I Hate Dialysis Message Board
Dialysis Discussion => Dialysis: F.A.Q. (Frequently Asked Questions) => Topic started by: Bajanne on December 10, 2005, 09:07:39 AM
-
I am new to this dialysis thing. Last session they took off 3 kilos. I asked the nurse if that gain was too much. She said not really. What is acceptable gain and what is unacceptable.
Also, my dry weight has been changed since I started at the end of Sept. It keeps going down a bit. But I know that I am losing weight because I don't eat as much. However my cholesterol is still a big problem.
I will start a post dealing with that if I don't see one.
-
Hi there, My weight gains are usually close to 4 kg.. I think a lot depends on whether you have urine output.. I have none so I have to be careful... getting the hang of it now.. lol
-
How much you can safely gain between treatments depends on your weight, activity level and lung health-- the 4 kilos that I can gain might make someone else go into respiratory distress.
Are you short of breath between treatments? That's a big sign that you're putting on too much fluid. Also, if you are cramping at every treatment that also means you are gaining too much fluid. Your body will give you little signs when the amount is getting to be too much-- treatments will be a lot harder and your BP will be unstable. Note when you have an easy treatment, and try to keep your fluid intake at that level for next time.
Learn as you go... it's all you can do! ;)
-
My dry weight keeps changing. I keep gaining dry weight (as opposed to fluid weight) so it is hard to tell. Sometimes I lie about my weight gain. If it is 55.9 I'll just say 55.5. My appetite is too good and I'm gaining weight. But, they keep trying to take it off in fluid. You can't squeeze blood out of a dry turnip. ::)
-
Don't lie about fluid gain-- the techs and nurses have to know how much you weigh, because they program that into the machine. If you say you weigh 55.5 and you really weigh 55.9, that's .4 over your dry weight, and when you come in for your next treatment, it'll be whatever you gained at home plus the .4 you left with. Over time, that could mean that you'll have real trouble getting down to your goal because you're always leaving 'heavy.'
If you believe you are gaining actual body weight as opposed to fluid weight, talk to your doctor and ask that your dry weight be raised. You can be run on a crit-line to determine what your actual fluid load is, and they will be able to see how much weight they can try to remove before your blood pressure goes down... that's a better way to set a new dry weight than trial-and-error.
-
What is a "crit-line"??
The thing is... I don't see the doc that often and the techs won't let me change my dry weight by myself.
-
A crit-line is either a free-standing machine or a program in the dialysis machine that can calculate how much fluid can be removed from your blood by watching your blood pressure and pulse as you go through your treatment-- limits can be set so the machine alarms when your pressure starts to go down, and they can back off the fluid removal for a while. When your pressure goes back up, they can again try to remove more fluid.
When they've put me on a crit-line, I usually am able to remove at least a half-kilo more than I normally would.
Doesn't your doctor make rounds during your treatment? They do here-- by law they have to at least a few times a month. Our doctors are usually rounding on Tuesday and Thursday.
If your doctors don't do that, you could tell the charge nurse that you would like her to ask the doctor to change your dry weight... you'll have to be a pain about it, if you have the kind of unit where they think only the doctors and nurses know anything about dialysis. Once they realize that you understand your treatments, they'll be more likely to work with you.
-
Okay, I'll ask about it. Yes, she (Dr.) does come around, but I have to remember to tell her I want my dry weight changed. I'm usually bitching about something else like how friggin COLD it is or how incompetent everyone is. >:( 8)
-
It's friggin' cold in my unit, too.
Occasionally I bring one of those back-pain warming patches in for my treatment, and put it on my stomach. It works well, but they're a little too expensive to bring them in for every treatment.
-
Well, it seems we just can't be pleased. I keep asking them to please turn the AC a few degrees lower! I like to feel cold. They said that the hospital techs say it should be at 72º and that is where it is supposed to be. but I don't feel comfortable. Maybe their thermostat isn't working and it is really hotter than that.
At what temperature does your unit operate, guys?
-
-40 below! ;D
LOH - They don't have crit-lilne capabilities. They did know what it was though ::) Surprise! Surprise!
-
Dear fellow renal readers,
In my unit in the hospital they don't really give a shit if I'm cold or hot or even sweating. As long as they get those dialysis needles in and I don't die during the treatment they consider there job done.
Unless they are too cold or too hot them selves then and only then this is a different matter it may be our life on the line we may or may not die but this is there job's were they can call in sick or take a day off or get Christmas off with pay or take two weeks off or even quite.
But for us there are no breakes no holliadays no choices and no freedoms if we were to try and take a break there is only one thing and you's know what I'm talking about.........Jamie-G
-
The 99 cent store has heat packs for 99 cents. MMM Warm.
-
I have been informed that the max weight gain is 4Kg anyting higher than that and you'll get the business, however it really depends on where you do dialysis.
