choosing the right solution strength

[midges]

I'm new to CAPD (just started yesterday!) and I have a question about choosing the strength of solution to use.
     I know that you're suppose to base the strength of the bag on your weight, bp and indicators of water retention like edema and shortness of breath. The problem I am having is that I have no signs of fluid retention, but my BP is really high (192/110). I am getting ready to do my 4th and final fill for the day and I don't know which bag to use. My BP has been high all day so I have done 3 green bags today and my BP just seems to be getting higher. This is actually the highest BP I've had since I got out of the hospital a month and a half ago. My weight is also 2# less than when I did my  last fill, but I figure this is due to the fact that I still pee.
      Should I just use another green bag, or should I do a red bag? I have read hear that red bags weaken the peritoneum so I don't want to do it if it's not necessary, but I really am worried about my BP being so high.

[MaryD]

Midges - Please ring your PD clinic and get their advice.

Have you been told to use green bags as much as tree times a day?  To me this sound bordering on dangerous.  (I've been on PD for 12 months and I have been told to use about three green bags time in that 12 months - but I am probably in a different situation medically)  Don't use a red bag tonight.  Ring the clinic tomorrow and talk to them.  Green bags are also hard on the peritoneum.  Please let us know how you go

[Whamo]

Your blood pressure does sound very high.  Are you using your meds?  If your BP is that high I suspect they'd have you on about five different ones.  Are you eating salt or sugar?  Both of these spike blood pressure.  I am a high BP person myself, so I pray for you.

[justme15]

my blood pressure remains high as well, usually around 130/104.  my clinic has instructed me to continue using two green bags.  they are hoping that as fluid is removed my bp will come down.  I would definitely call your clinic though, and see what they say.  having high bp is scary!

[Joe]

I agree with Mary and JM15, call your clinic and consult with them. I only go to the red bags when it appears I'm retaining fluid (my weight goes up 3+ pounds in a 24 hour period). When my BP elevates, I take a clonidine and that seems to pull it down to the normal range. And FWIW, my normal mix is a green 2L manual in the afternoon and a green 6L with a yellow 6L on the cycler at night. That's just what it takes to keep my Kt/V at 1.99.

Good luck!

[jeannea]

I agree. Call your clinic. There's nothing wrong with using green bags if you need them but it doesn't sound like everything is working right. Your nurse can help you figure it out.

[JLM]

Another thing to consider is if you are in pain.  If I develop an air bubble inside of me, my BP gets high.

[midges]

Thanks for the feedback, everyone!
     My BP does tend to be high-- I'm on 5 meds to manage it at this point. When my kidneys failed I was admitted to the er with a BP of 211/180 and it took days and lots of trials with several different meds to get those numbers lowered, so I know that my BP tends to be quite high. I have been taking my meds regularly, though, which is why I thought this weekends spike seemed weird.
      I am generally pretty compliant with diet, but I think I got a bit off track with the holiday, so maybe that's an explanation. Fwiw, when I started PD I was instructed to start with the green bag, and I never got any indication that it was a bad thing. I am going to talk with my nurse more to get some clarification on this point.
      I woke up this morning to find that my BP was still high, though not as high as last night. I took everyone's advice and called my nurse. I'm on my way to clinic now, as she is also concerned that my BP has been so high for so long. I guess I was hesitant to call her because I didn't want to be a bother, but y'all convinced me that this was actually kind of a big deal, and obviously it's not getting fixed by the green bags.

[Joe]

Don't ever worry about calling them, that's what they are there for.

[midges]

I did talk to the nurse, and after reviewing my logs for the weekend and discussing my diet and liquid intake, she's just as stumped as I am. I'm still taking meds at the scheduled times, but they don't seem to be doing anything. My BP is still high, though I have no signs of fluid retention. I am actually 4# lighter today than I was this time yesterday with fluid on, which is also weird. For now, my nurse has told me to do my next exchange with the green bag and call her if my BP remains high. We're going to take a wait and see approach. My BP is slowly coming down, but it's worrisome that it has been this high for so long.

[MaryD]

I'm relieved that you have been to your clinic.  As Joe said that's what they're there for - especially when you're new at it

[billybags]

Joe, so glad you got in touch with your nurse, they will get you sorted out. Don't ever be afraid to contact them, even for small things. That is what they are there for. Hope things settle down soon.