Appetite, 5 to 4 days, and some other stuff

[Malibu]

Hi guys!  I have not posted in a very long time.  Please excuse my absence -- I've been working!!! s.

MM has been on home hemo, NxStage now for 11 months and he is doing fairly well.  He recently talked to the Dr and they agreed to lower from 5 days to 4 days a week.  The reason he is lowering is Kt/v is 2.41, trying to lower frequency and keep same results...quality of life issue for him.  We'll see.  I am interested in if any of you have lowered your dialysis frequency.  When Dr was writing new scrip for 4 days he said 'If this doesn't' work you WILL go back on 5 days right?'  HAR.

Appetite:  it continues to get worse and his favorite things 'gross him out' where he can only eat a few bites and then is done.  Other times he eats the whole plate (last night, beef tenderloin with brandy/peppercorn sauce and a baked potato [yes I am getting fat trying to feed him high calorie/fat items!]).  He has stopped eating breakfast alltogether.  Nausea isn't a frequent problem but happened 3 times last week, as far as I am concerned that is too much.  He is taking phos lo, I don't think that is it.  He is convinced it is the bp meds.  He is now on 320 Diovan, 360 Diltiazem, 40 Lisinopril, Clonidine patch -- switches between 3 and 2 and 1....depending on how bad the constipation is at the moment.  Do any of you continue to suffer with appetite and nausea issues despite the fact that your Kt/v, potassium, phos etc are very good? Anyone know any natural remedy for appetite issues?  MM is hesitant at this point to add any more prescriptions.

Since starting dialysis 11 mo's ago we have been through 1 NxStage machine & 5 Pure flow control panels.  Everything has fallen right into place and seems 2nd nature now. 

OK, that's about all I have for now.  Thank you in advance for your replies. 

[greg10]

11 mo's ago we have been through 1 NxStage machine & 5 Pure flow control panels

Wow, 6 returns in 11 months.  I guess you got to see the UPS guys quite a lot.  Thanks for the heads up.

Is there other indications that required the use of all those BP medication?  Has he tried to ease off the BP? as many NxStage patients have done with the approval of their nephrologist.

The only paper that I have read that helped with the taste problems of dialysis patients is that of the inclusion of zinc in the dialysate helped alleviate the problem.  Unfortunately, more recent studies showed no improvement:

"We found a disturbance of taste perception in hemodialysis patients, particularly for the sour modality, which was not corrected by this regimen of zinc supplementation. These results cast doubts on the conclusions of earlier studies that indicated an improvement in taste after zinc supplementation."

http://www.jrnjournal.org/article/S1051-2276(03)00072-4/abstract

Sorry that was no help.