I'm now at a Bayshore clinic and as it is outside the hospital you are allowed to get away with a little more, fortunately my output even after 4 years is almost 100%
-
I read a study a while back (sorry, no link) that saw a positive correlation between higher fluid gain and better nutritional level of the patient. It's somewhat controversial ... you don't want average size people gaining 6 or 7 kg in between dialysis treatments.
I still think an arbitrary limit without considering the patient's size, activity level, etc, is not the best policy.
The problem as mentioned earlier in this Post is its effects on the heart.
But if you exercise often, perhaps that helps keep the heart in "good" shape, even if you gain more than what is acceptable. :-\
-
Well, it seems we just can't be pleased. I keep asking them to please turn the AC a few degrees lower! I like to feel cold. They said that the hospital techs say it should be at 72º and that is where it is supposed to be. but I don't feel comfortable. Maybe their thermostat isn't working and it is really hotter than that.
At what temperature does your unit operate, guys?
Did you know that most of the dialysis machines has a variable temperature control
If I feel too warm, I have it at 36.0 or lower. If I'm cold, I have it at 37.0. Normally it's at 36.5.
Also, if you suffer from low blood pressure during dialysis, lowing the temperature may help a bit.
-
Our unit got rid of the old standard of all people only having 1/2 to 1 liter a day. They use a percentage of dry weight. 3% during weekday treatments and 5% over a weekend.
The old way never made any sense in how a 100 lb person and a 200 lb person should only consume the same amount of fluid in a given day.
-
Our unit got rid of the old standard of all people only having 1/2 to 1 liter a day. They use a percentage of dry weight. 3% during weekday treatments and 5% over a weekend.
The old way never made any sense in how a 100 lb person and a 200 lb person should only consume the same amount of fluid in a given day.
That is different. How does the percentage system actually work? In my unit they just use the old system. I usually gain 4- 4.5kg over the weekend and during the week I usually gain 2-3kg.
-
Okay, let me see if I got this right.
Your last known dry weight is divided by your calculated fluid weight accumulation. The result equals your persentage. Is this correct?
-
That is different. How does the percentage system actually work? In my unit they just use the old system. I usually gain 4- 4.5kg over the weekend and during the week I usually gain 2-3kg.
Example would be if you had a dry weight of 50 kilos. Your acceptable weight gain by fluid would be 1.5 kilos (3%)during the weeks treatment. Such as M, W, F. Over the weekend F-M it would be 5% or 2.5 kilos.
The effects of fluid on a 50 kilo person and a 100 kilo person are completely different. Whereas taking off 5 kilos on a 50 kilo person is 10% if body mass and taking off 5 kilos on a 100 kilo person is only 5% of body mass.
-
How come more units are not going with this method? I know one guy in my unit .. he must be like 220lbs and he goes by the same as I do and I am about 140lbs I think (62.5kg). Now wonder why his BP always drops and he always has cramps.
(By the way, I can't figure out the math ... I am just not good at it and am dyslexic to boot. :( I need an exact math equation to figure out how :( :-[ . If Jeff thinks he got it I will just have to have him explain it to me..)
edit: Sorry I put my weight wrong.
-
How come more units are not going with this method?
Some staffers have a problem just figuring our weight gain. >:D
And it doesn't go with the mantra, "Why did you gain so much?" ;)
-
How come more units are not going with this method? I know one guy in my unit .. he must be like 220lbs and he goes by the same as I do and I am about 140lbs I think (52.5kg). Now wonder why his BP always drops and he always has cramps.
(By the way, I can't figure out the math ... I am just not good at it and am dyslexic to boot. :( I need an exact math equation to figure out how :( :-[ . If Jeff thinks he got it I will just have to have him explain it to me..)
Fluid gain by the method would be.
52.5 x 3% = 1.6 kilos during the week treatments.
52.5 x 5% = 2.6 kilos over a weekend.
The guy in your unit sounds like it is true weight gain, not fluid gain.
-
How come more units are not going with this method? I know one guy in my unit .. he must be like 220lbs and he goes by the same as I do and I am about 140lbs I think (52.5kg). Now wonder why his BP always drops and he always has cramps.
(By the way, I can't figure out the math ... I am just not good at it and am dyslexic to boot. :( I need an exact math equation to figure out how :( :-[ . If Jeff thinks he got it I will just have to have him explain it to me..)
Fluid gain by the method would be.
52.5 x 3% = 1.6 kilos during the week treatments.
52.5 x 5% = 2.6 kilos over a weekend.
The guy in your unit sounds like it is true weight gain, not fluid gain.
Thanks .. and ya .. I know he is that heavy because of true weight. I was just stating how they tell both of us to limit ourselves the same amount. And I think he said he still pees.
