weight gain on pd

[skinnacat]

so i have been doing pd dialysis for almost 3 months now and i seemed to put the most weight on the first month
of treatment...i gained 5 pounds in one month and then i was not happy...to say the least so i really tried to pay
attention to what i was eating and have managed to put 2 pounds on the last 2 months
it just sucks because i am a chunky girl to begin with and every pound is like 10 for me...i was'
wondering how much weight other people on pd have put on while on pd???
oh and i never count the 5 pounds of fluid i carry in my tummy cuz that dont count  

[Charlie B53]

I lost almost 40 pounds of water in my first couple of weeks on PD.  Went from a bloated puffy 310 back to my normally fat 270.

Over the last almost two years I've been carrying 2 liters of fluid, the pressure on my stomach has seriously reduced my appetite.  I found that eating slowly I do not eat nearly as much as I used to.  I feel full much quicker and have managed to lose another 40 pounds.  233 this morning AFTER filling with 2 liters of Ico.

Don't stress so much about your weight.  Pay more attention on HOW you eat.  Take your time, chew every bite slowly and enjoy it.  You will find that you are satisfied sooner, and do not want near as much.  Give this a year and see the difference.

I weigh morning and night to record in my PD Log.  The overall weight doesn't bother me as I'm looking to see how much water weight I've gained that day, and how much of that is taken of using the Cycler at night.

The main thing is to stop stressing about it.  Make a small change in your eating habits, the body will adjust and take care of itself without you having to worry about it.

[skinnacat]

well thanks so much for all ur great advice and i am trying to eat well but i have to eat so much protein to keep my albumin at 4
and frankly i am quite sick of meat and eggs anymore but i know i have to eat alot of it so i press on i was on the cycler at night but i
had some major problems so i am doing manuals now and its going pretty good and i feel pretty dam good too so thats nice...i have gotten
into a good routine and i use 1 yellow and 3 greens everyday and its been working good 

[skinnacat]

 oh yeah and i fill with 2000 liters too...i dont feel as bloated as i used to and i definately have my appetite back
to much so i think...i never really had alot of swelling so even when i started my weight stayed pretty much the same
i find though that i can go for a long time during the day and not be super hungry but i know i need to so i can stay healthy
and i do like  a nice meal and i am a chocolate lover which i had to completely stop eating when my kidneys  got really bad cuz i
itched like super crazy and it was not good but i have started to eat it again and my phosphorus is still ok so thats great cuz i love it     

[Charlie B53]

I really want to stress only two things.  Check the shins to see if there is any water puffiness when pressed, or just bone.

Eat S L O W L Y.  Take your time, savor every bite.  You will feel full sooner and not want to eat near as much.  Your body will adjust, any excess weight will slowly start to disappear, never to return.

Give it a year, there is no magic pill.  Exercise will speed it up, but is also a double edged sword, it will also cause a greater appetite.

[jcanavera]

My wife's lowest weight was on hemo.  She did balloon up when she went on manual PD.  While using red helped somewhat, the red also caused her pain.  We went to a cycler about 8 weeks after going on manual PD and she now carries about 4 lbs more weight that what she did when she was on hemo.  Even that weight can go up another 4 lbs or so if she develops a UTI.  She carries about 1,500 ml of extraneal in the daytime.

Jack

[Charlie B53]

Since the PD solutions are sugar based, every exchange we are gaining a percentage of the calories in the solution.

I can go to bed with a blood sugar of 107, use a 5 liter bag of green 2 1/2% and a 5 liter bag of yellow 1 1/2%, that's 6 exchanges during the night.  My morning sugar is usually around 160.  A 50 point gain from the solution.  I take 5 units of insulin to get my number back down.  Knowing our sugar intake it is important to cut a few carbs elsewhere in your diet.  Maybe a larger portion of a low-carb vegetable and a bit smaller portion of pasta.  End result, you're still well fed, just not eating quite as much carbs.

[jcanavera]

In my wife's case, her blood sugar can vary by 250 points depending on the mixture of fluids we use.  Interestingly enough she will very quickly get back to her normal state (for her) as a diabetic about 2-3 hours after going off the cycler in the am.  She uses Humalog with meals and Lantus for her long term.  We are going to see an endrocronogist to see if there is an idea on how to adjust for the night time therapy.  Her primary care doc says that adjusting insulin dosage to compensate for PD is out of his experience level.

Jack

[Charlie B53]

I'd be very leary of taking more fast-acting insulin before bed while on the cycler.  The insulin would work too fast, dropping sugars way too low.   I try to make sure I'm very near 100 then immediately test when I get up, taking whatever I need to get back near that 100.

It may be possible to increase our Lantus to help keep the sugar rise down a bit.  The onlyl thing with that is possibly not needing as much fast acting with meals, so the first day or two maybe cut the fast in half.  Retest in a few hours and take more if still needed.

But the thought of a possible very low sugar in the middle of the night while asleep.  Not good, she may never wake up.

[PrimeTimer]

My husband has Type 2 Diabetes and ESRD (End Stage Renal Disease). He takes Humalog during the day and then Lantus at bedtime. His blood sugar level is always highest first thing in the morning. He learned from going to his Endocrinologist that this is what some doctors refer to as the "Dawn Effect", in which blood sugar levels naturally rise during the night while we sleep. This was one of the reasons why he chose not to do PD (because of the glucose levels in the solution). So, he had to learn to take more Lantus at bedtime and test his sugar level first thing in the mornings to decide how much Humalog to take. He regularly tests his blood sugar level thruout the day and certainly before any meal. He does Home Hemo and this is why he's not afraid of the needles...altho the needles used for hemo are much much larger, he had already been sticking himself for years to take Insulin. He's way more braver than I would ever be.

Here's a link about the "Dawn Effect" or aka "Dawn Phenomenon".

www.mayoclinic.org/.../diabetes/.../dawn-effect/FAQ-20057937
 

[jcanavera]

We are aware of the dawn effect.  I'm diabetic and it is especially evident with me. 

Charlie, we wouldn't consider Humalog since we really don't know when the big rise occurs and it really is only for use with food.  My gut is that we probably will do a Lantus adjustment and that's why we will enlist the help of an endrocronogist rather than experiment on our own.

Jack

[Charlie B53]

I fully understand, I have the same fear of a severe crash while asleep.  Awake, I know something is going wrong and eventually, soon, figure out I need to test.

One of the ladies that worked in the High School Cafeteria, diabetic, died in her sleep from lower blood sugar.  They don't know if she miscalculated, forgot and took a second shot, or possibly even intentional.  Only that she is gone.  They all agree that she seemed fine and normal at work that week.

With this in mind I would much rather have a 170 or higher half the night than risk a bad crash while asleep.