dry weight

[George Jung]

Has anyone gone into treatment under weight?

I have been very consistant with my gains and then today I was almost 2lbs under.

Still have some function and have had a couple of very good bathroom breaks (standing up).

Although I am not as disciplined as say Zach (he is awesome) I am very conscious of what I put into my body.  My labs and gains are proof of that.

The nurse wants me to do a 24hr sample.

Thanks for any input.

[Rerun]

Any chance the scale was off?  How about clothing?  Do you usually wear your shoes to weigh and today you took them off?  How about a jacket? 

     Just brain storming.

[George Jung]

None of the above.  I am one of the last patients of the day to use the scale so I don't think that was it.

I am very consistant in my routine.

What else ya got?

I changed the oil in my bike the day before and I did sweat a lot.  A friend asked if I had been running a marathon.

Blood pressure was up just a bit 155/90.  has been consistant 140's/80's w/o any meds.

[glitter]

my husband sweats ALOT- he has to drink gatoraid because of the electrolytes he loses- but the point is he goes in at .5 and under all the time- (he doesn't pee at all) they have told him to increase his fluids if he wants- he cramps immediately if they try to lower his dry weight- and going in under does make him cramp- he tries to at least be even. I have seen him lose 6 or 7 pounds pretty easily from sweating. And he drinks almost as much as he wants.

[Amanda From OZ]

George maybe you have lost body fat?? 

[Zach]

Although I am not as disciplined as say Zach (he is awesome) I am very conscious of what I put into my body.  My labs and gains are proof of that.

Thanks George for the compliment!   

As glitter reminds us all, in the heat of the summer, the more active we are, the more we sweat.  And believe me, we can sweat a kilo (2.2 lbs) of fluid in just no time!  Add to that the fact that you still have some kidney function, and there goes your dry weight.

Just be careful not to become dehydrated.  Have an extra beer or iced tea on me!
 

[KT0930]

I've only done hemo temporarily, but I did go in under my dry weight several times. I also have some residual function. Anyway, you very well could have lost the weight from sweating. The nurses usually gave me several big cups of water when I complained about cramping.

[George Jung]

Thanks all.  One more question....

When you sweat do toxins leave the body too?

Zach, I did have that tall glass of iced tea today, cheers.  The nurse expressed concern about dehydration and thought my rise in blood pressure was a result of just that.  She warned to be careful as that condition can be fatal.

Again, thank you all.

[jbeany]

Yup, sweating will take toxins out through the skin.  If you get really sweaty, especially if you haven't dialysized in a few days, you can sometimes smell the toxins in your sweat - it's almost an ammonia smell.  If it gets in your clothes, you will probably need color-safe bleach to get rid of the scent - regular soap may not be enough.

[brenda]

I get the same way in the heat too George. I still have some function and forget when it's hot it's ok to drink a little more. I have had some times in the heat when I have nothing to take off and can sit there and drink a bottle of water on dialysis.

[George Jung]

Once it cools down a bit I am going to start running.
                                                                          1) I can drink more.
                                                                          2) I want to be as healthy and in the best shape as I can be for transplantation (should I be so lucky).
                                                                          3) I feel good after I have spent my energy.
                                                                          4) I need to be challenged.  (probably why I am controversial a lot of the time)

And do some weight training  to help build bone density.

[goofynina]

Once it cools down a bit I am going to start running.
                                                                          1) I can drink more.
                                                                          2) I want to be as healthy and in the best shape as I can be for transplantation (should I be so lucky).
                                                                          3) I feel good after I have spent my energy.
                                                                          4) I need to be challenged.  (probably why I am controversial a lot of the time)

YOU GO BOY!!! I have complete faith in you receiving your transplant my friend, just remember, keep your faith 

[George Jung]

So I have collected my urine from the past 24hrs and I have about a quart and a half.  I can't remember, is that very much?

[George Jung]

How much urine is produced per day?
Amount of urine produced in average adult = 1.5 liters/day.

On an average an adult man produces about 1.5 liters (3 pints) of urine every day. At the minimum the human bogy needs to produce and excrete 0.5 liter (1 pint) of urine daily to eliminate the metabolic wastes produced by the cells and tissues of the body.

Excessive or inadequate urine production may indicate illness. Doctors often use urinalysis (clinical analysis of the patient’s urine in a laboratory) in diagnosing many diseases.

For example, the presence of glucose in the urine is a sign of diabetes mellitus, a condition in which the body is unable to utilize glucose. Similarly, urinary tract infections are characterized by the presence of bacteria (or other infective organisms) in the urine. Presence of red blood cells (RBC) in the urine may indicate cancer in the urinary tract.

[Zach]

Once it cools down a bit I am going to start running.
                                                                          1) I can drink more.
                                                                          2) I want to be as healthy and in the best shape as I can be for transplantation (should I be so lucky).
                                                                          3) I feel good after I have spent my energy.
                                                                          4) I need to be challenged.  (probably why I am controversial a lot of the time)

Don't forget to add some weight training.
Not only does it strengthen and build muscle, but it improves bone density as well.

 

[goofynina]

So I have collected my urine from the past 24hrs and I have about a quart and a half.  I can't remember, is that very much?

Your sweatin AND your peeing AND they are removing fluid while you dialyze?  Wow George, you better make sure your drinking enough to replace all that fluid.  (some people are so lucky)  

[George Jung]

I had some car trouble today so I had to ride to the center.  I had wanted to skip the treatment but was strongly advised against it.  Even though I have been making urine I was told that I may not be removing toxins and until an official 24hr sample has been done and tested I need to maintain my schedule.  I ran a half treatment because I didn't want to be wiped out and have to ride back home.  Since then I have had a slight but constant headache in the back left hemisphere of my head.  I did feel better before treatment today.  I understand about not coming to any premature conclusions, but I can't help but wonder about my care at this point in time.  It is an uneasy feeling when you don't know what is happening with your health (good or bad).

