2010, 08:28:54 PM
Holy crap. I don't know where to start. Diagnoses: pericartial effusion. Fluid around the pericardium. He's on his 4th dialysis treatment now in less than 24hours. Last #'s on the K was 5.8. "better". Got him into heart surgery around 5:30 this evening. BP was about almost night something/over almost 50 something. something. Still couldn't get it up. He could not breath and was just in AGONY for hours. Oh, it was even hell to watch. They dialyized to help pull as much fluid off as possible to get the BP up and help with bring down the K. SO.... the surgeon came into talk to us after the surgery. He started "slipping away" on the table. They had made the incision into the chest to put a tube into the heart sac to drain the blood/fluid from there. His oxygen level went to 0(?) and his BP started to bottom out at 45. They put the tube in to drain the fluid and in like 1 second, his BP shot up to 195! His lungs were "collapsed" so to say from fluid pressure also. Now, you're not gonna believe this, and the surgeon said it was the MOST FLUID HE'S EVER TAKEN OUT OF SOMEONE.... he had 2 freakin' liters around his heart sac. The pressure from that made it so his already enlarged heart from CHF unable to even hardly beat/move. He said that is about double the most he's ever taken off. He also said if he wasn't brought in last night to start working on him, he ABSLOTUETLY with no doubt would have made it through tonight. Oh, my heart dropped. All these smacks of reality I keep getting. Anyway, out of antheshia they were trying to incubate (?) him with a tube and he was fighting to pul l it out. They heavily sedated him and restrained his hands for his own protection not to pull that tube out. I've heard getting those tubes are horrible and people dofight them. He is also on a ventilator to give him a break overnight/maybe tomorrow. Was breathing somewhat better after surgery but needed a break for his body. All this a result of not seeking medical attn 2 weeks ago whe he has chest pain/ temp of 102, low grade efevr last part of 2 weeks, not telling the dialysis unit about any of this,  and......not going in for dialysis that 3rd day! Talked to his dialysis ctr. today. They have been telllinghim for quite some time to start 3rd day. Are you coming wed.? No he says. If you change your mind call us please. We'll get you a chair. Most people don't get what I'm going through because they don't live with him. friends and family have known for years how he is with is health. other than that, he is a great guy in that he takes great care of me and my children, funny, VERY responsible with other things in life oddly enough, we get along great and are goofy together. But.... this is getting to be too much. So.. that's where his stands. Oh, the importance of dialysis sessions.
Title: Re: K too high, in ER
Post by: texasstyle on September 10, 2010, 08:33:44 PM
sorry I forgot to do the spelling check on that last one. My minds is slightly frazzled at the moment lol
Title: Re: K too high, in ER
Post by: okarol on September 10, 2010, 08:58:27 PM
Spell check is not operating at the moment, but don't worry about that.
I am sorry you're going through this, it's absolutely frightening!
Have you slept at all? I hope you can get some rest. It sounds like they are addressing his issues.
I pray he gets through this ok. Sending you BIG HUGS!
 :grouphug; :grouphug; :grouphug;
Title: Re: K too high, in ER
Post by: MooseMom on September 10, 2010, 11:06:04 PM
What do you think it is behind this particular characteristic of his where he is so reliable about taking care of others but not himself?  I see it in my own husband to some degree...he will hover over me but takes so little care of himself.  Is this just a guy thing?  I don't understand this behaviour.  Do you think that after this dreadful episode, your husband will take better care of himself?
Title: Re: K too high, in ER
Post by: RichardMEL on September 11, 2010, 01:19:56 AM
oh dear sweet texasstyle.... what can I say??? How horrible for you both - for him to endure (I won't bother to go through everything we all know about how hhe caused most of this himself through his acton - and inaction) and for you to witness in someone you liove. I can't imagine how wretched you must feel now - on top of everything - to come so close to actually losing him.

All I can do, at this point, is send you my hugs and love and best wishes for improvement in his situation and well.. obviously... that he actually realises how bloody serious this is and what he needs to do to NOT repeat this kind of situation.

