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Author Topic: Trying to understand hemodialysis  (Read 785 times)
Aaisha.Dar
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« on: July 24, 2018, 11:41:56 PM »

I've been on here a lot today (can't sleep),
So I want to know what does dialysis do to your heart? Does it get damaged over time from the many years of dialysis? Also, with such a strict fluid restriction it's weird although there are days I can feel fluid overloaded it feel.my body needs hydration. Refusing to hydrate your body when needed sounds awful what are the effects of doing so?
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kristina
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« Reply #1 on: July 25, 2018, 07:36:31 AM »

Hello Aaisha.Dar,
I was informed by my nephrologist ... and the same information was also reiterated by some dialysis-nurses, that dialysis itself does not damage the heart or any of the other organs and ... if there is any damage to the heart taking place, it is because of the life-style chosen by ESRF-patients i.e. eating the wrong food & ignoring a kidney-friendly-diet plus ignoring strict fluid-restrictions... all of  that "does it" and damages the heart. I was also told that ESRF-patients who ignore their fluid-restrictions put an enormous stress on their heart ...
I cannot answer your question about fluid-overload etc. because I have not had such an experience (fingers crossed it won't happen in the future either, because it really sounds frightening ...). When it is an extremely hot summer-day i.e. like today with 31 degree in the shadow, I can only adhere to my liquid restrictions by eating very little food and make sure the food is very bland and could never make me thirsty and once every hour or so. I let some ice-cold-water run over my wrists ... that always refreshens me a little ...
Best good-luck-wishes from Kristina. :grouphug;
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Bach was no pioneer; his style was not influenced by any past or contemporary century.
  He was completion and fulfillment in itself, like a meteor which follows its own path.
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                                          ...  Oportet Vivere ...
cassandra
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When all else fails run in circles, shout loudly

« Reply #2 on: July 25, 2018, 09:14:10 AM »

Hi Kristina sometimes the Learned Ones really do my brain in. The hemo D machine pumps your blood with quite some speed the 'wrong' way to your heart, probably more than 9 hours a week. How can that not cause damage? Of course being non adherent to the strict diet/fluid regime won't help.
But blaming the life-style of the patient is pathetic. The Learned ones should be honest and just admit that when the patient is lucky, has some education, adheres to the diet, doesn't get prescribed the wrong medication or prescription by (of course) another Learned one, the patient might live for quite some time with only limited damage to the heart.


https://www.belmarrahealth.com/kidney-dialysis-treatment-negatively-impacts-heart-function-breakthrough-mri-study/
« Last Edit: July 25, 2018, 09:40:37 AM by cassandra » Logged

I started out with nothing and I still have most of it left

1983 high proteinloss in urine, chemo, stroke,coma, dialysis
1984 double nephrectomy
1985 transplant from dad
1998 lost dads kidney, start PD
2003 peritineum burst, back to hemo
2012 start Nxstage home hemo
       still on waitinglist, still ok I think
Aaisha.Dar
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« Reply #3 on: July 25, 2018, 11:29:08 AM »

Hi Kristina sometimes the Learned Ones really do my brain in. The hemo D machine pumps your blood with quite some speed the 'wrong' way to your heart, probably more than 9 hours a week. How can that not cause damage? Of course being non adherent to the strict diet/fluid regime won't help.
But blaming the life-style of the patient is pathetic. The Learned ones should be honest and just admit that when the patient is lucky, has some education, adheres to the diet, doesn't get prescribed the wrong medication or prescription by (of course) another Learned one, the patient might live for quite some time with only limited damage to the heart.


https://www.belmarrahealth.com/kidney-dialysis-treatment-negatively-impacts-heart-function-breakthrough-mri-study/
See what you say kinda makes sense. Yes dialysis helps remove toxins and replaced the kidney function but the whole idea kinda sounds like it would give your heart problems. I'm sure half the time people leave with still some fluid inside them and all that pressure has to do some damage on your heart. I feel like I have cut down drinking so much which is why my busy stays dry even with lots of moisturizer on my face. I have to put it on everyday and if I skip one day I break out. (Yes, you can break out due to dry skin).
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kristina
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« Reply #4 on: July 25, 2018, 12:01:23 PM »

