when to eat on your D day?

[Hubbs]

Hiya gang,  I been doing some testing,  my D thing is @ 2PM  Tue, Thu. -N- Sat.  They always tell me to eat or have you been eating right..  .. so being a newbie.. I ate Breakie and lunch before i went..  I've noticed, if i eat lunch the wight is still there when i sit down and  well, Bleed. lol,  thing is they add the meal as fluids that need to come off.. and i'm F#*k up the rest of the day cuz they took too much out.. so i been skipping lunch but eating breakie around 10AM  (pretty big one too) so when i get off the D thing i'm not as dry.
so i'm asking; how do u set yourself up for D day?

[galvo]

I'm also on arvos, Hubbs. I have a lightish brekky early, around 0730 then nothing else before dialysis. Same reason as you - I don't want the weight of lunch added to my pre D weigh in. Depending on where I dialyise I get either a sandwich or some bikkies and cheese, together with a cuppa during D. Seems to work for me.

[Epofriend]

The other approach is to up your target weight by half a kilo when you eat lunch before dialysis, given the effect you've noticed. If you normally try to come  off of dialysis at 90.0 kg, for example, tell them to only take you down to 90.5 kilos when you've just had lunch.

I eat a light breakfast before very early morning dialysis, keeping it light so that the digestive process doesn't affect my blood pressure. I also tell them what to take me down to at each session.

[Restorer]

I start at 11:30. If I don't eat a decent breakfast before dialysis, my blood pressure stays really high and they start questioning me ("Your blood pressure is so high.", "Why is your blood pressure so high?", "Did you take your blood pressure medications?") and nothing but food brings it down. I keep protein bars in my dialysis bag just in case, so if I didn't have enough breakfast and my blood pressure's high, I can eat one in the last 30 minutes and they won't try to keep me there.

Even if I eat before I go in, I'm usually hungry for lunch afterward, and I don't often feel up to cooking something. All this eating out is making my bank account start to float away. 

[thegrammalady]

eat when you want. solve the problem by telling them what to take off not letting them decide.  or outright lie, if you've eaten tell them you haven't. it really isn't their choice, it's your decision. i track my weight very carefully. keeping track of what i weigh out at and what i weigh in at for the next treatment. if the difference is 3 that's what we take off. as for eating.... when i started at 5:30  am i took a little someting to eat during dialysis. now that i start at 7pm i also take a snack. especially if i haven't felt like eating dinner before i leave home. maybe a sandwich or i'm especially fond of popcorn. the thing is you know you, how you react and how you feel. it's not the tech's decision, it's yours.

[Riki]

I don't go in till 1:30pm and I don't tend to get out of bed till around 10am, so I usually have something to eat that will keep me from wanting to gnaw on my arm near the end of my treatment.. *G*

I used to have a limit of 3.2kgs that they could take off before it affected me, but that's gone down in the last couple of weeks to about 3kgs, so it doesn't matter what I come in at, the most that will be coming off is 3kgs.  They always confirm everything with me before they do anything, which is the way it should be. AFter all, you are the one who has to live with the after effects if they take too much off.

[Hubbs]

Okay, cool, thanks for the heads up.   sometimes i wish they had a Mc D's next to my center   
 i'd prolly just order large fries. instead of eating vanilla wafers all the time.. (gives me gas)    i did start weighing myself in and out, and i do have more control over my wight.. anyhow.. lets move on

[Stoday]

I have the twilight shift, so I don't get hooked up until 1845 earliest.

I have a reasonable lunch, then a snack before leaving home for the clinic.

[RightSide]

I follow the adage:

"Breakfast like a king; lunch like a prince; dinner like a pauper."

I eat my biggest meals, hours before my dialysis appointment at 4 PM. That way, most of the extra fluid and most of the toxins from metabolizing the food, get dialyzed out of my body.  And I have only a light dinner when I get home from dialysis.  Keeping the dinner meal light also helps me get to sleep at bedtime.

Essentially, this is the inverse of the rule that you should take most meds AFTER dialysis (so they don't get dialyzed out).  Ingest the bad stuff before dialysis, ingest the good stuff after.

Don't worry about the extra weight from the meals.  If your center is anything like mine, your dry weight will be periodically adjusted to take all that into account.  It's simple really:  If you start cramping during the session, then too much fluid is being pulled off and your dry weight will be adjusted upward to compensate.

