Low Blood Pressure Problems

[Bajanne]

I have been having some really bad problems with low blood pressure.  I am hypertensive, and I have been accustomed to reaching to my unit with a BP of about 140/90.  Then it tended to fall during the session and by the end of the session I would leave at about 110/80.
Now I have ongoing low blood pressure.  I would reach the unit at about 110/70 or less.  They tend to give me saline immediately.  Then during the session it would drop dangerously low.  On Saturday (I exchanged my Friday with someone) when the session was ended they would not allow me to leave.  My BP was 88/43.  I had to stay until it came up to about 100/53. 
I left and went to get something to eat.  Everything I ate just came back up.  I could feel my BP was low.  I went to the ER.  Yup - VERY LOW!  They put me on a drip.  I stayed there from 7 in the evening until 2.00a.m.  Even after all that drip, I left with a BP of 99/66.
No one seems to know what to do with low BP except give you saline.

Any of you guys have low BP problems?  What do they do with you??

[okarol]

I am sorry you've been having trouble bajanne.
Are they taking off too much fluid? Have they reset your dry weight? If possible you may want to get a Crit-Line evaluation.  It is a blood volume monitor and it measures your Hct in real time. Some facilities have them and it is a great tool to help not remove to much fluid during hemodialysis or see if you have extra fluid - more info http://www.hemametrics.com/Patient_Booklet.pdf
Can you have a little broth to increase your sodium level? Have they changed any of your medications lately? (You can check possible drug side effect here http://www.rxlist.com/drugs/alpha_a.htm)
Hopefully your doctor will rule out any heart or thyroid issues. I hope you get some solutions soon!
 
 

[tyefly]

    Thx for the crit-line information.....   I am not on dialysis yet ...but I am learning all I can.....   with the nxstage system can we us the crit-line monitoring.... is that available...or is this a in center only method....  does everyone use this.......   thx again....

[Hanify]

I get low bp too - and it's usually always dehydration too.  Have to drink more - you'd think that would be marvellous, but it's not when you just do it for the sake of it!  I'd look at changing your dry weight too.

[willowtreewren]

 

How you get this licked soon.

Aleta

[iketchum]

My bp drops during treatment also. Last treatment I cramped from my toes all the way to my ribs. They returned one liter of saline to stop the cramps but it took one and a half hours to get my pressure high enough to let me go. I ride a motorcycle and they worry about my bp alot.

[peleroja]

Yup, when I was on hemo more than once my BP dropped and I would have to stay an hour or two drinking salty chicken broth to bring it back up.  I learned to find all the drive thru restaurants on the way home as I knew I would be too tired to cook, and I didn't dare get out of the car to go eat!  I agree that it sounds like they are taking off too much fluid.  Perhaps having tomato juice or V-8 in the car ready to drink might at least help you get home.  Perhaps it's time to revisit BP medication?  That's all I can come up with.  Let us know how it goes.

[cherpep]

I have low bp with every treatment.  It's not that they are pulling off too much much fluid, it happens even when no fluid is being pulled. My doctor gave me some medicine, I believe it's called Mitrodine, to increase my bp.  I take it about a half hour before I start my treatment.  It has helped. 

[Bajanne]

Thanks for all your thoughtful and caring replies.  I have not taken any BP medication for well over a year.  I know they are not taking off too much fluid because I have not been having any cramps whatsoever (and that used to indicate too much removed).  I will ask the doctor about Mitrodine.b

[kitkatz]

Geez!  Woman you got to take care of yourself.  I have no advice, but wanted you to know I care! 

[Bajanne]

Geez!  Woman you got to take care of yourself.  I have no advice, but wanted you to know I care! 

That is just as good as advice, Kit 

[monrein]

I too am thinking dehydration bajanne but whatever it may be, I hope you get it figured out and corrected soon.  What a colossal drag for you. 

[effinxmandy]

This may sounds like a stupid question, but are you being sure to NOT take your BP medication before dialysis? Many times I've had patients come in who are hypertensive who have taken their BP meds, which left me to work with a pre-tx BP of 99/56 (or somewhere else really low).

Also, I would talk to your doctor about your dry weight, perhaps it needs to be increased. Dehydration will seriously effect your BP, making it low. Maybe you've gained body fat and not fluid? It's also a big old warning sign that you can't keep anything down after tx, and you had to go to the ER to get fluid PUT ON.

Let us know if you ever get it figured out. It would be nice if their was a straight answer when things like this occurred, but unfortunately, it just doesn't work like that! 

[YLGuy]

I am sorry you've been having trouble bajanne.
Are they taking off too much fluid? Have they reset your dry weight?
 

I was having problems with my BP dropping after HD.  The doctor DID reset my dry weight and it seems to have worked this week. Bonus: It took care of the cramping too.

[jpearce]

My Bp drops about 1.5 hrs into my run the nurses slow down my flow and shut off the UF for 5 min then my bp jumps up again. They have told me that the fluid has to be drawn from the extavascular system and it doesnt' happen quick enough, that's why my bp drops. Somedays are better than others!!

[Bajanne]

This may sounds like a stupid question, but are you being sure to NOT take your BP medication before dialysis? Many times I've had patients come in who are hypertensive who have taken their BP meds, which left me to work with a pre-tx BP of 99/56 (or somewhere else really low).

I haven't taken BP medication now for much more than a year.  I don't even have any at home! 

Last month the neph said that they should up my dry weight.  But the problem is that he told me but did not put a note in my folder!
And so I have to wait until he returns (we only have a visiting neph about once a month now) to see what he will do.

On Friday, my BP went so low in session -76/43, that they stopped taking of the fluid and I went home 1kg above my dry weight.  But I felt great!!  And I have had none of the post-session problems that I had been having.

[pdpatty]

My bp drops low during treatment too. Trouble is ,it keeps dropping after I get home. Yesterday it was 66/55.It came up a little to 77/66 and stayed low all evening. When it gets that low I cannot walk,my arms feel like dead  weights .This am it was  still very low so I drank 8oz of PowerAid. It has only 25mg of potassiun per 8oz so is pretty safe. Pressure came up to 101/69. the monitor is correctt ,measures husband's bp same as when in doc's office.