Bones ache and weakness after PD?

[austinsoul2011]

Hi all,

There's no end to the problems my dad feels after he's done his night's cycler PD.  He always complains of soreness in his bones and weakness in the morning after all the cycler exchanges are done.  He's always feeling listless and depressed, and has no energy to leave the couch (where he insists on sleeping every night).  He's in his third week of CCPD (liberty cycler) and if anything, he's getting weaker and more irritable from dialysis.  His kt/v is good I think (3.6) and we've removed the initial weight gain (6 kg in first 1.5 weeks) quite well.  I did have him on 3 cycler nights of 4.25% + 1.5% last week to remove all that initial water, and for this week he's been 2 x 2.5% .

Could it be he's still adjusting to PD?  It has already been nearly 3 weeks and I'm not seeing any improvements.  His labs look fine too, and we've stopped with the 1500mL daily dwells cuz he can't stand the bloated feeling.  Has anyone experienced this overall bone soreness and weakness?

Thanks!

[Annig83]

Hi there.

Sorry your father is feeling so badly .  I don't get bone soreness, but I do get weak every once and a while (I don't know how old your father is, but I'm only 28, and I know that age can sometimes have some affect on the way you feel).  I've noticed that the more "exercise" I get the weakness eventually leaves during the day.  I just take a walk with my son and it's enough to make me feel a little bit better throughout the day.  If his labs are good maybe it's still

I would suggest trying to get your Dad off the couch and into a bed... I know when I sleep on the couch I don't wake up feeling refreshed at all. I use a 2.5% on the heater and a 1.5% on the side. I generally get over 1000 off at night and feel okay...if I have had a high sodium day, or feel "bloated" I'll use two 2.5% bags, and that makes me extremely weak in the morning, almost where I have to sleep it off for another hour or so.  Maybe using two 2.5% is too high for him... what's his BP been at?  Has he felt bloated?  I would suggest switching one of the bags to a 1.5% if his BP isn't too high...this may help with the weakness. 

Like you said it's also possible for him to be adjusting to the PD as well, but he should still be able to get up and move around and do some normal activities... if he is depressed this can also wear on him.  I would suggest having go to a support group, or talk to the social worker at the D center about his moods...being depressed is horrible, and could also be causing him bone soreness... my mother had depression and she went on Cymbalta (for the pain and moods), it seems to help her.  Maybe for the time being until he gets used to D, he could start a low dose of anti-depressant...like we don't take enough pills as it is.... but it may help... see if his Neph. would suggest anything....try support/therapy first and then maybe the medication??( Just a suggestion). 

[jeannea]

I am tired a lot. But I think first you should insist he sleep in bed. Try to get some real rest. I always feel crappy if I sleep on the couch too long. Then follow up if he is depressed.

[Atooraya]

Check his iron level and hemoglobin?

[Joe]

You might want to see how he does with a 2.5 and a 1.5. My neph pulled me off the 2 2.5s on the cycler because I was feeling a bit puny coming off that. And I agree with trying to get him to sleep in a bed.

[lmunchkin]

Get the clinic to give you a guideline on the proper solutions to use:  The ranges in other words.  Example: if his BP & Weight are UP use higher %,  If mid-range use Mid %,  if BP & Weight down use weakest solution.

Age could be playing a part in some of this, Steve, but not all of it.  I believe it could be the selection of what proper solutions to use, IMHO.

  Bless your heart Steve, you are so good to your Dad! God Bless you for the Honor you show your father.  You love him so much, and it is very evident in your actions! Most do love, but never take the time to show it!

lmunchkin
 

[austinsoul2011]

Thanks for the advice and support, y'all!  Well, it seems there has been some improvement with dropping down to the 2 x 1.5% bags, but he's still feeling beat up, sore, and weak.  My dad did gain 6-7 kgs (!) of fluid over 1.5 weeks, and so the rapid water loss (using the 4.25% and the 2.5% bags) to remove all that must have taken a heavy toll on his body.  Yes, his iron is very low (he's 8 vs normal 30-50 range) even after the iron IV treatments, but his hemoglobin rates are normal.  We're pushing him hard to eat red meat and bring up his iron levels, but it's difficult when he's not in the mood to eat.  And I think it'll take a long time for him to adjust to the bloated feeling from the fills.  Sigh.