Tired at work even though I am young

[angieskidney]

I have now been back to work for 3 weeks but now I am exhausted from work .. and it is only 2 hours each day, 2 days each week! What is wrong with me? I am only 32 and I bike to work and back and at work I am up and down taking expired items off the shelf at a grocery store. Today however my BP is lower than normal (still am off my BP meds) ever since Wed's dialysis and I was surprised that it is still so low even though I came off the machine 1/2 kilo up! It is frustrating because I am young and shouldn't feel like this! It is only a couple hours! And here it is only 9pm and I am ready for bed I don't get it.

I just had blood work yesterday and even though I won't get to see the results until Friday's dialysis, the nurse came back to me all concerned about my meds because she says my iron stores are REALLY low. I told her, "Yes I am taking my One-Alpha like I am supposed it (Vitamin D) as well as my Iron pills!" She automatically assumed I must not be taking them 

I assume low iron stores make you tired easier? I am not sure. Can anyone add to this?

[Epoman]

I have now been back to work for 3 weeks but now I am exhausted from work .. and it is only 2 hours each day, 2 days each week! What is wrong with me? I am only 32 and I bike to work and back and at work I am up and down taking expired items off the shelf at a grocery store. Today however my BP is lower than normal (still am off my BP meds) ever since Wed's dialysis and I was surprised that it is still so low even though I came off the machine 1/2 kilo up! It is frustrating because I am young and shouldn't feel like this! It is only a couple hours! And here it is only 9pm and I am ready for bed I don't get it.

I just had blood work yesterday and even though I won't get to see the results until Friday's dialysis, the nurse came back to me all concerned about my meds because she says my iron stores are REALLY low. I told her, "Yes I am taking my One-Alpha like I am supposed it (Vitamin D) as well as my Iron pills!" She automatically assumed I must not be taking them 

I assume low iron stores make you tired easier? I am not sure. Can anyone add to this?

What is your HCT or HGBx3 levels? When was the last time you received iron via an IV? What was your HCT last time? I watch my levels very closly because any HCT level under 32 and I feel tired. I have a lot of energy when my HCT is in the 36+ range.

[goofynina]

Ummm Angie,  dont take this the wrong way but, i am here all hours of the night and i see you here also.  Maybe your sleep pattern is making you tired,  you know,  not enough

[sandman]

Ummm Angie,  dont take this the wrong way but, i am here all hours of the night and i see you here also.  Maybe your sleep pattern is making you tired,  you know,  not enough

I may have to agree with that.  Angie and I usually are up very late.  And I wind up going to work with only 4 or 5 hours of sleep.

[angieskidney]

I am in the Eastern Time Zone and work late afternoons and I go to dialysis in the evenings .. so for me .. my days are later and my nights are later .. but I do get between 8 - 10 hrs sleep (only some times going on 5 - 6 if I am tossing and turning and can't sleep )

[geoffcamp]

I feel you Angie!  I am always tired it seems!  I do put a lot of time into work (I own my business) and I sleep weird hours.  I think my sleep pattern is all screwed up from sleeping on dialysis in the late evenings then notgetting back to sleep when I come home until late and the pattern continues into non-dialysis days.  I have heard a lot of people on dialysis suffer sleep problems.  My doctor gives me sleeping pills but I mostly use them on dialysis so I can sleep thru treatment because they leave me groggy the next day if I take them to get me to sleep when not dialyizing.  On dialysis some of the meds are filtered out with the rest of the toxins.  Lately I have been taking naps in the afternoon more and more.  When I workout it seems to get better but I have been off my workout schedule due to an ankle injury so I have been feeling especially tired too!  My iron is low and so is red blood cell count and they say I have to get my iron back up so the EPO can take effect.  But I understand how you feel... I feel like an old man who needs a nap to get thru the day and I am only 37!!!!  If you find a way to get more energy let me know!  Good luck!
Geoff

[MattyBoy100]

Hi Angie,

I know how you feel!  I work full-time and then have dialysis in the evening 3x a week!  By the time I get home I am exhausted!  By the end of the week on Saturday, I just sit in a big chair at home and fall asleep for a few hours, I find that helps.  But, I have to agree that you are up late sometimes (remember my message earlier?).  Maybe you need to change your sleep pattern.  You`re tossing and turning at night cos you`re not used to sleeping those hours.

[AlasdairUK]

Hi Angie,

I found when I started HD I stopped taking my blood pressure tablets and it took a while for my blood pressure to stabilize and find what my true weight was with regards to fluid. You may need to play around with this and even increase your fluid level if you are continuously low.

You do need to have a look at your blood results as your first point of call. This will pin point anything from low HB to low iron levels and you will be able to make the required adjustments.