Lucky?  If that is the case I am long over due, believe me.

[angela515]

Hope you feel better George.

Hemo was not for me, and I did it for over a year before I found out about other options such as PD. NO matter how good my labs were on hemo, I felt horrible all the time.. I wanted to do nothing but sleep. I don't know why your having a headache, or whatever else is going on, but I do hope you find a "happy medium" soon and start to feeling somewhat good all the time.

 

[George Jung]

Thanks Angela, I appreciate your compassion.

Maybe you misunderstood the point of my post.  It's not about what type of treatment is right for me, that has been determined.  What is a disconcerning is the state of my condition at this point in time (the past 2 weeks).  There has been a trend in my gains (or lack there of) and what on the surface seems to be a direct corelation with my urine output. 

Although I do normally feel fatigue after treatments this is not how I feel today.  As for the "happy medium" I believe I have surpassed that from a dialysis patients standpoint some time ago.

   Just had to clarify, we don't want any misunderstandings (hope it makes sense).  xoxo

[angela515]

No, i'm still confused. 

Love ya George

[st789]

I can related to about the uncertain of your health when being diagnosed with kidney disease.

[Amanda From OZ]

I can also relate to that situation. I hope your feeling better George.

[aharris2]

I had some car trouble today so I had to ride to the center.  I had wanted to skip the treatment but was strongly advised against it.  Even though I have been making urine I was told that I may not be removing toxins and until an official 24hr sample has been done and tested I need to maintain my schedule.  I ran a half treatment because I didn't want to be wiped out and have to ride back home.  Since then I have had a slight but constant headache in the back left hemisphere of my head.  I did feel better before treatment today.  I understand about not coming to any premature conclusions, but I can't help but wonder about my care at this point in time.  It is an uneasy feeling when you don't know what is happening with your health (good or bad).

(alene writing)
Hi George, How were your numbers - were you under your "dry" weight? Headache and being wiped out can be symptoms of dehydration.

I am guessing that your real (meat, fat, bones, etc.) weight is stable since you haven't mentioned anything that might make one think otherwise. If that is correct, your dry weight should not be changed. The loss or gain of real weight is the only reason for changing your dry weight.

Optimally, any person needs to maintain a consistent fluid load. This is complicated for someone like you, specifically, someone losing fluid through peeing, sweating, and dialyzing. What you lose must be replaced to avoid dehydration. When you walk into dialysis at or below your dry weight and there is no reason to suspect real weight loss, they need to GIVE you fluid during your treatment to bring you back up to your dry weight and replace what is being taken off by the machine. The nurses are highly resistant to that - they just assume that you've lost real weight and proceed to remove fluid as usual.

Equally, dialysis is about cleaning one's blood. Even in the presence of dehydration for whatever reason, dialysis is necessary to prevent uremia.

There's one thing you mentioned which seemed inconsistent. It was regarding blood pressure, specifically:
"The nurse expressed concern about dehydration and thought my rise in blood pressure was a result of just that."
Dehydration lowers blood pressure. Conversely, lower blood pressure indicates dehydration. It is not a linear relationship. All things being equal, when a lower than normal blood pressure is observed, you are dehydrated and need fluid and it gets worse quickly.

This thing about the nurses taking people below their dry weight without knowing the whole story ... someday I am expecting to see an implosion followed by a *poof* as someone turns to dust. We fight to make sure it is not Rolando.

You like a challenge? There it is - take charge at the dialysis clinic and make them do it your way! This whole thing - it's like riding a wave in a very violent sea. Sometimes you're on top riding it well and other times it's looming over you about to crash down on you. If you're not already there, George, I'm sure you'll be back on top riding it well again soon. Good to see you back 

[George Jung]

Hi Alene (what up Ro)

Well said.  I do believe I had been dehydrated, causing the headaches.  I will discuss the blood pressure some more.  My last treatment (Thurs) I weighed in two tenths over dry and blood pressure was slightly above normal 150/92 (something close to that).  I have started running the past few nights and along with that I have increased fluids.  The exercise has increased appetite so even if I end up being slightly over tomorrow I will opt for no fluid to be taken off, anything over a killo might be fine.  I must say it has been great with the relaxed restrictions, I have a deep respect for those who don't have it so easy.  I do stay away from salt as often as possible and I try to eat healthy (no fast food, minimum soft drinks, ect) so I like to take some credit, rather than tossing it up to luck.

You are correct about it being a challenge to take charge at the clinic.  They have pulled some stuff on me in the past and I was having none of it.  I believe I am a unique patient there and they're not sure how to handle me at times.  I will get my way, no question about it.  I get harassed about my access weekly and it use to be every time I was there.

I have been feeling much better so thank you all very much for asking.

[George Jung]

Good News - Pleasantly Suprising

On Tues I had my weekly lecture about my access and how I need to have a fistula, "I am concerned about the scaring." (with regard to internal scaring around the catheter) and all of the usual questions about appetite and things.  It was a routine meeting/Q&A.  Today when I come in the tech says in a confirming manner, "so your dry weight has been raised."  "Yes", I replied.  She then says to me, .......(get ready for this)......."and she changed your time."  I paused and repeated what I had just heard......... then, she tells me I am at 3 1/2 hrs now. 

I am in disbelief that my time was reduced out of the clear blue sky and my dry weight adjusted without question.  Just figured that was worthy of sharing.