feeling underdialyzed, any remedy?

[bette1]

Right now I am on incenter hemo, 3.5 hours 3 times a week.  I don't feel good and I want to feel better.  I don't have a nocturnal center near me, and I can't switch to home hemo right now.  My labs are good except for my pth, which is going down slowly.  Any suggestions?  Can you just ask them to add to your time? 

[jbeany]

Yes, you can push your doc to change your time to 4 hours.  You can possibly have them up your pump speed, too.  I was running at 400 for 4 hours.  450 makes a huge difference in the yucky metal-mouth taste.  If neither of those two changes make a difference, look into pushing for a bigger kidney as well.  My center runs everyone on 160s, but they make bigger ones.

Welcome to the Oliver Twist version of dialysis - "More, please, sir, more!"

[G-Ma]

I'm on 4 hrs at 500 and am feeling rather well...knocking on wood as we know that doesn't last...using the new smaller kidney and now the new lines...my numbers are very good but I would check with the Dr about requesting more than 3.5 hours.

[Wallyz]

More dialysis, bigger kidney, ask for another day so you don't have  aweekend.


Get on home hemo!!

[RichardMEL]

PTH going down is generally considered good!!

[BigSky]

How is your Kt/V?

If that is ok maybe its something else associated with dialysis??

[okarol]

What meds are you on? What are your symptoms? How's your dry weight? Sometimes you have side effects from BP meds or something else and don't realize it's from a change in meds. Or you can be retaining fluid around your heart and they don't see it. Or maybe you are allergic to the dialysis filter. Keep asking questions.
Whatever it is I hope you're feeling better soon.

[breezysummerday]

My s/o occasionally gets "crit-lined".
His body is good at hiding fluids.

Here is a link to explain a 'crit line'

http://renalfellow.blogspot.com/2008/11/what-is-crit-line.html

[bette1]

Maybe that's what's going on with me.  I ususally don't gain much between treatments and I have been having chest conjestion. I am actually below my dry weight.  My primary care physician thought I might have bronchitis, but I have been on the antibiotics for two days and don't feel any better.  If I feel crappy tomorrow I may have to go to the ER.  I hate to go to the hospital, but I don't know what else to do.

[qwerty]

You say you are under your dry wieght? Is it possible you may be too dry? We supplement our patients on occasion if come in under thier dry wieght especially if any diarrhea/vomiting. I usually try to send someone under thier dry wieght that is stable out at what they came in at. I supplement the saline to equal what we pull off. I've found it to work for several of mine and they also have great numbers. Just a thought.

[okarol]

How are you doing bette?

[RightSide]

Maybe that's what's going on with me.  I ususally don't gain much between treatments and I have been having chest conjestion. I am actually below my dry weight.  My primary care physician thought I might have bronchitis, but I have been on the antibiotics for two days and don't feel any better.

Are you bringing up a lot of sputum?  Is it discolored deep yellow or thereabouts?  If so, that really does sound like acute bronchitis.

With me, and with a lot of other folks I know, it takes 3 to 4 days before antibiotics kick in on a respiratory infection.  So maybe you just haven't given the antibiotic enough time, or maybe the bug you have is resistant to the particular antibiotic you're taking.

Were you feeling OK before this past week or two?  If so, then it may well be some bug you picked up.  If not, then yes, it might be time to look into changing your dialysis regimen.

[bette1]

Thanks all your help.  I am feeling much better. Turns out I caught a nasty bug and now that the antibiotics have kicked in I have most of my energy back.  I really appreciate you guys!