I think you will know the difference in your body between being tired from lack of sleep to something not being quite right. We all know are bodies better than anyone else and sense when something is not the norm.

Cheers
Alasdair

[BigSky]

Since you say you are low on iron I would bump up your iron intake.  If I remember correctly you said you are iron tabs and not given IV iron.  Iron tabs are very poorly absorbed. 

If you level is low I would see just how low.  From there I would either increase the amount of tabs you take of your present brand or switch to a brand and style that has increased absorption.  However such better absorbed types tend to be more expensive. 

You need to be more proactive in your health care.  Listen to your body and what your blood tests show. 

As to your bp have them put you on a crit line and find out your true dry weight. 

[AlasdairUK]

Hi Bigsky,

To show my ignorance. What is a crit line? I have always wondered how you get your true dry weight as I have just adjusted mine to meet my required dry weight.

Cheers
Alasdair

[stauffenberg]

A number of things make dialysis patients tired all the time.  Because they tend to have low iron levels, they have trouble making red blood cells. 

The fact that dialysis can only clear toxins 10% as effectively as normal kidneys causes the toxin build-up to damage the nervous system, which can also make you tired.  Neurological damage prevents many renal patients from getting a full night's sleep, so they often pop awake in the middle of the night and can't get back to sleep, making them tired the next day.

The kidneys play a major role in the formation of red blood cells, so nearly all renal patients are anemic.  Epo can help slightly in treating anemia, but its tendency to cause blood clots means that it cannot safely be used to bring your red blood cell count up to where it should be, which is around 140 for men and 120 for women.  Although a normal male patient would receive immediate therapy for anemia at a level of 130, most dialysis patients are maintained at a level of from 100 to 120.  (The U.S. does not use the "system internationale" unit convention introduced in the rest of the world in 1985, so its measure of blood values is lower by a factor of 10.)

The kidneys are also important to maintain and repair normal muscle tissue, so loss of muscles can make everything renal patients do seem harder.  Low testosterone in male renal patients adds to their exhaustion.

Having doctors try to guess how much fluid you should lose on dialysis instead of having nature take care of this automatically means that you must often suffer from low blood pressure after treatment.  The main effect of this is exhaustion.

The result of all these factors combined is that, of renal patients in the normal working age, only 30% actually are able to work.

[TrophyWife]

The fact that dialysis can only clear toxins 10% as effectively as normal kidneys causes the toxin build-up to damage the nervous system, which can also make you tired.

................................Wow, Stauffenberg...............I did not know that. I would have never thought it only did 10% of normal kidney function.
Is it the same percentage no matter what type of dialysis you are on? or is one better type better than the other?
 I also did not know Epo has a tendency to cause blood clots..You are full of info

[BigSky]

Hi Bigsky,

To show my ignorance. What is a crit line? I have always wondered how you get your true dry weight as I have just adjusted mine to meet my required dry weight.

Cheers
Alasdair

A crit line is a machine that can measures the oxygen content of the blood and its hematocrit.  When the blood is full of fluid the hematocrit is lower.  As fluid is removed hematocrit rises.  The machines measures this hundreds of times a minute and displays it on a screen.  As each minute passes it shows what the level is in a manner similar to a bar graph.  If not enough fluid is being removed the bars stay pretty much level as each minute passes.  If too much fluid is being removed their is a spike in the bar over the previous one.  The ideal graph is one that in each minute the bars gets a little bigger and bigger so that if it looks similar to a diagonal line  from start to finish.

It can also be used to measure what the blood flow is of the access itself.

There are a couple of different machines on the market.  This is the site of crit-line.
http://www.hemametrics.com/Default.jsp

[Zach]

A number of things make dialysis patients tired all the time.  Because they tend to have low iron levels, they have trouble making red blood cells. 

The fact that dialysis can only clear toxins 10% as effectively as normal kidneys causes the toxin build-up to damage the nervous system, which can also make you tired.  Neurological damage prevents many renal patients from getting a full night's sleep, so they often pop awake in the middle of the night and can't get back to sleep, making them tired the next day.

The kidneys play a major role in the formation of red blood cells, so nearly all renal patients are anemic.  Epo can help slightly in treating anemia, but its tendency to cause blood clots means that it cannot safely be used to bring your red blood cell count up to where it should be, which is around 140 for men and 120 for women.  Although a normal male patient would receive immediate therapy for anemia at a level of 130, most dialysis patients are maintained at a level of from 100 to 120.  (The U.S. does not use the "system internationale" unit convention introduced in the rest of the world in 1985, so its measure of blood values is lower by a factor of 10.)

The kidneys are also important to maintain and repair normal muscle tissue, so loss of muscles can make everything renal patients do seem harder.  Low testosterone in male renal patients adds to their exhaustion.

