Spinner in hospital ---please I need info

[angieskidney]

Well, from what Angie has been telling me, draining you to a point where it causes you severe cramping is the best method for finding your actual dry weight.  The only problem with that is, that the patent is not able to communicate with the nurses very well at that point and without someone watching over the patient closely, this could cause a serious problem.

You do NOT want to be THAT dried out that it brings severe cramping Jeff. If you cramp a little at the same time as your BP dropping .. that says you are too dry at a little lower or at the dry weight.

Am I right about this?

[Panda_9]

Cramping can also be caused by being too overloaded. When you are overloaded you generally would be running at a high UF rate. The rate at which the fluid is coming off, is too fast for the shifts in cellular fluid inside your body. So the machine is taking fluid too quickly before the cells get a change to replace it.

[SpeedFleX]

Yes I get this alot. These are usually what I get when my weight is too low.

Dizzy
Cramps
Low BP

Then when I get up after dialysis BAMM I see black my hearing echos so I stand there a second and it goes away I tell the doc I drink something they up my weight and then I feel great again!

But I have a quick ? what is a tech exactly I don't think we have them here where I dialyze

[angieskidney]

Yes I get this alot. These are usually what I get when my weight is too low.

Dizzy
Cramps
Low BP

Then when I get up after dialysis BAMM I see black my hearing echos so I stand there a second and it goes away I tell the doc I drink something they up my weight and then I feel great again!

But I have a quick ? what is a tech exactly I don't think we have them here where I dialyze

we don't have them in my Canadian city neither. At least not the same type of techs. Our techs are only guys who work on the machines and that is all. And by work on them I mean .. repair them.

Ya when my bp is low and I stand up my ear pop like crazy and if it is too low my visit goes dark and I need to sit back down fast or I will end up sitting without me wanting to.

[slothluvchunk]

If you're having trouble getting fluid off without drop in BP an cramping, there are a few options.

The first is obviously to see if you need to raise your dry weight a little bit.

Sometimes though, people crash without hitting their dry weight.  There a few really simple things you can do to help fight this.
Have the techs lower the temp that your blood is returning at.  The warm fluid that is coming in from the machine is a vasodilator, meaning it makes your entire vascular structure expand.  This results in a lower blood pressure.  Cooling this just a tad helps to constrict your vessels a bit, reducing the risk of that BP crash we all hate.

Another option is to make sure that UF profiling is enabled on your machine during your treatment.  This alters the UF rate throughout the treatment, so that you're pulling more off at the beginning, and less off at the end.  There are a number of different UF profiles, but the most "even" that I've found is #2 (on the Fresenius 2008H and K models).

Sodium profiling is also an option if you're cramping a lot. 
I personally prefer my own version of sodium profiling:  I make sure to bring a nice meal with me, and I try to load it up with some of what's being depleted during treatment.  I then eat it first thing, as eating it later may further compound the problem of low bp (all that blood rushing to the stomach for digestion).
I find that this helps to replace a bit of what's coming out.  Also, if you bring a drink with you, factor it into your goal so that you're not wondering why you're overweight when you leave.
ALSO:  keep in mind that the food you just ate has mass and therefore has weight - but shouldn't be factored into your goal.  If you seem a little "heavy" when leaving, and ate a foot long sandwich, don't worry - as that food digests and leaves, so will the weight from it.  Unfortunately many techs can't understand this very simple concept. (first grade science anyone?)

Bring in some pickle juice, or chicken broth, or something salty that you can drink a bit of if you're beginning to feel woozy.

You can also simply ask the tech to turn off your UF for a bit, because you're feeling kind of dry.  This means that the machine is continuing to dialyze, but is not pulling off any fluid.  You want to (if at all possible) get your full treatment in.

More dialysis always = good
Your peers are getting kidney function 170 hours a week - you're getting 12.

It can be very hard to finally find a weight that feels "right" - and a system of avoiding those nasty bp crashes.  This place is a great resource though, as we can all share what has worked for us, and in doing so provide a veritable encyclopedia for the newcomer.

Good luck spinner! 

[goofynina]

Hey Slothluvchunk,  Wow, where were you when i was on hemo,  all that infomation you just gave would've helped me greatly,  gonna have to remember for if and when i go back on the dreaded hemo.   Great post, very informative.  Thank You...