[RichardMEL]

large fries huh? Potassium AND sodium! Brilliant! 

Actually reminds me of the ten types of grief a new patient got just last week when he brought in a sports drink to snack on. I swear 3 different nurses saw it, picked it up, and gave him a lecture about sodium and potassium blah blah. In the end I just said to them to give it a rest - the poor bloke got the message! 

As for lunch, no I tend not to eat lunch before my session(I am T/T/S afternoon shift) but we also get sandwiches and a cup of tea after we start, so they sort of provide the lunch, they then add that weight on. The difference is that I come in without having eaten that extra, so them adding 0.5 to compensate is fine, because it's only making room for the "extra" (and the washback). Sometimes I will get a hot coffee right before I start, take it in, and weigh the cup along with me so that I take account of that fluid before I get on.

Maybe you could take some lunch in with you and eat it at the start of your session, but after you've weighed? Then it won't be so much of an issue? If they let you eat at your unit of course.

We have one guy that is ALWAYS eating (he's a big man - nearly 100kg) he has the lunch they give him, plus he conns them if there's any spares left to give to him, plus he also brings in a massive roll, like a foot long from subway, and he ALSO has about 5 or 6 packets of biscuits!   

I also agree with the others - it's YOUR treatment, you should be able to tell them what you want off. If it's too outrageous and they challenge you then give your reasons why (just had a big lunch...) if you're reasonable I see no reason why they shouldn't adjust to take off what you request. That's the way it works in my unit.

[Hubbs]

Ever here the saying:  "Do you want fry's with that?"    once in a while i like to spoil myself and be Human again    My Dry weight is 78.5 Kg,  anything above 82 KG  means i over did it.. cuz taking off 4kg in 3hrs is OMG!
I'm K.O'd for the rest of the day..  man they spoil u there with the lunch  we gotta bring it all..  I'll tell you, if i ever win the lottery, i'm ganna invest most of it into my center.  then I'll really be the BOSS!   i.e. new Machines, chairs, TV's, O2 tanks Back up Ginnies,  and anything ells i can think of,  oh yeah, and fire the techs who think they can get away with anything.    beleave it or not. i'm not really that hungry  for lunch.. i eat when i'm hungry/starved!   also eat the things my body needs to to stay in my limits. ..

[RichardMEL]

cool. My Dry Weight is *also* 78.5 It's very rare I get over 80.5.

And yes, I'm guilty of the odd order of fries, though it's almost always a small one  I am human too! Just ask the girls! 

[Riki]

he's a big man - nearly 100kg

I was kind of taken aback by this.  my dry weight is 100.5kg, and I'm sure that right about now, I'm pretty close 104kg because I missed my treatment today.  does this mean I'm big too?  don't answer that, I already know the answer.  Damn, I wish I was tall.. *sigh*

as for eating, I'm trying to figure out how I'm going to get anything to eat before dialysis tomorrow.  I have an appointment for a mammogram (for the transplant list. I swear, they come up with new hoops to go through all the damn time) at 11am, then they want me to go straight over to dialysis after to try and make up for today's lost treatment.  I'm also a little worried about what positions they're going to try to get me in at the hospital, because of my arm.  to type, I have to pick it up and set it on the keyboard.  I"m not able to lift if without causing pain.  I'm sure the ladies know what I mean.  I have a feeling that they'll be wanting me to lift my arm over my head, and as of right now, I just can't do it.  If it weren't for the pain, I'd say that arm was dead weight..anyway.. I've got off topic.. *L*  so I"ll shut up now

[RichardMEL]

Sorry Riki (and anyone else I may have offended without intent). I just meant this particular gent very much enjoys his food, and he's also tall. It was a specific comment about one guy, nobody else. Again sorry if I caused offence

[Poppylicious]

We have one guy that is ALWAYS eating (he's a big man - nearly 100kg) he has the lunch they give him, plus he conns them if there's any spares left to give to him, plus he also brings in a massive roll, like a foot long from subway, and he ALSO has about 5 or 6 packets of biscuits!   

At Blokey's twilight shift there's a chap who is big (bigger than Blokey whose dry weight is currently 102kg and still falling; it was 160kg just before he began dialysis) who eats enormous amounts of food each session.  He has about three sandwiches, at least two grab bags (the sharing ones) of crisps (chips for the non-UKians) and piles of biscuits.  Often his dad brings him burgers and/or chips (fries for the non-UKians) from Burger King as well.  He then spends the whole night farting loudly.

