Why my dialysis. Doesn't always go well

[Ebonylouise]

I cramp a lot and my blood pressure drops at dialysis,does anybody else have any of the same issues









EDITED: Thread moved to proper section: "Dialysis: General Discussion" - jbeany, Moderator

[lmunchkin]

Yes, Ebony, they are taking too much off you.  They probably need to adjust the Dry Weight!  It can be tricky sometimes!  Just mention it to the nurse or neph. and they should make adjustments!

Do they make you stay until your BP goes up?  My husband's would drop sometimes too, but they would keep him a little while longer!  Usually they would give him some crackers to bring it up. 

I may be wrong, but I think they need to adjust your Dry Weight!

God Bless,

lmunchkin     

[jbeany]

Two more options to think about besides dry weight...

1.  How do you do with controlling your fluid intake?  Are you keeping to the amount of fluid gain the docs have told you?  If you are going way over, it's really difficult to pull more than the recommended amounts.  The body just can't release the fluid that fast.  That can make you crash a lot, too.

2.  Some people also have to lower their fluid intake under what the docs give for a limit.  I was one of them.  It's just the way my body reacted to D.  I couldn't take off more than about 1.5 per session without crashing.  I had to restrict what I was drinking or pay the price in the chair ever time. 

[Ang]

all of the above


its definately fluid,apart from fluid control, salt longer exists if you a big salt user.

as night follows day,fluid follows salt

[Ebonylouise]

Yes, Ebony, they are taking too much off you.  They probably need to adjust the Dry Weight!  It can be tricky sometimes!  Just mention it to the nurse or neph. and they should make adjustments!

Do they make you stay until your BP goes up?  My husband's would drop sometimes too, but they would keep him a little while longer!  Usually they would give him some crackers to bring it up. 

I may be wrong, but I think they need to adjust your Dry Weight!

God Bless,

lmunchkin     

[kamar55]

My pressure drops a lot, too and they're not even pulling that much. I get a hypertonic and then lie down totally flat. It usually helps a lot.

[rsudock]

I assume you are doing in center hemo three times a week...you didn't mention it on your introduction....have you thought about doing home hemo or nocternal dialysis? That way the machine runs much slower and is gentler on your body....just a thought. I know sometimes if you are cramping heat can help or the nurse can inject the lines with some sort of salt water I think...that is suppose to help the cramps....hang tough!

xo,
R

[Rerun]

I drink some (1/2 cup) of Tonic Water before dialysis.  It contains Quinine which is a natural muscle relaxer.  It works for me for cramps.

             give it a try......

[lmunchkin]

How has it been going, Ebony?  Anymore cramping?  Have they adjusted anything for you?
Can you get a transplant?  You might, like Rachael said, check into other modalities. PD, Home Hemo or Nocturnal!
There are some on this site doing all kinds of home dialysis, that can help you with any questions you may have.  I am currently doing husband at home on dialysis machine called NxStage.  I use to do PD on him for about 5 yrs, but he got an infection and could no longer do that.  It was a great modality too.  But once we got home hemo, it really works for us and our needs.

Let us know how you are doing. We will empower you with information that will keep you atop of your health!  If we can't, we will find someone who can.  I know this is frightening to you but it will be okay.  Time seems to put things in perspective, and will become routine after awhile!  So please, feel free to ask.  People here have been through what you are going through and love to help in any way they can!!!!

God Bless,                         

lmunchkin     

[dialysisadvocate]

I am not a dialysis nurse, but a dialysis advocate for safe care .. It has been my experience that many units do what is called 'challenging the patient'. (simply put - taking enough fluid off to initiate cramping, etc). Cramping is an indication, as others have mentioned, that staff are taking off too much fluid. There are several things that come to mind, considering I have frequent patient calls about this ..

(1) Staff/physician should be evaluating your dry weight as far as I am concerned each treatment, depending upon your condition e.g. if you have chest congestion, edema (fluid) in your ankles, etc. Interesting as some units stopped listening to the patient's chest to determine if there was fluid present and if the lung sounds were good. Personally, and, my opinion, as a nurse, is that this part of the assessment is so very important.

(2) The unit Dietician should be educating patients as to how much fluid to drink, what foods contain more fluid, which foods contain salt which retains fluids, etc.

(3) A conference/care plan/treatmen planning meeting should take place with patients so that all of this can be discussed. The patient IS part of the team and a most valued member of the team provdiing input that is needed in order to prescribe the treatment and medications. Many units post a sign in the lobby of their unit stating that if the patient wants to participate they can ask. But, it is your right to be present

(4) The patient should be educated on their estimated dry weight (EDW), how to calculate fluid removal e.g.amount of fluid removed, rinseback, etc. The patient should always check the machine data to make sure the staff have entered the correct amount. Staff are human and humans make mistakes PATIENTS CAN PREVENT MISTAKES WHEN THEY ARE EDUCATED

(5) Staff should educate patients on ALL symptoms that might be experienced during diaysis that indicate a problem, e.g. too much fluid removed

(6) Staff should teach the patient, if the patient wants, about the machine and what each entry means.

Staff and patients/families working together can prevent errors. It is not we against you but a team -

http://www.renalbusiness.com/articles/2008/03/dialysis-patient-safety.aspx
http://www.renalbusiness.com/articles/2008/03/dialysis-patient-safety.aspx

above opinions of Roberta Mikles BA RN Dialysis Patient Safety Advocate
www.qualitysafepatientcare.com

[lmunchkin]

I concur, Roberta!  Sadly, not all nurses or techs are like that!  Even some doctors do seem somewhat desensitized by their patients.  I really hate to say this, but it is all about the money, isnt it?

lmunchkin

[cberetz]

The amount of tonic water you would need to consume to get any benefit from quinine would likely give you sever gastric distress long before your cramps were relieved. Unfortunately, when the FDA banned quinine for relieving muscle cramps it left hemodialysis patients with few options to ease their suffering. Recently our company developed a solution to this problem: Quellitall. Quellitall is a dietary supplement containing ingredients that have undergone a number of clinical studies, the results of which show great promise for both the prevention and treatment of cramping due to dialysis. Formulated in consultation with a board-certified medical doctor trained at the University of California, San Diego, Quellitall is produced in an FDA-inspected facility that meets the highest standards for quality and purity. It is strong stuff, and we recommend taking Quellitall only under medical supervision. You can learn more at www.Quellitall.com.

Respectfully,

Chuck Beretz
Founder/CEO
Carlsbad Trading Company, Inc.