My fingers are crossed.. I am thinking of you.

 :grouphug; :grouphug; :grouphug; :grouphug; :grouphug; :grouphug; :grouphug; :grouphug;
Title: Re: K too high, in ER
Post by: texasstyle on September 11, 2010, 04:48:51 AM
Hi everyone. Got about 4 nice hours of sleep last night. That felt good.Yes, there is definetly some physcological issue going on here but can't figure it out. On the other end of the dycotomy, he will go so far out of his way to help someone out and does it often. Dr. reccommend no less then 3 sessions now. I know someone do even more than that for reasons. Honestly, last night I was thinking I just don't want to deal with this anymore. Let someone else take care of him kinda atittude. If this is NOT the final wake up call, nothing will and it will either be from this whatever physcological issue, or just being an arrogant jerk regarding his health. He might start the 3 days, but needs big education on this. I don't think he REALLY understands medically what's going on ,or what can happen. I'd like to feel I've taught him some stuff for just the amount I've learned. Maybe we can arrange a "class" or something at the center to help educate the patients a little better. Hhm... I think I like that idea. It's early and I'm optimistic (with reservations) about the day. WHEW. I am here alone, but have family/friend support. Secretly: I kinda like having the house to myself for a bit lol. I wish under different circumstances though. Hope everyone's day goes well. Take a minute to look around and see just hopw many blessings you do have.
Title: Re: K too high, in ER
Post by: RichardMEL on September 11, 2010, 06:15:56 AM
TS maybe you should chat to the dialysis unit - social worker maybe??? about education resources?

The problem I feel though is that hubby probably feels like all he gets is lectures "do this. do that. don't do this!" etc and it might well go in one ear and out the other. Sadly, I tend to agree with you - if nearly dying on the table won't convince him that this is serious shit.. well nothing well. :(

good luck.....
Title: Re: K too high, in ER
Post by: MooseMom on September 11, 2010, 02:01:08 PM
Perhaps YOU could talk to the social worker.  I'd bet that s/he sees this sort of thing all the time...patient in denial, patient not willing to do what it takes to look after himself, spouse frustrated, angry and scared as a result.  Maybe the SW has some ideas on how you can cope and what strategies you might employ that have a good chance of "educating" your husband.

I imagine that some men think they are supermen and refuse to accept any evidence to the contrary.  They build their self image around the idea that they are the ones to take care of OTHERS, but when the situation is reversed, their self image is challenged, and that is very difficult for some men.  I've seen exactly this sort of thing happen before, and these kinds of men can become depressed.
Title: Re: K too high, in ER
Post by: RichardMEL on September 11, 2010, 05:01:39 PM
MM sorry but your post reminded me of something funny that happened at D yesterday. We have a new patient - a nice young guy in his early/mid 30's. Ironically he's actually a doctor. ANyway they were assigning him a locker and he said "oh no I don't want my name on the locker" (that's a bit weird but ok) and they said well what about a nickname? SO he said "Sure, call me SUPERMAN!"

Sure enough, his locker now reads "superman"

 :urcrazy;

Sorry just had to share that one.

As for men thinking they're superman.. yeah but when the s*@#)@ hits the fan you'd THINK most men would think "umm yeah maybe I'm not the man of steel" and do something about it. Hell I'm far from perfect myself (I resisted going to the dentist for nearly 10 years....  >:D) but I've learned very quickly that it WAY better ti get something looked at when it's noticed, not just carry on "it will be OK" - now I have the mantra that I'd rather be safe and maybe feel silly for asking, than sorry for letting something slide.

