Just in case 3x a week isn't enough..

[Jess21]

I called my clinic this morning, and as long as they get an order for me to get an extra session (which they don't see why not-I was 3kg over my dry weight w/ high BP yesterday after my treatment- they are surprised the nurse didn't call one in for me last night!)
This is the first time in the year I've been on dialysis that I've needed an extra session.  I said I wanted a shorter treatment, but I don't know if she wrote it down.  Are extra session normally shorter? 

[cris]

With Mom, extra session is always the same hour lenght. Maybe it depends on how much fluid they have to take off.

[twirl]

I know one patient and he comes in for an extra treatment and it is an hour shorter of his regular time.

[graftgurl]

Jess, I've only been on dialysis since late August, but I had to have an extra session a few weeks ago. I had gained over 6Kg on my 3 days without and could only take off 2.7 the first day and only another 3 on Thursday but I had gained back 1.8 in between. They ordered a 2 hour session for me (I usually do 3.75) and finally all the weight came off. I can't tell you whether the shorter session is normal or not, but that's what they did for me. Hope it helps you get back to where you need to be   

[nursewratchet]

An extra session is OK, as long as justified medically.  It can be regular time, or shorter.  It can also be a "PUF", meaning, they are only removing fluid. There is no cleaning of the blood during a PUF.. Sometimes a PUF is done because there is a lot of fluid, but not a high BP.  If the BP is in normal to low range, it is difficult to remove much fluid.  The puf allows fluid to be removed without changing the composite of the blood, so all the toxins and electrolytes (potassium, sodium, etc) would be the same, thus not affecting the blood pressure.   Usually a puf is not a full treatment lentgh.    PUF stands for Pure Ultra Filtration. 

[Wallyz]

I think a PUF should be considered malpractice.  The benefit of an extra treatment is that it allows the movement of excess nutrients and minerals out fo the cells and into the blood to be dialyzed of by the artificial kidney.  Wasting an opportunity to do that seems ridiculous.

[nursewratchet]

Not at all,  some people, have too much fluid, but have good clearances, and a Blood Pressure that is too low to remove the fluid.  That is when you would use the PUF.. By leaving the electrolyes, the Blood Pressure si not affected as much, and allows you to remove fluid. 

[Budluv]

I puffed for the first time yesterday.... I normally run 2 and a half hours... This time I Puffed for an hour and did regular dialysis for my 2 and a half... 
I thought I would feel like dung afterwards but I felt fine. ..   I had never heard of puffing until yesterday. 

[nursewratchet]

Great!  Puffing is a good way to get the extra, without bottoming out BP.   You can do part of a regular treatment, and part PUF, like you did yesterday.  There are many safe and creative ways to set the machine to get fluid off.  This is one of them.  The Dr.s at my clinic consider a "Fluid overload" hospitalization to be  "improper dialysis"... Unless a patient misses treatment, shouldn't be overloaded. 

[Rerun]

Jess you should see if there is a Nocturnal dialysis program in your area.  In stead of trying to take off 6 kilos in 3 hours they take it off slower at 8 hours while you sleep.  No puf here.  They clean and take off fluid for 8 hours .  Longer slower dialysis.  You will feel so much better.

                           

If more dialysis is better then I don't agree with a puf.  I do agree with an extra session of regular dialysis.  Why waste the money if you have to setup the same.

[boxman55]

I learned a new term today. Never heard of PUF...Boxman

[Bajanne]

I have!  PUF the magic dragon.......

[kitkatz]

Sounds like you are sitting in a chair puffing something. Now what could we possibly puff?

[nursewratchet]

Rerun, your right about the setup time, etc.  The PUF won't (can't) work for everyone.  It's only for low BP, heavy fluid.  It's the opposite of turning off the UF.  There, you clean the blood but remove no fluid.  In the PUF,  you aren't cleaning the blood, only removing the fluid.  It's sometimes done too, for example, you took a med, pain med, or BP med, whatever, that drops your BP.  Sometimes we see someone come in with a BP of 95/45, with 5-6 kilos of fluid.  The BP is really too low to remove much fluid, if any.  You can PUF, for 1-2 hours of the treatment, get off some fluid, and run the rest of the treatment normally, cleaning the blood.  You're right though.  Longer is always better.  We only have a couple of nocturnal programs in San Antonio.   

[Jess21]

Jess you should see if there is a Nocturnal dialysis program in your area.  In stead of trying to take off 6 kilos in 3 hours they take it off slower at 8 hours while you sleep.  No puf here.  They clean and take off fluid for 8 hours .  Longer slower dialysis.  You will feel so much better.

                           

If more dialysis is better then I don't agree with a puf.  I do agree with an extra session of regular dialysis.  Why waste the money if you have to setup the same.

I don't think there are any around here..