Electrolytes Affecting Nerves, or Something Else?

[Restorer]

Recently, I've been experiencing something weird. Some evenings, I'll feek "floaty" - though it's hard to describe. Sitting still, I feel heavier than normal. But when I move my limbs, they feel much lighter than expected and I end up moving them to where I want them faster than I wanted to. I'd like to call it a problem with the proprioceptive system, but I'm not sure. Also, when I get up from sitting, my legs feel weak, and I sometimes lock my knees too far back and almost fall over. Along with that is usually tingling in my hands, and what's either a warm feeling in my face or a bit of a fever (though I've never measured my temperature during an episode).

The problems occur in the evenings, I think after a big meal (recently two early dinners involving potatoes), and only if I sit for a while (e.g. watching TV or a movie). If I get up and walk around a bit, the tingling and weakness go away. It doesn't really feel like objective weakness, it just feels like I can't control my limbs as well.

My guesses of possible factors:
- potassium
- phosphorus
- protein (or metabolites thereof)
- other electrolytes?
- blood pressure (because walking around remedies it)

My blood pressure used to be very high, but with new medications it's gone down to normal, or even a bit low sometimes. I did have these problems occasionally before I changed BP meds, usually when I wasn't getting enough dialysis. What could be causing it now?

As an example, it happened to me tonight. I had a (rather big) meal of a large grilled steak, a baked potato with olive oil and a bit of feta, grilled zucchini, iced unsweetened green tea, 4 Renvelas, and 1 750mg Fosrenol. Then I sat down and watched a movie. The feelings started during the movie.

[BigSky]

Feeling heavier and weakness can be associated with high potassium.


It maybe potassium since you say it occurs after a big meal involving potatoes.

The amount of potassium in your meal you describe depends solely on the portion size.  There are 3 things in it that are higher in potassium.

Meat-                  Roughly 90mg per oz cooked.
Zucchini-              Roughly 150mg per half cup raw
Potato-                Roughly 450 mg per 3 oz baked with skin

[Restorer]

This was a pretty substantial meal. 1800+ mg of potassium, probably. Since I started dialysis, I've never had any problems with potassium. It was always just fine in my labs. Before I started dialysis, my potassium was often high, and it didn't do this to me. What it did do was give me constant diarrhea and, on occasion, heart palpitations. But it never affected me like I felt last night.

Potassium was one of the first things I suspected, but it just doesn't match up with what potassium has done to me in the past. The weakness makes sense, but I still don't know if it's real, true muscle weakness, or just perceived weakness or a problem with perception. And high potassium has never caused neuropathic-like tingling in my hands.

[kitkatz]

A low calcium can cause tingling.  How are your calcium levels?

[Restorer]

My calcium has always been in the good range on my labs, but that might not help if my calcium levels are transiently changing at times. I'd have to get blood drawn while I was feeling the tingling to confirm it, I think...

[BigSky]

Most peoples limits for potassium are in the 2000-2500 range for the entire day.  That was a pretty large amount of influx of potassium in one meal for  your body to process.

Add that amount to whatever else you may have ate that day and you might be consuming too much potassium.

Also just because you reacted one way to high potassium doesnt mean you will always react that way.  Some people do not even experience any signs of high potassium.

The tingling could have been from the high potassium as that is one of the signs.

I would talk to the doctor about it and the next time you eat like that and experience it get labs drawn to see what is going on.




Here are the most usual signs of high potassium.

    * Irregular heartbeat
    * Fatigue
    * Weakness
    * Tingling, numbness, or other unusual sensations
    * Paralysis
    * Difficulty breathing
    * Changes in nerve and muscle control

[Inara]

I don't think you should wait....this sounds serious.  I would call the doctor and TELL (don't ask!) him/her that you need your electrolytes checked STAT!!