I havn't crashed like this since I was in-centre!

[Adam_W]

Yesterday I had my absolute worst crash I've ever had since starting home daily dialysis. Most of the treatment I felt fine, and about 15 min till the end I started noticing I was feeling "a little dry". Before I even had a chance to hook my bp cuff hose to the monitor to check my bp, I suddenly got extremely dizzy and nauseous, and I reached over to turn the UF off, but the machine was in it's system check and none of the settings can be changed during that time. Before I could really register my next thought, things went from bad to a lot worse, and I was feebly banging on the wall to get my partner's attention with one hand, and clawing at the clamps to open the saline line with the other hand. I didn't even look at the saline bag. I just let it flow. I ended up administering about 200cc, and was finally able to turn the UF off, and I ran the remaining 15 min without further incident. My bp had dropped as low as 90/50, when it normally runs about 135/85. I bounced back quickly, though. Within an hour or so I felt perfectly normal, and I wasn't even tired. I've upped my dry weight from 58.5 to 59.0, and today's tx was fine. My nurse is working on getting me a Crit-Line monitor, and it will be nice to be able to actually see how much fluid content is in my blood. Has anyone had any experience with a Crit?

Adam

[Bill Peckham]

Wow. How much fluid were you trying to take off total? Glad you were able to get through the situation; no crit-line experience here.

[cambonesegirl]

Glad you're okay now and are able to share. Hope that never happens again.

[goofynina]

Aye yi yi Adam, just reading that i was scared out of my wits, Is there any way you can get a two way monitor or a beeper of some kind that you can press so your partner can hear you, or perhaps one of them "i've fallen and i cant get up" thingamabobs, so that can alert the paramedics?  I hope and pray that never happens to you or anyone else for that matter, i have been there myself while being in center and it is a very ugly and scary feeling.  I am glad you are ok Adam. 

[Joe Paul]

Adam, sorry you went through that. I have never heard of the crit-line monitor, sounds intresting, if it works.

[Ken Shelmerdine]

The more I hear haemo horror stories the more glad I am that I do PD and hope to do so for as long as possible.

[Sluff]

Glad you are ok Adam. 

[Deanne]

Very scary! Did your partner hear you banging and come running or did you have everything back under control by the time help arrived? I'm glad you're ok.

[jbeany]

Aye yi yi Adam, just reading that i was scared out of my wits, Is there any way you can get a two way monitor or a beeper of some kind that you can press so your partner can hear you, or perhaps one of them "i've fallen and i cant get up" thingamabobs, so that can alert the paramedics?  I hope and pray that never happens to you or anyone else for that matter, i have been there myself while being in center and it is a very ugly and scary feeling.  I am glad you are ok Adam. 

I use a walkie talkie set with an emergency call button on it.  Works wonders, and my partner can be outside working on the lawn and still hear if I need him.  They only cost about 25 dollars, but are well worth it.

Next time, Adam - skip the bp cuff - go straight for the saline line!

[Black]

... about 15 min till the end...
Adam

Just curious, Adam, do you take the fluid off through the entire session?  Mike has his set to take all fluid off by the end of the second hour of his 3 hour session.

What do you think happened?  Maybe you're doing so well that you have gained actual body weight?

Mike has gotten so discouraged with the inaccuracy of his scale that he just takes off the same amount every day, unless he has edema, and then he takes off an extra .1 for a day or two.  The form has to have weights entered, so he enters what the scale shows and then shows the dry weight as 1.3 less.  Rarely is the dry weight the same number two days in a row.  Out of the 1.3 he takes off, .3 is to offset the fluid he gains from the prime and the rinseback. So, in a week he is usually taking off between 6.0 and 6.3.

BTW, if you get the monitor please let us know.

[Meinuk]

I never go by my dry weight - I always use my BP as a baseline.  Typically I take off a total of 1K  (300 rinseback 200 flush and 500 fluid removal)  Keep in mind though I am still a urinator.

[Adam_W]

I'm pretty sure it was from me gaining extra body weight. I've been steadily gaining weight over the last year, which is good because I've always been too skinny. I do take fluid off for the entire treatment, but sometimes I will decrease the rate toward the end (kind of like a "manual" UF profile). I upped my DW by half a kilo, but about 20 min to go in today's treatment, my bp started dropping and I had to give myself 100cc saline. My UF rate was at 6.5, which I've always been able to handle, so I'm not sure what the deal was today. Still waiting for more news on the Crit-Line, but I'll be so glad when I get it.

Adam

[skyedogrocks]

Yikes Adam, that really sucks.  Glad you were able to give yourself some saline and bring that bp up.

Rob had a bad crash like that, it was sooo scary.  BP was really low and then he started cramping like crazy.  He learned his lesson and now he takes the majority of his fluid off in the first hour and then the rest which is like .4 by the 2nd.  This works really well for him and he doesn't get the low bp or cramping.

What's a crit?

[Adam_W]

What's a crit?

It is the Hemametrics Crit-line monitor. It monitors the fluid volume of the blood, so basically the UF can be set to remove the exact amount, and it can be used to determine if all the fluid is being removed. People who use Crit-lines usually don't crash because they (or the dialysis staff) know when the fluid volume of the blood has dropped to the right level and they can stop pulling fluid. It's a bit more complicated than that, but I'll know more once I have my training to use it.

Adam

[Redbomb]

What's a crit?

It is the Hemametrics Crit-line monitor. It monitors the fluid volume of the blood, so basically the UF can be set to remove the exact amount, and it can be used to determine if all the fluid is being removed. People who use Crit-lines usually don't crash because they (or the dialysis staff) know when the fluid volume of the blood has dropped to the right level and they can stop pulling fluid. It's a bit more complicated than that, but I'll know more once I have my training to use it.

Adam

NOw, something else to ask my Training Nurse tomorrow! She's beginning ti "hate" you guys because of all of the questions I come up with, some on my own, others because of you all!  -- Actually, she likes them because then she learns too! 

Redbonb

[BigSky]

They use crit lines in our unit from time to time.

Pretty nifty machines.  They can let you see just how to take excess fluid off in a level manner so that its not too fast or too slow. 

[alrightstill]

I've never heard of a crit line either?  Is it small?  What does it attach to?  So many questions, haha.

Glad to hear you're ok.  I agree with the others who said to have a walkytalking thingamabobber.  When I began Nxstage in 05, my mom bought the cordless phones that come with 2 in the package.  It's great because I keep one by the machine and when the phone rings I can get it, but more importantly if I need to get her attention I just press the walky button. 

Oh. I guess I should add, it doesn't happen often, but if I ever start to feel crappy and have less than 20 minutes left, I usually just take myself off the machine early, rather than go thru the whole 'give saline' process.   I guess that's not really recommended though.   

[Black]

How are you doing, Adam?  Did you raise your dry weight more?

[cev]

Yikes, Adam, you scared me too - I worry that my husband will have a problem and I am not within earshot, glad you were able to open the saline line, 200 isn't that much.  We recently raised his dry wt. (per instructions from the Neph), because as they tracked his charts they saw near the end of his runs his BP would be much lower than when we start, something I missed because his BP is all over the board.  Taking off fluid too quickly will also lower the BP and cause cramping.  He can only handle about 1.2 per hr.  so when he ends taking off fluid depends on his wt gain. Chicken broth (salt) will help bring the BP up also, just not as quickly as the saline.