-
Okay, from what I can make of this. Your dry weight times 3% or 5% will give you a rough idea of what acceptable weight gain for your weight should be, correct? So for example... someone weighing 62.5k, there acceptable weight gain at 5% would be 3.1k.
Okay, I can see where this would be practical to dictate what a person of a specified weight is acceptable to consume but where would this be practical when the patient has had more or less fluid gain then what the percentages dictate? Can someone help me out here? I'm lost.
-
After you get settled in at a stable dry weight, you may be able to tell by how much edema you accumulate. If I start seeing the first signs of swelling, I know I've hit my limit. I try not to do that, but sometimes I see it in my ankles and fingers by Sunday night (I run MWF). I weigh a few times a day, and go in with 2-2.5k on regular days, and 3k on weekends. 3.5k in the winter. I hate winter when I can't sweat it off.
How sensitive you are to cold can be related to your hemoglobin. Those people in shorts and t-shirts probably have hgb of 13 or better.
-
Okay, I can see where this would be practical to dictate what a person of a specified weight is acceptable to consume but where would this be practical when the patient has had more or less fluid gain then what the percentages dictate? Can someone help me out here? I'm lost.
There is no relation to what you are asking.
The idea is to stay under the fluid allowance goals to help limit any potential damage that may be done by fluid overload and to help keep patients from crashing from having too much fluid to remove in the limited amount of time on the machine.
-
Ya, Sandman is still learning as he doesn't understand and it is hard for me to explain what I am still learning. The less you drink the better because only so much can be taken off safely. You don't want to be too dry though after dialysis (especially diabetics) but having fluid overload is very dangerous as it can cause fluid to be in your lungs and around your heart.
I had Pneumonia twice last year. It is not a good thing to have too much fluid on you.
But dry weight can be hard to calculate .. but once you know where you stand .. it is easier to calculate how much your fluid allowance is.
-
Ya, Sandman is still learning as he doesn't understand and it is hard for me to explain what I am still learning. The less you drink the better because only so much can be taken off safely. You don't want to be too dry though after dialysis (especially diabetics) but having fluid overload is very dangerous as it can cause fluid to be in your lungs and around your heart.
I had Pneumonia twice last year. It is not a good thing to have too much fluid on you.
But dry weight can be hard to calculate .. but once you know where you stand .. it is easier to calculate how much your fluid allowance is.
If you have problems with finding the right dry weight they should be monitoring you with a crit-line or similar machine.
Personally I pretty much change my dry weight from treatment to treatment. I always determine what is right from how I felt at my last treatment. Doctors are suppose to be the ones to change it but its easy enough to get it changed to what I want and just tell the doc to change it when they come around. They usually come around 2 of the 3 days I am on the machine.
-
I think that the lower weight u gain the better. Except when u go minus that isn't good either. I gain about 1 - 2 kilos sometimes when there's a party then 3.
But I do wonder how some people gain 4, 5 even 8 kilos. You would have to drink at least a gallon and more to gain that which to me isn't be very good about the fluid intake.
my record is 4 kilo through I could breath fine but I still believe that 1 - 2 kilos is enough no matter how much your weight is.
The only time I thinks it's alright to gain more is if your dry weight has to be uped because you maybe ate alot but in between dialysis I doubt u can gain more then 1.5 kilos on fat or whatever
-
Ya, Sandman is still learning as he doesn't understand and it is hard for me to explain what I am still learning. The less you drink the better because only so much can be taken off safely. You don't want to be too dry though after dialysis (especially diabetics) but having fluid overload is very dangerous as it can cause fluid to be in your lungs and around your heart.
I had Pneumonia twice last year. It is not a good thing to have too much fluid on you.
But dry weight can be hard to calculate .. but once you know where you stand .. it is easier to calculate how much your fluid allowance is.
If you have problems with finding the right dry weight they should be monitoring you with a crit-line or similar machine.
Personally I pretty much change my dry weight from treatment to treatment. I always determine what is right from how I felt at my last treatment. Doctors are suppose to be the ones to change it but its easy enough to get it changed to what I want and just tell the doc to change it when they come around. They usually come around 2 of the 3 days I am on the machine.
Heh ... you are lucky. I see the Neph only once a month ... and the nurses never like me to change the dry weight goal too often .. more than once a week is pushing it in their eyes .. :-\ Seriously!!
-
I think that the lower weight u gain the better. Except when u go minus that isn't good either. I gain about 1 - 2 kilos sometimes when there's a party then 3.
But I do wonder how some people gain 4, 5 even 8 kilos. You would have to drink at least a gallon and more to gain that which to me isn't be very good about the fluid intake.
my record is 4 kilo through I could breath fine but I still believe that 1 - 2 kilos is enough no matter how much your weight is.
That may be your belief but consider this. Fat, carbs, protein and total calories are based on body size so why wouldn't water.