P.S. What I have mentioned above is what I was told by the Learned Ones as "bits and pieces" of important inputs by the patient, which is fair enough ...
If "things" go wrong it is "usually" when many different factors come together...
Best wishes again from Kristina. :grouphug;
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Bach was no pioneer; his style was not influenced by any past or contemporary century.
  He was completion and fulfillment in itself, like a meteor which follows its own path.
                                        -   Robert Schumann  -

                                          ...  Oportet Vivere ...
kickingandscreaming
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« Reply #5 on: July 25, 2018, 12:41:07 PM »

When talking about death with my neph--several years ago -- she said that kidney disease itself is unlikely to kill me, but some heart problem is.  And that was several years before I had any sign of the heart problems I now have.
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Diagnosed with Stage 2 ESRD 2009
Pneumonia 11/15
Began Hemo 11/15 @6%
Began PD 1/16 (manual)
Began PD (Cycler) 5/16
Charlie B53
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« Reply #6 on: July 25, 2018, 08:14:20 PM »


As I understand it there are two major possibilities for heart problems.

First, large amounts of fluid take-offs 'shock' the body, leading to what they have termed 'Cardiac Stunning'.  Being strict with your fluids and diet can prevent this.  Some of us do far better than others.  It is a constant learning process just how you handle it as we are all slightly different.

Second is again watching your diet and taking your meds Religiously.  Keeping the proper balance in your labs as too far off can lead to calcium transfer, dissolving it out of the bones and depositing it into muscles, including the heart.

Basically, keeping a better diet, strict fluid control, taking your meds, many can do far better and have a long life.

At least I hope so as 5 years in and I think I am doing just fine, considering.  I'm even losing some of that extra weight I've carried around for far far too long.

Take Care,

Charlie B53
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GA_DAWG
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« Reply #7 on: July 26, 2018, 09:46:30 AM »

There is no doubt that some patients leave with fluid still on them. That is usually caused by them coming in far over their dry weight. the more fluid that has to be removed, the greater chances of things like cramping, which they then ask that the techs stop pulling them. If repeated for many visits in a row, it becomes a decided risk of damage to the heart. While I have no doubt that there is a chance of some damage to the heart from dialysis, I have to agree the greatest danger is from non=compliance with diet and fluid restrictions. we have one patient at our clinic who routinely comes in 8-10 poinds over dry weight, swears she has no idea why, asks them to stop pulling her due to cramps, and at least quarterly spends a week in hospital as they get her back down to dry weight, then repeats the entire process. Techs, nurses, doctors and even other patients have all tried explaining how damging this is, yet she continues on. She just returned from one of her trips to hospital and regaled us all with how while there her gains were less than when she was on her own, never stopping to acknowledge that while in hospital, they were able to control her diet and fluids.
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rcjordan
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« Reply #8 on: July 26, 2018, 05:42:45 PM »

>greatest danger is from non=compliance with diet and fluid restrictions. we have one patient at our clinic who routinely comes in 8-10 poinds over dry weight, swears she has no idea why

It was the same in my clinic ...some would stop at Burger King after they checked out.  3 liters was a common, daily pull for a lot of them.
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Coastal US, NE North Carolina
2018 right nephrectomy - cancer. Left kidney not filtering, start hemo. After 3 months, start Nxstage home hemo
Aaisha.Dar
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« Reply #9 on: July 26, 2018, 05:43:57 PM »

