Explain the fluid restriction

[Bajanne]

I want to know exactly why we have a fluid restriction.  These days are rather hot, and I get very thirsty.  What does excess fluid do to a person on dialysis?  Can't they just take off the extra fluid next time?  How will it harm me?  Please answer these questions for me and add anything else I need to know in this area.

[Epoman]

I want to know exactly why we have a fluid restriction.  These days are rather hot, and I get very thirsty.  What does excess fluid do to a person on dialysis?  Can't they just take off the extra fluid next time?  How will it harm me?  Please answer these questions for me and add anything else I need to know in this area.

I'm guessing you must still urinate. Well eventually you will stop all together and maybe if your lucky a drop of pee will come out. Well here's the deal everything you drink will stay inside of you and will get absorbed into your bloodstream and also into your tissue, if your careful your lungs won't fill up with fluid and cause you to internally drown. You will however have to sleep siting up if your lungs do get fluid that way you will be able to still breath. Oh did I forget the "Heart"? well the process of having to remove fluid "gain, remove, gain, remove, gain and so and so on WILL cause your heart to enlarge after all your heart is just a muscle and like any muscle the more you work it the bigger it will get. And having an enlarged heart can cause all sorts of problems like High blood pressure, Congestive Heart Failure, and other pesky complications. But really that is the least of your problems your heart will most likely be damaged by all the potassium and phosphorus circulating in your blood stream causing your arteries to clog up. but that's another story all together. Back to the fluid issue, what about the tissue damaged that will be caused from your tissue absorbing all this fluid well let's NOT talk about that shall we. Remember other things besides fluid will cause you to have excess fluid build up, things like ice cream, jello, many types of fruits like watermelon and orange juice. But you know what we all are going to die from complications of dialysis and not kidney failure anyway so drink what you want and when you want just do it in moderation. Enjoy yourself just have self control and if you start hearing bubbles coming up from your throat you need to drink less. You won't be able to stop your heart from enlarging over time anyway so enjoy!

I hope this post didn't sound sarcastic because it's just the truth and that's what this site is all about. 

[cabarle]

I want to know exactly why we have a fluid restriction.  These days are rather hot, and I get very thirsty.  What does excess fluid do to a person on dialysis?  Can't they just take off the extra fluid next time?  How will it harm me?  Please answer these questions for me and add anything else I need to know in this area.

I'm guessing you must still urinate. Well eventually you will stop all together and maybe if your lucky a drop of pee will come out. Well here's the deal everything you drink will stay inside of you and will get absorbed into your bloodstream and also into your tissue, if your careful your lungs won't fill up with fluid and cause you to internally drown. You will however have to sleep siting up if your lungs do get fluid that way you will be able to still breath. Oh did I forget the "Heart"? well the process of having to remove fluid "gain, remove, gain, remove, gain and so and so on WILL cause your heart to enlarge after all your heart is just a muscle and like any muscle the more you work it the bigger it will get. And having an enlarged heart can cause all sorts of problems like High blood pressure, Congestive Heart Failure, and other pesky complications. But really that is the least of your problems your heart will most likely be damaged by all the potassium and phosphorus circulating in your blood stream causing your arteries to clog up. but that's another story all together. Back to the fluid issue, what about the tissue damaged that will be caused from your tissue absorbing all this fluid well let's NOT talk about that shall we. Remember other things besides fluid will cause you to have excess fluid build up, things like ice cream, jello, many types of fruits like watermelon and orange juice. But you know what we all are going to die from complications of dialysis and not kidney failure anyway so drink what you want and when you want just do it in moderation. Enjoy yourself just have self control and if you start hearing bubbles coming up from your throat you need to drink less. You won't be able to stop your heart from enlarging over time anyway so enjoy!

I hope this post didn't sound sarcastic because it's just the truth and that's what this site is all about. 

Damn. That's a wake up call. I can still urinate, but I will heed this life saving advice. Lucky for me, the nurses say I don't gain too much and they seemed please with this. Why is it nobody else has explained this to me? 

[Bajanne]

That is why I like this website and am sticking with it.  You do get the truth (even if the honesty's too much) and some valuable advice that the professionals forget to give.  Anyway, which one of them has been here??

[BlackJack]

It is a good website.  As a professional, I honestly think that this advice from a fellow patient means more to you than if it comes from one of the staff.  Unfortunately, in no area of healthcare does a more obvious mistrust between patient and staff exist than in hemodialysis.  I have no explanation other than the sheer amount of time spent together allows patient and staff to see flaws in each other that are not exposed in other healthcare modalities.  Anyway, my point is that you can or should be able to trust your fellow patients not to blow smoke up your arse.  Epoman gave a concise and excellent explanation of the hazards of chronic fluid abuse.  Thanks.