Thinking of you TS. Coffee machine on standby.  :cuddle; :cuddle; :cuddle;
Title: Re: K too high, in ER
Post by: Stoday on September 11, 2010, 06:48:36 PM
I resisted going to the dentist for nearly 10 years....  >:D)
Isn't that exactly the same characteristic that Texastyle's husband has? Denial... It's not happening to me... Except, of course, after ten years RM got to grips with himself before he was beset with more serious episodes.
Title: Re: K too high, in ER
Post by: kitkatz on September 11, 2010, 09:00:18 PM
I really hope he gets better and comes to terms with his 3rd day of dialysis. Makes a difference.
Title: Re: K too high, in ER
Post by: Jean on September 12, 2010, 01:33:41 AM
WOW, TS, what a lot to deal with in such a short time. When you get him home, just slap him upside the head and tell him he will go to D 3 times a week, OR ELSE. ( in his case, it could be or else die). Sorry you are having to go thru all of this, hope he wakes up soon.   :grouphug;
Title: Re: K too high, in ER
Post by: RightSide on September 12, 2010, 04:06:22 PM
Honestly, last night I was thinking I just don't want to deal with this anymore. Let someone else take care of him kinda atittude. If this is NOT the final wake up call, nothing will and it will either be from this whatever physcological issue, or just being an arrogant jerk regarding his health. He might start the 3 days, but needs big education on this. I don't think he REALLY understands medically what's going on ,or what can happen. I'd like to feel I've taught him some stuff for just the amount I've learned.
I think the way that renal failure is typically explained to patients like your husband's can be self-defeating:  Namely, they always try to present an optimistic--even Pollyannaish--storyline ("Living Well and Happily on Dialysis!")--which gives patients who are already in denial, a rationalization to continue living in denial about how serious an illness kidney failure really is.  We've got at least one such patient at my dialysis center.

No doctor or nurse or social worker ever gave me the true statistics and prognosis about kidney failure.  I had to find those out for myself.  And once I saw how grim the situation really was, I resolved to do what needed to be done.

So if you've got a patient who appears to be conscientious but is depressed, then sure, try to buck up his spirits.  But if you've got a patient like your husband's, who is in denial, then you may have to break through that denial with the grim truth.

Title: Re: K too high, in ER
Post by: boswife on September 12, 2010, 05:55:12 PM
ohhhh texastyle, my heart goes out to you...  ENOUGH is enough!!  I surly hope he helps ya out here and if nothing else does his *more* dialysis for YOU!!  Mabie you could put it that way since he's willing to do for others??   I hugely dislike (putting it nicly) being in your shoes.... it's so hard on our hearts...  Hope things are smothing out..
Title: Re: K too high, in ER
Post by: RichardMEL on September 12, 2010, 06:15:17 PM
RightSide - I see what you're saying - but I also experienced the exact opposite when I first saw a  neph back in 1993. I had done a routine physical for work and they found protein in the urine. Me, being 22 and ignorant, thought "so what?" - well we all know what it's about now. Anyway they referred me to this neph and I walked in (luckily I had my mother with me too) and the VERY FIRST THING this bloke said was "Well you've got two years." FULL STOP. I never did know if he meant I had two years to live, or two years till dialysis or what. Later in the meeting he said something like "We're required to give you ALL the facts and the possible outcomes" - well yeah... if I was in denial before I sure as hell wasn't then - but then again if I had continued with that jerk I might have given up there and then thinking "what's the point?"

I'm not sure that being told how you can live a full and mostly normal life with dialysis is going to affect anyone in denial one way or the other - since at some level they just won't think it's an issue that will affect them because "it's not happening"