Having doctors try to guess how much fluid you should lose on dialysis instead of having nature take care of this automatically means that you must often suffer from low blood pressure after treatment.  The main effect of this is exhaustion.

The result of all these factors combined is that, of renal patients in the normal working age, only 30% actually are able to work.

He's just full of positive facts!       

Make sure you're receiving adequate dialysis.
http://ihatedialysis.com/forum/index.php?topic=1271.0

And try to exercise as best you can:
http://ihatedialysis.com/forum/index.php?topic=415.0

And make sure your nutrition intake is adequate:
35 Kcal per kilograms of weight per day; 1.2 grams of protein per kilograms of weight per day.

[sandman]

Wow, I am impressed guys!  Loads of great information here.     Angie is suppose to have her blood work results today so.... we will see.

[angieskidney]

A number of things make dialysis patients tired all the time.  Because they tend to have low iron levels, they have trouble making red blood cells. 

The fact that dialysis can only clear toxins 10% as effectively as normal kidneys causes the toxin build-up to damage the nervous system, which can also make you tired.  Neurological damage prevents many renal patients from getting a full night's sleep, so they often pop awake in the middle of the night and can't get back to sleep, making them tired the next day.

The kidneys play a major role in the formation of red blood cells, so nearly all renal patients are anemic.  Epo can help slightly in treating anemia, but its tendency to cause blood clots means that it cannot safely be used to bring your red blood cell count up to where it should be, which is around 140 for men and 120 for women.  Although a normal male patient would receive immediate therapy for anemia at a level of 130, most dialysis patients are maintained at a level of from 100 to 120.  (The U.S. does not use the "system internationale" unit convention introduced in the rest of the world in 1985, so its measure of blood values is lower by a factor of 10.)

The kidneys are also important to maintain and repair normal muscle tissue, so loss of muscles can make everything renal patients do seem harder.  Low testosterone in male renal patients adds to their exhaustion.

Having doctors try to guess how much fluid you should lose on dialysis instead of having nature take care of this automatically means that you must often suffer from low blood pressure after treatment.  The main effect of this is exhaustion.

The result of all these factors combined is that, of renal patients in the normal working age, only 30% actually are able to work.

Ya I lost a LOT of muscle since I was malnourished from July to about Oct and my body took even longer to bounce back (my hair was falling out for months in HUGE handfulls every ALL THE TIME every single day til about Jan where it Finally started growing back! .. my poor long hair .. all gone *weep weep*). And my Hemoglobin was low but it finally has come back up. I just got my results and my Hemoglobin is back up to 120! But my Ionized Calcium is low and they may have to raise my Vit D pills. They also might raise my Iron pills.

I have noticed that I sleep for 3 hrs (and this is when I am already tired but not yet exhausted) and I wake up .. wide awake. Then only 5 hrs later I am tired again. What a nuisance! I can only sleep for a good 8 hrs if I sleep only when I am exhausted!!

I have tried everything but figure .. well .. this is part of dialysis I guess. I used to be able to work a 12-hr shift job for 9 years and take on extra shifts and fall asleep when I got home after eating dinner .. I was always fine. But since I started Hemo .. seems I have such a hard time with sleep.

Sometimes when you see me up late is only because I simply can't sleep. I am not the type to stay on the computer when I am falling asleep like my mom does lol

I also noticed that my BP was low at work yesterday and I think that was why I was so tired. Like you said. Because I found it very exhausting to try to do my job and not pass out at the same time when I had to keep going up to the top shelf and back to the cart and back up again and back down! And when I told the manager he said ok next isle and he told me to start at the top! Wtf!! I told him I will just do the bottom rows because of how I feel and he said .. ok.

I have never seen any critline things at my unit or the hospital unit. Does it look different depending on what dialysis machine you are using? I am on the Fresenius 2008K machine.

[Zach]

When I dialyzed on the 5 am shift, by 3 pm I got "punchy" ... I didn't work well with others at that point.

Now that I dialyze on a later shift, I can usually sleep off that night's treatment fatigue.

[Rerun]

Zach, that is what I use to do and I think I'm going to regret going to mornings.  I think sleeping off the effects is the way to go.

[thom]

i worked four houes every other day and i was completly whacked after that an i was 19! i was sat at a till aswell, i think most of it was becuse i just started dyalisis though.

also...  - what the hell/

[thom]

When I dialyzed on the 5 am shift, by 3 pm I got "punchy" ... I didn't work well with others at that point.

Now that I dialyze on the 6 pm shift, I can usually sleep off that night's treatment fatigue.

I also dialyze T-TH-S, so only two business days are affected.     

yeah i dyalisis 5 - 9pm so when io come home i jut sleep, sometimes i can wake up with a shit headache but it's better than going in the morning and beaing awake all day.