Madness.

Blokey skips breakfast, eats an ordinary lunch at work, occasionally has a snack mid-afternoon, and then has the sandwich and biscuits he gets offered at dialysis.  He tends to be quite hungry when he gets home, which isn't so good because he doesn't get home till eleven-ish and that's not the best time to eat.

 

[RenalSurvivorDotCA]

May be TMI, but I don't eat lunch before dialysis because I'm very regular and if I eat lunch, I have to get them to take me off around 3pm for a potty break. 

They give us tea/juice and Social Tea cookies for a snack. I'm always starving by the time I get off dialysis.

[RichardMEL]

At Blokey's twilight shift there's a chap who is big (bigger than Blokey whose dry weight is currently 102kg and still falling; it was 160kg just before he began dialysis) who eats enormous amounts of food each session.  He has about three sandwiches, at least two grab bags (the sharing ones) of crisps (chips for the non-UKians) and piles of biscuits.  Often his dad brings him burgers and/or chips (fries for the non-UKians) from Burger King as well.  He then spends the whole night farting loudly.

Madness.

Wow. Madness is right. Imagine all that potassium from the chips (not to mention sodium!).. do the staff not try and explain to this guy his diet is dangerous?

if I was a fellow patient I'd be pretty annoyed by all that eating, food smells etc... it seems quite selfish to me to do that in front of others.

In my unit the staff will sometimes note if someone's eatung too much and gently chide them. A new patient brought in a sports drink the other day and the poor bloke got it from not one, not two but THREE nurses all in a row. I felt sorry for him - but I think he got the message! 

[RichardMEL]

They give us tea/juice and Social Tea cookies for a snack. I'm always starving by the time I get off dialysis.

Being hungry when you finish is your body's way of saying "hey, that boody machine stole protein from me. Give me more.. NOW!" and is actually a good sign

[Riki]

I'm always hungry when I get off, but I'm done around 6=6:30pm, and we're home about 7:15pm, so Mom will wait for me to get home before she makes supper. When I'm late getting off because of bp issues, or if they were late getting me on, she'll stop and pick something up.  I've gone out for supper afterwards with the girls a few times as well.  The only problem with that is, as soon as I've stopped, I'm usually ready to sleep.  I went out with the girls after dialysis for supper and a movie one night, and I was falling asleep in the car on the way home.

[SassyArizona]

I just had my first outpatient dialysis treatment today, scheduled for T/TH/Sa at 3pm.  My clinic doesn't offer snacks or food options, however, they don't prevent patients bringing them in.

Being new and trying to quickly learn a thing or three, what are good snacks/drinks to take?

I picked up that burger/fries and sports drinks are off the list.

[RichardMEL]

You probably don't want anything too smelly (to upset other people) or noisy.. or salty (thirst). I usually have a jar of mints on my table (nurses eat 'em too ) and that seems to work well (sugar helps with BP too). Of course if you're diabetic that could be an issue.

Re drinks - you may be put on fluid restrictions when you start D so you need to keep that in mind. We normally have a cup of tea or coffee with a snack. Some people have a little bit of water. It's probably not a wise idea to take a big gulp of coke in - specially if the dietician is around! 

good luck!

[SassyArizona]

Thank you for responding so quickly, Richard.

I've no restrictions yet, so far they aren't taking any extra fluid off, I don't have any.

What about a Nepro? I am diabetic and having falling bp issues for the first time versus high bp all last week while hospitalized (go figure), does food bring it back up?

Or water and hmmmmm sugar cookies?

I don't mind bringing in enough to share either, just want to be sure it's not a renal ignorant snack.

[Tracy]

That is interesting.  At my unit, they do not offer anything but ice chips (you want them, you get them in the lobby) and that is it.  No food is really allowed.  I have seen one man eat some little crackers, but I was told when I started there in May, no eating.  I do bring a snack in because I am diabetic and I don't want to go low with nothing there.  But, I sure don't eat it.

I do try and eat a salad or light sandwich on days I have D.  Does seem to make a huge difference. The more fluid pulled off at once, the worse I feel.  I try to not gain more that 2 kg per visit.