I Hate Dialysis Message Board
Dialysis Discussion => Dialysis: General Discussion => Topic started by: Restorer on January 24, 2009, 11:58:20 PM
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When I started PD a few months ago, my dry weight was about 113. For the past few weeks, my weight's been stuck just above 120 and I haven't been able to pull off that weight with higher concentration solutions. My PET isn't back yet, but all indications so far have me believing I'm a fast transporter, so maybe these 5-hour dwells just can't pull off the fluid. But my legs aren't swelling anymore, and I'm not waking up feeling puffy. It's possible I've actually gained dry weight.
I've heard about how they sometimes recheck dry weight on hemo - by pulling fluid until the patient crashes :-\ - but I can't really do that. How do you recalibrate your dry weight on PD?
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Marvin has become somewhat of an "expert" on adjusting/refiguring his dry weight over all these years. He is on hemo, though -- home hemo for the last 18 months.
Immediately after a treatment, Marvin can tell if he still has some fluid left, and he adjusts his dry weight the next day by decreasing it a little. If he feels "dry" and cramps that night, he ups his dry weight the next day. We usually adjust in .5 kilo increments. Sometimes, it takes a day or two with adjusting until he feels "right" on his dry weight. It's tricky now, though, because Marvin's appetite has returned, and he's putting on real weight and not fluid, so we have to be careful not to pull him down too far.
On home hemo, we've found that it's much easier to adjust his dry weight because we're having treatments 6 times per week (it was only 3 times/week when he was in-center). To us, it's kind of like a guessing game, but he has become so in tune with his body that he can tell if it needs adjusting up or down. Overall, it's not good that he's been on dialysis for so long (most of the last 14 years -- except for a three-year break in the middle with a transplant), but one of the "perks" of long-term dialysis is that he knows what it "feels" like when he's met his true dry weight.
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I do a combination of dry weight and blood pressure. The higher the blood pressure and/or weight, the more fluid needs to come off. Also, remember, just cuz you have shapely non-fluid ankles doesn't mean the fluid isn't lurking somewhere else in the body. The two places you don't want excess fluid is the heart and lungs.
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I am still trying to figure this out. My right ankle is always a little puffy but when my ankles are swollen, I can really tell. My nurse would press on my legs and say yes, you have some fluid on you but it has been hard for me to tell.
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now admittedly i'm on incenter hemo, so things are a bit different. however no on on dialysis or not weighs the same thing everyday. we weight ourselves 6 times (or more a week) i can tell if i'm retaining fluid by how tight my shoes feel. since i have been loosing weight my dry weight is just a wild guess. i determine how much to take off by how much i've gained from one treatment to the next and push it .5 or so. if i weigh 75 when leaving and 76.5 when arriving i take off 2 to 2.5 and if i start cramping have it stopped. the most fun i have is when the doctor has my dry weight at 76 and i come in weighing 74 some of the techs just have hysterics. those that know me well, just smile and say how much today. of course when i go out to dinner the night before and eat a half loaf of sour dough french bread with butter i know i've gained real weight. i guess my point is dry weight is really just a guess and everyone is different, you really have to find out what works for you.