[Epoman]

It is a good website.  As a professional, I honestly think that this advice from a fellow patient means more to you than if it comes from one of the staff.  Unfortunately, in no area of healthcare does a more obvious mistrust between patient and staff exist than in hemodialysis.  I have no explanation other than the sheer amount of time spent together allows patient and staff to see flaws in each other that are not exposed in other healthcare modalities.  Anyway, my point is that you can or should be able to trust your fellow patients not to blow smoke up your arse.  Epoman gave a concise and excellent explanation of the hazards of chronic fluid abuse.  Thanks.

  Thanks "Blackjack"

[Jamie]

THe diet and fluid is quite easy to remember and explane. It goes like this "Can't eat nothing, Can't drink any thing " and if you breath hevey in large breath's you have to pay G.S.T. to the Government for that....Jamie-G

[Bajanne]

I was doing very well this year.  I keep the memory of what Jamie went through as an encouragement to be compliant where fluids are concerned.  However, I don't know what happened last weekend.  I really was not feeling very well, a bit of flu, or something like that.  Anyway, when I went to my Mon dialysis, I had on 5.4 extra litres (I usually have 1.8, or 2.4 or something like that).  What happened is that my blood pressure went down and I had to have saline added.  When I came off, after 4 hours, I weighed about1.5 litres more than my dry weight.  As the nurse told me, "until you come back, don't even swallow your saliva!"
Of course I couldn't comply with that!
But I have become even more careful with my taking in of fluids.

[kevno]

I have those small cans of coke 150mls, Suck on ice cubes.  If you do not urinate The Doctors  (Ha!) say you should only drink 500mls a day, I do not think any renal patient sticks to 500mls a day. I drink about 1000mls a day, I am usually 1 - 2kg up.  It also depends on how much you do, exercise, work or just sweat.

You must be careful of you fluid intake.  I have seen a few patients die with being overloaded, you can always tell when you are getting overloaded.  out of breath quickly, swollen ankles and the doctors can tell by your veins in your neck.

Kevno

[Rerun]

That sounds strange.  If you had flu like symptoms that means you probably didn't eat or drink much. 

I did the math wrong on Tuesday.  I figured out that I needed to take off 3.1 kg.  Well, my bp dropped and I felt sick at the end and I weighed 1.2 less than I should have.  DHA... I should have only taken off 2.1.  I subtracted wrong. 

Everyone says "didn't they double check your figures"  NO and I don't want them double checking me.  I want some control.  So, I tell them what I want off.  (I'm going to carry a calculator with me from now on.) 

[kevno]

Rerun No wander you BP dropped. It's a horrible feeling,when  you have lost to much fluid, you start to sweat, feel sick or even sick. So you are losing more fluid.  You soon feel better when the pump that saline in you. . The only thing is it sometimes it takes the nurse to long to check the BP. I have a target weight of 62kg today I was 63.1kg so thats 1.1 up .3 for wash back, .3 for drinks.  so a total of 1.7 to take off. Good Luck with your maths next time


Kevno
(make sure the calculator has a battery in!)

[Bear]

Don't you have some control over the machine ReRun???
  As soon as I was used to the procedure and knew what was what, I would adjust
the settings as necessary. I also found it was better to actually key in a bit more
than you really wanted to lose, so your hourly rate was, say 575. Then, if the b.p.
started to drop (I was taking it at least hourly in clinic), I would reduce the target
and that would drastically reduce the hourly rate for the last hour or so.
  Also, their formula of taking the difference between you 'ideal' weight' and your
actual weight, then adding 300mils for saline & 300mils for drinks is a bit 'iffy'.
For e.g., I had put on 2.5kg, so I added 300 for saline & 350 for drinks =3150.
SO yesterday I keyed in 3150, running @ 575 over 5.5 hours, had my two cups of
tea....I went on @ 135, so I was trying to get back to my (current) 'ideal' of 132.5.....
but came off @ 132.1. This often happens & I think it is the saline part of the calc.
that is suspect...I've tried to work it out...900ml saline bag into circuit....connect up...
run out to bag....connect venous. No real saline intake there..Coming off, disconnect
arterial...connect up saline...run until you get your blood back...it IS getting paler as
there is some saline in by the end....but I don't think it often reaches 300ml.
  There are of course the occasional sessions, where I don't clamp off the saline in
time & the blood runs up the saline line & I have to clamp the arterial & let some
saline into the circuit to clear....so then I don't meet the target (maybe).
  BTw I think the 500mils is SO unrealistic, altho I DO understand why they give
this figure to in-patient dialysers. I usually have about 1.2-1.5 per day, but with
breathing & perspiration, my total on the alternate day before dx is usually 1.6 -
2.5. With 4 sessions a week, I don't have that probelm of the extra day between
session the 3 x 5 people get. That must be where their worst fluid gain is. Whereas
for me, with the 4th session, I'll only have 1.2-1.8 on as it's only about 28 hours.
  Cheers (raising empty glass! )

[susie q]

My targets usually are around 3.5 to 4 kg..  3xweek  Mondays are the worst... I get to decide how much to take off...
On our machines you can select a "profile" which will regulate when and how much fluid comes off... my profile takes more at the beginning and much less towards the end, pretty much eliminating bp problems and cramping... 