oh just on me and the dentist - I wasn't in denial so much - I knew the longer I left it the worse it would get - but I just hated dentists so much I didn't want to deal with it!! Anyway I finally got my act together and went in (this is like 10 years ago now) and fessed up at how bad I had been. Good thing they caught a couple of things in time before they became major. The dentist said if I'd left it much longer I could have been in deep trouble. It's stuff like that, and a few experiences post dialysis that have definitely convinced me that it's better to get checked out rather than not - even if it ends up being something minor.
Title: Re: K too high, in ER
Post by: paris on September 12, 2010, 06:18:11 PM
Hi sweet Texastyle.   I am busy catching up on posts and just read through this entire thread.  I think you knew this day was coming.  I am glad he is in the hospital and others are carring for him now.  You need a break.   He is dealing with a boatload of junk but unfortunately, it is because of his own decisions.    Keep leaning on our dear Richard. He is so kind and so supportive.   We are all here for you.  I think we all just ache for what you continue to deal with.   I am sure he is a very good man.  Now, he needs to understand how much this is hurting you.   Praying for better days for both of you.  You are such a sweet person and we all love you.    :cuddle;
Title: Re: K too high, in ER
Post by: RichardMEL on September 12, 2010, 06:22:42 PM
hell yeah!!! who needs  a wonderbra when you've got me??!  :rofl; :rofl; :rofl;
Title: Re: K too high, in ER
Post by: texasstyle on September 13, 2010, 05:40:02 AM
Morning gang. I'm so glad for the support here. AND the honesty. I'm pretty worn down but starting to get myself together. We're all a lot stronger than we realize. Fro what I understand now, they are starting a dialysis series on him today. His lungs and heart in better shape than they were, but there is low oxygen in the blood. I don't know much about that. They did a can to rule out a pulmonary embolism and that was negative. He is on double oxygen. The thin tube under the nose and the bigger mask on top of it. Ate a dinner in the chair last night then zonked out there from the pain killers lol. They sure have done an awful lot of dializing in the last few days. Today will be his I think  5th time since 3am Friday. What's up with the low oxygen? Has anyone gone through tthat problem before. They call it the oxygen saturation. I assume if the oxygen is low the carbon dioxide is high. Hhhmm... What are the possible complications that could arise. I think his level is in the 60's-ish. Bloop pressure still hanging pretty low. Was 87/45 yesterday afternoon. He's awake and talking pretty good for a person who is ill. Can getting extra EPO in your dilalysis session help with the oxygen levels? He is seemily "ok" with an extra session and i think this was his fiall wake up call. I mean when the surgeon tells you that you were as close to death as you can be with out actually dying, and that you wuld not have lived through the night, it's better be your wake up call! Geez.... Richard, oops... I mean wonderbra lol, most people really don't realize how imperative a protein count can be. Especially at 22. Anyway, I'm habing in waiting for my plumber to come fix a minor situation with my shower valve. (hopefully it's minor) lol. Thanks gain for all the support. it's been a wild ride....
Title: Re: K too high, in ER
Post by: RichardMEL on September 13, 2010, 06:07:04 AM
whoa.... his sats was in the 60's? that's MIGHTY serious!

To divulge for a bit.. my mother DID have an pulmonary embolism (caused by a DVT in her leg that moved up to her lung) and in the end that's what killed her. Yep, it's that serious. Anyway the day she was admitted to hospital she simply couldn't breathe and could hardly move. She struggled to walk over to the hospital (about 100m walk from her place - very close - yet it took her apparently half an hour). Anyway when they did her sats she was at 72 - and they said that was the lowest they had ever seen a patient who still managed to stand - so 60's... well that's VERY low.

I don't know a HEAP about it, but epo stimulates red blood cell production, and red blood cells carry oxygen around the system, so I am certain the two go hand in hand. He must have had a very low hemoglobin suggesting that he just wasn't getting enough oxygen to his cells, due to low red blood cell count, and perhaps other reasons. If the cells are starved of oxygen, erll.. bad things happen.

The normal sort of figure for the sats is 97+. Last time I had mine done it was 98% - so even with a not normal red blood cell count you can still have normal sats - that's why I think other stuff was going on - perhaps the fluid around his lungs and heart was also affecting the flow of oxygen around.

hmm TS are you sure the plumber is only coming to look at your shower????  >:D >:D >:D >:D (hmm I must go do a course then offer to check your valves...  >:D >:D
Title: Re: K too high, in ER
Post by: texasstyle on September 13, 2010, 08:38:19 AM
By the way Wonderbra, I love the new profile pic! No embolism apparently and that's a good thing. He's not struggling to breath but they got to get to the bottom of this oxygen thing. I may have a couple of girlfriends over Thursday that I haven't seen since high school. They moved across country and are in the area. One is a chef. Yummy... I think I'll invite her over for dinner, tell her I burnt it, then SHE'LL be forced to whip something delicious up! HAAAAA!!!