I passed out today!

[Annig83]

Oh my goodness what a scary feeling.  Recently, as some of you know I transfered from CCPD to Hemo due to an infection in my cath.  I have been doing it for a week and things have been good until today.
I ate some goldfish crackers before dialysis, and I think it was too close to my time because I got stomach cramps and passed out.  My BP dropped to 60/45!!  I was able to get the nurses' attention before completely passing out, but when I came to, I felt awful.  Luckily, after a cool compress and being laid back I felt much better... my BP is still low though 90/75... Is this a normal occurence where BP takes some time to come back up?

I'll be honest I'm a little scared to dialyze again on Saturday... obviously, I'm going to avoid eating too close before Hemo...

[jeannea]

I'm not sure eating caused it. Were you already hooked up to the machine? Unfortunately, passing out on dialysis is way too common. Someone can probably explain it better, but I think it has to do with taking off too much fluid too fast.

[YLGuy]

I do not think the goldfish had anything to do with it either.  It sounds like you crashed.  Do you know how much fluid they were trying to pull off of you?  What is your flow rate? Dry weight is a tricky thing.  If you search for that topic in this forum you will find information that may help you. 

http://ihatedialysis.com/forum/index.php?topic=27102.msg434386#msg434386

http://ihatedialysis.com/forum/index.php?topic=24382.msg393540#msg393540

http://ihatedialysis.com/forum/index.php?topic=12637.msg217058#msg217058

http://ihatedialysis.com/forum/index.php?topic=15326.msg270663#msg270663

There are a few to start.  Unfortunately it is a guessing game. 

[ChrisEtc]

 I've passed out a couple times.  It usually happens when I'm really relaxed and as you near the end of your treatment and you're running out of fluid your BP tanks.  You can either try to stay more alert or don't take off so much fluid or both. 

[Whamo]

When they take off too much fluid it strains your heart.  Doctors like to add .5 liters to your fluid takeoff to get a better cleaning, but I think pushing it to the point where people go into cardiac arrest or black out is stretching it too far.  I'm so glad I'm going PD because now I'll be in control. 

[newgrl]

This has been my second week on hemo.  I have not passed out.  However, my blood pressures have been extremely low when it is time for me to leave.  Today, I was told that it was 80 over 60 something and they gave me fluid back.  I can start to feel cramping in my legs and fingers.  They told me today to stop the rinse or something like that.  I am not sure what it is called.  However, I don't gain much weight between sessions.  So they don't have to take off too much fluid anyway.  I usually walk in around 56 to 57 and leave between 55 - 56. 

[KatieV]

I wouldn't think eating some Goldfish would cause you to crash.  I do NxStage at home and, because of my schedule, eat a full meal on dialysis every night.  If I were to wait until I was done with dialysis, I wouldn't be eating dinner until 10:30 pm! 

I have never crashed on NxStage (don't think I crashed in-center a couple years ago either).  I did have very bad cramps the other night though.  Apparently I've gained some dry weight.  I ended up with blurry vision and ringing ears and thought I was going to pass out, but didn't.  I believe it was from the pain; I took my blood pressure soon after and it was normal with a slightly elevated pulse.

You haven't been on hemo long, correct?  Perhaps they have miscalculated your dry weight or you need to get to your dry weight slower.

[Worthy1]

The kidney machine doesn't know it's hooked up to a person and the machine is prepared by the operator to take you to your dry weight.   UF profiling is available on Fresenius machines, there are four different profiles preprogramed into the machine.   It enables the machine to pull harder in the beginning of the treatment and not as much at the end when bp isn't as available.  You will still get dry just in a different stepwise fashion.  The idea is that you never should pull faster than your vascular system can refill.  Also remember that Dry Weight is a fluid number and the estimation of which is the art of dialysis.  Dialysis should never hurt. Almost all of the life changing adverse events that can happen in dialysis are a result of pulling you too dry.  Know the signs and preempt the adverse consequences. Sounds to me like you need your dry weight adjusted up. Remember to limit your fluid intake between treatments because it is easier on your heart also don't eat food during the last hour of dialysis (blood goes to gut to digest food and is less available for your extremities)  Good Luck.

[MightyMike]

The .4kilo is for prime and rinse back the machine usually adds .2 when you start treatment and another .2 when they return your blood at the end of treatment.  The machine is not always exact though some people give up fluid easier then others during treatment.  If your bp is getting that low by the end of treatment you probably need your dry weight increased.  Another thing you could try is if you take bp meds before treatment you might want to hold off taking them so you don't have those and the fluid removal bringing down your bp.  Eating before dialysis is usually a good thing because it can help keep your bp and sugar somewhat stable.  Even though it is important to get that excess fluid off don't remove so much that you cramp and feel like crap that is why it is also important too not to gain so fluid between treatments I average about 1.5 - 2 kilo between but the more fluid you gain the harder it's going to be on your body.  I hope this helps best wishes.

[noahvale]

*

[ChrisEtc]

Honestly, I eat in dialysis all the time.  I've never had any problems.  Actually one time I ate a lemon pie (one of those small ones in a package you get at the gas station) that made me throw up but I think that was just a crappy lemon pie that did it, not the dialysis. 

[BobN]

Annie, everybody's different, but for some people, eating close to the time you're being dialyzed can cause blood to rush to the stomach to begin the digestion process.

This can cause a decline in bp.  If you're also removing a lot of fluid, or if they're removing too much too fast, it can cause dizziness and fainting as your blood pressure just gets too low.

This happened to me early on in my dialysis life and since then, I've avoided eating during or shortly before treatment.  It has helped a lot.

As you can see from the other responses, this doesn't affect everyone the same way, but might be the reason for your episode.

[jeannea]

I always had some LifeSavers with me but I never ate a lot on dialysis. But the poor people from the county nursing home had to. Since we were there over dinner, they were sent with a boxed dinner and had to eat it there. Sucks to be old and stuck in the county nursing home.

[Riki]

Going from PD to HD can be tricky if you're trying to figure your dry weight.  I had the same problem as you, only opposite.  They were afraid to take too much off, but I was carrying so much fluid, I wasn't able to walk without the aid of a walker.  I did crash a couple of times, but after a month or so, we had everything figured out.  I had a dry weight that left me feeling pretty good at the end of the run, and I knew how much they could take off before it was too much.  So now, after being on HD for 4 years, i don't crash, I don't cramp, and I rarely get headaches.  It might take a while to get things figured, but once they are, crashes like that will be few and far between.  And no, eating a few goldfish crackers did not cause this to happen.

[Whamo]

The freedom of PD is great, but the risk of infection is always there.  Adjusting to hemo is tough.  I was actually doing pretty well with hemo after a year, but I wanted the freedom of PD, so I switched.  I'm glad I have a good fistula because I can use it if I have to go back on hemo instead of one of those chest catheters.  I hate those things.