[sandman]

Wow, good stuff there slothluvchunk.  I have asked Angie about her UF profile because as I sit and watch her machine, I swear that the rate gets faster toward the end but she tells me no.  The machine stays at an even rate all the way through.  Angie tells me that it could be that I am not perceiving the read out correctly and just think that it's getting faster toward the end when in fact, has stayed the same, which could very well be possable.  I was not aware that you can change the UF profile so that is would ramp down toward the end.  Has anyone else tried this method?

[angieskidney]

I have the  Fresenius 2008 K model (I just checked today). I just got back now from dialysis. My BP is a lot better this time as they raised my dry weight up .5 and my pulse was good til the end when I stood up to do my standing BP.

All that information is exactly what I wanted!! Thank you so much!! This is the type of stuff I have been looking for and am so glad I have found a place that provides it! Most of the sites that explain this are too technical for me to understand and they don't go into it like you do but they assume you know what certain things are.  Thank you.

I asked them about sodium profiling last week and now I have one set up. But I don't have a UF profile yet. I have tried to ask about it but since I didn't know the correct terminology at the time .. they didn't get what I was asking. When I asked about the sodium profiling infact, I asked 2 nurses and the one thought I was talking about that sodium concentrate they inject into the dialysis if your BP drops before the last hour. The other nurse figured out what I meant though so that is good.

More dialysis always = good
Your peers are getting kidney function 170 hours a week - you're getting 12.

Wow and I get less than 12 hrs/wk! I never thought of it like that but how true!!

[Mom3]

Do most dialysis clinics allow people to snack while they dialyze? Both of my son's clinics have had strict enforced rules against it!

And how is Spinner doing now?

Mom 3

[sandman]

Do most dialysis clinics allow people to snack while they dialyze?

I can't speak for all clinics but the one that Angie goes to, does allow snacks and light meals.  As long as it's acceptable foods of course.  You can't just walk in with a large peperoni pizza, dripping with sauce and cheese.  They would seriously frown on that.  Angie and I have brought in a dozzen low sugar doughnuts to share with everyone there.  Even the nurses enjoyed them sometimes.

[Panda_9]

At our home hemo unit we get morning tea which is a drink and biscuits, then lunch which is a drink, sandwhiches, and a yoghurt/fruit/jelly etc. I used to take my own lunch in alot which wasnt a problem. As long as you arent going to sit up for a buffet or something. However in the acute Dx ward they tend to only let you eat after you come off the machine, but you get a cuppa.

[angieskidney]

At our home hemo unit we get morning tea which is a drink and biscuits, then lunch which is a drink, sandwhiches, and a yoghurt/fruit/jelly etc. I used to take my own lunch in alot which wasnt a problem. As long as you arent going to sit up for a buffet or something. However in the acute Dx ward they tend to only let you eat after you come off the machine, but you get a cuppa.

wow you are sooo lucky! Where do you dialysize?

[Panda_9]

Im in australia

[angieskidney]

Im in australia

Bah I am in Canada

[slothluvchunk]

I was looking at dialyzing in some German clinics this summer (I was going to visit my old stomping grounds on business) - and the clinics I checked with through Switzerland and Germany all offered snacks and meals as part of the treatment.

In San Diego I was offered flavored crushed ice - like snow cones, and crackers during treatment.

In the Bahamas they had small sandwiches and some juice - though that place was scary enough as it was, I didn't accept anything from them. 

L.A. hasn't offered me anything, and in the few clinics I've used there, the techs and the patients always seem to be pretty angry.

[sandman]

In San Diego I was offered flavored crushed ice - like snow cones

They have those in my city ( Philadelphia ) too but here, there called water ice.

[angieskidney]

I was looking at dialyzing in some German clinics this summer (I was going to visit my old stomping grounds on business) - and the clinics I checked with through Switzerland and Germany all offered snacks and meals as part of the treatment.

In San Diego I was offered flavored crushed ice - like snow cones, and crackers during treatment.

In the Bahamas they had small sandwiches and some juice - though that place was scary enough as it was, I didn't accept anything from them. 

L.A. hasn't offered me anything, and in the few clinics I've used there, the techs and the patients always seem to be pretty angry.

Wow thanks for this I am thinking of making a new thread where we talk about which units were the best because honestly .. it is the only way for me to know where is good and where is not so good Sandman tells me I have to go check places out but if I am thinking about the States but don't live there .. it makes it hard to check it out. OTher people's words help a LOT! Thx

Here is the thread I just made: Dialysis: Centers: Which units did you like and don't like? (I think this is the perfect place for the post)

In San Diego I was offered flavored crushed ice - like snow cones

They have those in my city ( Philadelphia ) too but here, they're called water ice.

Really? Does this mean you have been checking out dialysis units?