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| | |-+  Could Use Some Ideas About my Dad - Passing Out
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Author Topic: Could Use Some Ideas About my Dad - Passing Out  (Read 2727 times)
dadsindialysis
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« on: February 08, 2011, 07:22:55 PM »

Hi there -

My name is Deb, and I'm from PA.  My dad just started in center dialysis about 4 weeks ago.  Please bear with me, as I'm sure I don't know all the right information.  This is all so new, and I cold really use some experienced input.

To start - Dad is 71, has high BP, heart issues, and diabetes - all of which have culminated in kidney failure.  He's also recently been diagnosed with Pulmonary hypertension.

Just before Christmas, he had the surgery to do the fistula in his arm.   By new years, he had retained so much fluid that he was unable to breathe and ended up in the ER.  This turned into a 10 day hospital stay, and the only way they could finally get rid of the fluid was to put the catheter(?) in his neck and start his dialysis earlier than originally planned.  So they dried him up.

He came home and started his in-center dialysis on MWF.

This was fine for 3 weeks, until last Monday when, before even getting hooked up to the machine, he passed out cold.  Dropped like a stone with no memory of it happening.

He's been in the hospital ever since (9 days now) because he's passed out 3 more times.  All they know is that his BP has a sudden drop and he's out.  They can't figure out what is causing it.  He can't even feel it coming.

The first time it happened was 2 days AFTER a treatment.  It's happened twice DURING dialysis, and it happened between sessions as well.  They even took him off his heart and BP meds and it still happened.  There doesn't seem to be any rhyme or reason for it!!

So I guess I'm asking if any of you have ever heard of or experienced anything similar.  It's getting really frustrating and it's so scary!

I'd really appreciate any thoughts that you have.  Thanks so much!!

Deb

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RichardMEL
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« Reply #1 on: February 08, 2011, 07:34:29 PM »

Welcome Deb!

That situation seems quite worrying with your dad! :( While it is true that dialysis often lowers blood pressure (and thus patients are often told to not take BP meds the day of treatment) for him to have a low BP and pass out even before being hooked up seems to suggest that whatever is going on is not specifically related to dialysis itself. Now of course, it could be anything to do with his various conditions and age - or a combination thereof. I'm really not certain what to suggest - they clearly are trying the obvious courses of action to try and sort out the situation. It must be very worrying for you though!!!

Maybe one of the real docs on here (Paging hemadoc - stat!!) might have some thoughts.

I really hope this can be solved very soon !!!

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3/1993: Diagnosed with Kidney Failure (FSGS)
25/7/2006: Started hemo 3x/week 5 hour sessions :(
27/11/2010: Cadaveric kidney transplant from my wonderful donor!!! "Danny" currently settling in and working better every day!!! :)

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greg10
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« Reply #2 on: February 08, 2011, 08:41:22 PM »

..
To start - Dad is 71, has high BP, heart issues, and diabetes - all of which have culminated in kidney failure.  He's also recently been diagnosed with Pulmonary hypertension...
He's been in the hospital ever since (9 days now) because he's passed out 3 more times.  All they know is that his BP has a sudden drop and he's out.  They can't figure out what is causing it.  He can't even feel it coming...
Welcome to the forum and I am sorry to hear about your dad's condition.
Your dad must have seen a cardiologist in the hospital and have they not considered that PH (Pulmonary hypertension) may be causing him to pass out?  Does your dad get better with oxygen or other PH treatments?  From what I have read, a graft or fistula may actually worsen PH : "It appears that patients with end-stage renal disease (ESRD) acquire endothelial dysfunction that reduces the ability of their pulmonary vessels to accommodate the AV access-mediated elevated cardiac output, exacerbating the PH. "
http://www.ncbi.nlm.nih.gov/pubmed/16970730
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Newbie caretaker, so I may not know what I am talking about :)
Caretaker for my elderly father who has his first and current graft in March, 2010.
Previously in-center hemodialysis in national chain, now doing NxStage home dialysis training.
End of September 2010: after twelve days of training, we were asked to start dialyzing on our own at home, reluctantly, we agreed.
If you are on HD, did you know that Rapid fluid removal (UF = ultrafiltration) during dialysis is associated with cardiovascular morbidity?  http://ihatedialysis.com/forum/index.php?topic=20596
We follow a modified version: UF limit = (weight in kg)  *  10 ml/kg/hr * (130 - age)/100

How do you know you are getting sufficient hemodialysis?  Know your HDP!  Scribner, B. H. and D. G. Oreopoulos (2002). "The Hemodialysis Product (HDP): A Better Index of Dialysis Adequacy than Kt/V." Dialysis & Transplantation 31(1).   http://www.therenalnetwork.org/qi/resources/HDP.pdf
tyefly
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« Reply #3 on: February 08, 2011, 08:55:35 PM »

  Thx  Greg10      great information.....  I hope that helps.... 
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IgA Nephropathy   April 2009
CKD    May 2009
AV Fistula  June 2009
In-Center Dialysis   Sept 2009
Nxstage    Feb 2010
Extended Nxstage March 2011

Transplant Sept 2, 2011

  Hello from the Oregon Coast.....

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thegrammalady
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« Reply #4 on: February 09, 2011, 12:57:42 PM »

this past summer i got very dizzy and light headed while at the county fair. it was extremely hot and they decided i was dehydrated. i had been having dizzy spells for some time and they decided it was because my blood pressure would drop. since the county fair episode got me hauled off in an ambulance they just decided to keep me and run every test imaginable. they decided my blood pressure was dropping because i had been dehydrated for quite some time. they were apparently taking off too much fluid during dialysis. i get to carry more fluid weight, which means i can drink more. if they rule out heart and neurological problems they may need to raise your father's dry weight.
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« Reply #5 on: February 09, 2011, 03:52:06 PM »

Has he had an Echocardiogram to diagnose the Pulmonary Hypertension?  What is his right sided pressures?



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PD started 09/08
PKD kidneys removed 06/17/09

Failed donor transplant-donor kidney removed,
suspected cancer so not used 06/17/09

Hemo 06/2009-08/2009

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dadsindialysis
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« Reply #6 on: February 09, 2011, 06:30:00 PM »

Thanks for the responses.  I'm just at my wits end.  It's so upsetting.

He had both an echo and a catheterization to diagnose the PH.  It seems like everything started after he got the darn fistula surgery.  I'm not sure what the pressures were, but he said they were very high.  I'm pretty sure they raised his dry weight about 6 pounds 2 sessions ago.

I was just hoping to hear that this is something that sounded pretty common. 

He's also absolutely exhausted after dialysis.  Is that normal 4 weeks in?

Thanks again,
Deb
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carol1987
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« Reply #7 on: February 09, 2011, 07:02:37 PM »

Hi Deb... in my experience... I was exhausted after dialysis even 4 weeks in... and I am only 48 with the ESRD being my only medical condition...
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Diagnosed with  PKD July 2002 (no family history)
Fistula placed April 2009
Placed on Transplant list April 2009
Started HD 10/6/10
Transplanted 1/6/11 (Chain Transplant My altruistic donor was  "Becky from Chicago" , and DH Mike donated on my behalf and the chain continued...)
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« Reply #8 on: April 21, 2014, 12:42:51 PM »

Wow another cliff hanger.

What been happening here, any resolve show up?

talker
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