Theres been this new nurse who sometimes works at my clinic. Today he was working on me. There are times where I would start dialysis and my eyes would be bloodshot red along with that I would feel pressure where my lines are and in my face. I also would feel flushed. It happened so many times before I have complained way in the past but the nurses wouldn't do much so eventually I just dealt with it. (kinda sad how we just have to deal with crappy things). Today the nurse noticed my eyes and he said do your eyes always get like that and I asked red and he said yes. I said sometimes it gets like that. He asked how I'm feeling I said okay, he said you sure you dont feel anything? Then I told him yeah pressure in my face and lines. He says yep it's because the venous pressure is high. Its was I believe 500 and they lowered it to 300. Instantly I started feeling better. He was smart to catch that and do something about it. I appreciate people like that. He also called the doctor to inform him.
Also why is venous pressure blood flow important. What do different rates mean?
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iolaire
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« Reply #10 on: July 27, 2018, 06:09:59 AM »

Today the nurse noticed my eyes and he said do your eyes always get like that and I asked red and he said yes. I said sometimes it gets like that. He asked how I'm feeling I said okay, he said you sure you dont feel anything? Then I told him yeah pressure in my face and lines. He says yep it's because the venous pressure is high. Its was I believe 500 and they lowered it to 300. Instantly I started feeling better. He was smart to catch that and do something about it. I appreciate people like that. He also called the doctor to inform him.
Use this person as a resource to ask your dialysis questions to.  When I was on dialysis there were a few tech's (who came and went) that clearly cared more about the treatments and thus knew more and were able to provide suggestions and educate me.   I'm glad that you found someone who could solve that issue (and that your chair was moved!).
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Transplant July 2017 from out of state deceased donor, waited three weeks the creatine to fall into expected range, dialysis December 2013 - July 2017.

Well on dialysis I traveled a lot and posted about international trips in the Dialysis: Traveling Tips and Stories section.
GA_DAWG
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« Reply #11 on: July 28, 2018, 09:29:54 AM »

I second what Iolaire said. all of our techs are good about listening to patients and staying on top of their job, but there is one in particular it is obvous the rest take their cues from. When I first started, one day she was my tech and of course was asking if there were any problems since the last treatment among other things. I made the comment I was still trying to figure out how this all worked. she told me, any question I had I should feel free to ask. After that, she answered them all, even the ones I now realize were pretty silly. To this day, whenever I have a question, she is the one I look for to get the answers. I am glad you got your chair situation resolved. Dialysis is an uncomfortable procedure as it is, without things that can be avoided.
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Aaisha.Dar
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« Reply #12 on: July 28, 2018, 02:02:25 PM »

Today the nurse noticed my eyes and he said do your eyes always get like that and I asked red and he said yes. I said sometimes it gets like that. He asked how I'm feeling I said okay, he said you sure you dont feel anything? Then I told him yeah pressure in my face and lines. He says yep it's because the venous pressure is high. Its was I believe 500 and they lowered it to 300. Instantly I started feeling better. He was smart to catch that and do something about it. I appreciate people like that. He also called the doctor to inform him.
Use this person as a resource to ask your dialysis questions to.  When I was on dialysis there were a few tech's (who came and went) that clearly cared more about the treatments and thus knew more and were able to provide suggestions and educate me.   I'm glad that you found someone who could solve that issue (and that your chair was moved!).
Thank you! I'm also glad I finally got moved:,)
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Aaisha.Dar
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« Reply #13 on: July 28, 2018, 02:06:55 PM »

I second what Iolaire said. all of our techs are good about listening to patients and staying on top of their job, but there is one in particular it is obvous the rest take their cues from. When I first started, one day she was my tech and of course was asking if there were any problems since the last treatment among other things. I made the comment I was still trying to figure out how this all worked. she told me, any question I had I should feel free to ask. After that, she answered them all, even the ones I now realize were pretty silly. To this day, whenever I have a question, she is the one I look for to get the answers. I am glad you got your chair situation resolved. Dialysis is an uncomfortable procedure as it is, without things that can be avoided.
Thank you! You are right! We spend a majority of our time at dialysis might as well make it less dreadful
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