[kitkatz]

There goes the kegger party, too.  Dang!
Sorry couldn't resist.  I hate the fluid restrictions.  I am so sick of eating ice cubes I could scream!  Crunch!Crunch Crunch!  I allow (what a crock) myself to have one glass of whatever I want everyday then eat ice all day long.  Sucks, but watcha gonna do?

Katherine

[Fox_nc]

Ok guys forgive me, but I just started fluid restrictions yesterday and already I'm having a nervous breakdown b/c of it.  I did a little search-a-roo and found this older string to help me.  I see that chewing ice helps, but are there any other helpful tips out there?  I like drinking ... drinking is good ...  And how in the heck do you track such crap?  I was on a low-protein diet once (21 grams a day) that had me measuring lettuce and I just though that was bad.  After day one of this fluid BS I already know I need help ... and I think I know where to get it ... so lay it on me ... your words of wisdom ... please ...
 

[goofynina]

I wish i had the right words to tell you but i was horrible on my fluid restriction,  i was always going in 5 - 6 kilos over (when i was on hemo)  with PD, fluid isnt AS restricted but you still need to be careful.  It gets easier with time but of course its still hard to do (if that makes any sense at all)  Good luck and keep us posted, especially if you find some good pointers, we can all use some now and then  

[Fox_nc]

Will do! 

[Panda_9]

I really hate the fluid restriction and Im having a lot of trouble sticking too it as Im thirsty ALL the time! I am never not thirsty. I drink out of a 250ml measuring cup so I can roughly guage my intake. I am having a lot of trouble keeping it under 3kg gains. Ive been getting chest pain for the past few weeks so Im starting to worry 
I can chew on ice all day long, if anything it makes me even more thirsty. I have started cutting back on salt which really does help. The less salt I eat the less drinks Im looking for. I also try not to keep cold drinks in the fridge, as its just too tempting. However my other half does and I often take a few swigs of them, cant help myself. Im now moving onto the milk though, as its usually the only thing cold in the fridge. I was a lot less thirsty on PD.

[kitkatz]

Sip, sip, sip.  Drink anything slowly and make it last a loooong time. I can make a can of soda last hours now. A cup of ice can last hours if I am not in a crunchy mood or if I am busy.

[angieskidney]

I am not good on mine .. but .. well .. any bit of advice helps right? I am anywhere from 2kg up to 4.5kg up

I don't take ANY drinks back to the computer or else I will drink the whole thing. I use only small (200ml) cups and I keep all drinks in the fridge (canned pop .. never Pepsi or Coke though) and have to come to the fridge for a drink .. but only have a couple sips ad then put it back in the fridge. Lasts longer that way.

Also my dietitian told me to measure everything out this way (which I don't):

If your limit is 1000ml, carry 1000ml container with water. Every time you have a drink, when you are done your drink, put the same amount of water into the glass or whatever ... when your 1000ml container is OUT of water .. you are DONE for the day.

Also sucking on "Freezies" help.

[kitkatz]

Good luck with the fluid restrictions.  I HATE it!  I crunch on ice all day long, but the teeth get weary after awhile.  I usually have one soda a day with a meal. Then just ice in a cup.  Use a small cup, not like me with the big cup.  Bad bad!

[Bajanne]

I have been buying those large bags of ice-pops.  I bought them primarily for my grandson, but when I realiized that they could be a refreshing substitute for a drink, I was thrilled.  An ice-pop is only 3 ounces of fluid.  Just like ice, you can make them last a very long time.
[Now I just have to learn how not to take 12 of them in one night!  Just kidding ]

[Panda_9]

Ive bought these fruit ice block things that are only 35mls each and 99% fruit with no added sugar. They are much more refreshing than the cordial based ice blocks I have found.

[glitter]

my husband is on 1000ml a day,and some days he suffers so badly-on the worst days i give him a stronger ativan (2mg) and let him sleep away-but of course he can't do that everyday.He eats grapes and sips 2 oz at a time-eats those little dole cups of peaches 4oz and only 70 potassium.
 
He also eats unsalted pretzels,or cookies by the bag-he said they make him forget he is thirsty-whatever works for him I am in favor.

[Zach]

I try to only drink seltzer water during the day (that is, after a cup of coffee in the morning).  I keep liter bottles in the frig, and limit one bottle a day.

Keeping it real cold helps, and the bubbles prevent me from drinking too much at a time.
And the single bottle allows me to easily keep track of how much I'm drinking.