lapband question

[jhodges58]

Hi:

I've been on dialysis for roughly 18 months and can't proceed with a transplant until I lose 75-100 pounds, so I decided to go in for a lapband 'cause I wasn't doing well losing weight on my own (too sedentary since dialysis started).

Anyway, I just started the two-week pre-surgical liquid diet and I'm dropping weight pretty quickly (surgery is in about a week's time). My problem is that I'm in a constant fight with the kidney center techs about what they should be pulling off each session.

I used to pull off 5.5 kilos a session (I'm a big guy). The first session on the liquid diet I told them 5 kilos. Today, I came in slightly below my "dry weight" and told them to take off 4 and had a huge fight (I keep explaining that I'm on a 1000 calorie diet but I still need to have the fluid pulled off).

My question is if anyone else has gone thru a lapband while on dialysis, how did you handle your fluid target each session? I'm figuring if the blood pressure holds, to keep yanking 3-4 kilos but I can see it's going to be a fight each time.

Just curious.

Thanks.

[glitter]

Sounds like you need to have a talk with your Neph and be sure he follows up with some orders the techs can't ignore.

What I do not understand is, if I understood your explanation perfectly clearly, why can't they? I swear sometimes it seems like they argue for the sake of it!

I would really like to hear how you do with this.

[jhodges58]

I had a talk with the kidney center's overseeing nephrologist this afternoon (I only see him once a month – his nurse practitioner meets with patients twice a month).

He understands my weight will be in flux for a while and that they're going have to be flexible about a new dry weight. I think it's mainly the tech supervisors who really don't like not having a target weight to work with that's the problem.

When I asked the nephrologist how much I should pull off each time, he said we'd just have to play it by ear. That's kind of why I'd love to chat with someone who's gone thru this before (someone on dialysis who did a lapband and then dropped a lot of weight fairly rapidly).

[smcd23]

When my SO was on hemo and losing weight from making diet changes, they stuck with a set number, regardless of his weight. I think they aimed to pull off 2 - 3 kilos per session, and would adjust depending on how his BP was. They could tell by how he said he was feeling (if he felt like he had swelling internally, or visibly etc) his estimated fluid intake between sessions and how his BP was throughout treatment what the "right" number was for him that session. He was lucky enough to have flexible and understanding nurses though. I definitely think you should chat with the neph and make sure he gives the some sort of guidelines to follow so they don't run you to dry, or don't take off enough!

[SugarBear]

It also depends on the center's regulations, in my old center techs must follow the doctor's orders exactly.  They were not allowed to deviated from those orders.  When I was losing weight I had similar problems with the staff. 

I say similar because I would program the machine myself and set my own desired fluid removal as I was an in-center self care patient. But during their rounds the nurse would changed them back to the doctors set numbers.  So it was a constant back and forth until they start to see I was correct and start to trust me.  I didn't always guess right as their were times my BP would crash from too much pulling, but it happens.   

Keep trying as the weight loss will greatly improve the effectiveness of dialysis and the way you feel.