-
When the temperature outside is in the 90s, I sometimes leave a little more on me. Outside in that weather, I sweat a great deal and could lose too much fluid. Of course I would drink more, too. Partly for fluid replacement and partly to help my body cool down.
Also, when I go to the beach, I bring a liter of frozen water. After a few hours, it's empty and I haven't gained any additional weight. :o
-
Is there any reason why you sweat so much Zach? That is alot!! I have a hard time with my weight pre Dx as its hard to determine how much of it is food weight and fluid weight, as Im on nocturnal. So you are weighing yourself at the worst time of the day. I am having trouble keeping my gain under 4, sometimes I just loose track of what Im drinking, plus Im thirsty all the time. I do feel it a little bit at 4kgs, I get a little out of breath. The most Ive had on is 7kg and I was having alot of trouble breathing, and had to sleep sitting up. That felt so awful.
And dont forget the effects on the heart from getting too overloaded all the time! I really need to force myself to cut down because I dont want a dodgy heart too :-\
-
I think my sweating is a good thing ... as long as you don't mind the smell. :o
Sweating a liter sounds about right, when you consider that I'm at the beach for several hours.
-
Wow Amber that is terrible! Fluid overload being bad enough where you have to sleep sitting up! That caught my attention because with my Peritonitis I had to sleep sitting up because it hurt too much to do proper full drains .. man that was not fun!! :(
Anyway, my dietitian started telling me tricks (that I don't use but thought I would share anyway) to keep my drinks under control. She said I should bring a bottle (liter or what ever is my max/day) and either do one of two things:
- Have the bottle full and any drinks I drink then fill the container with fluid from the bottle. When the bottle is empty I have reached my limit for the day.
- Have the bottle empty and fill it with an equal amount of fluid from any drinks I have had and when the bottle is full then I have reached my limit for the day.
-
I used to do that angie, but I probably wouldnt follow it. I drink out of a 250ml measuring cup for cold drinks, and for hot drinks I know how much all my mugs hold. Most of our glasses are 300ml or more so Ive opted to use something smaller. It was easier to follow when I was living with my parents as for some reason all their glasses are really small, and probably only hold about 200-250ml.
-
I have a hard time with my weight pre Dx as its hard to determine how much of it is food weight and fluid weight, as Im on nocturnal.
...why don't you weigh yourself before dinner, Amber? I do. Not every night, but then I don't have a big dinner every night, but
once or twice a week I weigh before dinner, then again before going on the machine (or to bed if it's an 'off' night). It just gives
me a regular check/idea, how much food weight gain there is. So, if I'm 131 before; have dinner and 2 cups of tea & then I'm 131.8,
then my 'real' fluid gain between the 2 was only about .4, with the food about .4. I started doing this when I found I was coming
off regularly below the target. Then I tried to cut down on big dinners (I've never really liked them anyway) esp. on pre-dx nights, as
they made me feel uncomfortable later when I was on.
Then I found the under-target days were intermittent and I realised I hadn't accounted for food when weighing. My target is also
the keyed in target (i.e. I don't add the classic "300 for saline; 300 for drinks" thing), and even if I have a couple of cups of tea, I
still usually meet the target. I suspect there may be some magic mixed in with the science tho.. ;D
-
I usually guesstimate what my dinner weighs. I sometimes weigh myself before and after dinner but most of the time I forget. My post weights are sometimes all over the shop, which is probly because of big dinners, which doesnt make me look too good in the fluid department! I count the 300ml washback, but I always take a cup of tea or cold drink with me before bed which I dont count, and most of the time I come off spot on. I try not to eat too much, as whenever I put something in my mouth, my abdomen swells, and swells, and by the end of the day I look pregnant, bit like being on PD really.
-
I have to 'fess up. I have not been doing too well this last week in restricting my fluids and I have been ending up with as much as 4kg over my dry weight. I had a severe wake-up call today. After the weekend, I had 4.2 to take off. I had quite a nice session, sleeping away until about the last 10 minutes. I woke and found myself with severe cramps - my left calf and my right foot. Excruciating pain!!! All I wanted to do was put my feet down, but the nurse thought that there was the possibility of my keeling over since my BP was low. It took a while for things to cool down. I was frantic!!!
I am almost glad that school is starting back. That controls my liquid intake greatly!
-
I think I would definitely drink less if I had more things to do. Alot of it is probly boredom.
-
I think I would definitely drink less if I had more things to do. Alot of it is probly boredom.
I think you've got that right!! ;)
-
I spend most of my time at home, so I am always bored. If I could do more things I would forget that Im thirsty or hungry. Im just too tired to do anything.
-
I completely agree! I find that I am bored and sad a lot and much like chocolate icecream might be the evil treat any woman would want to sneak and enjoy full heartedly, any nice cool drink is that evil treat for me .. and when I am thirsty and I know it is in my fridge ... somehow I never used to see drinks this way :P Of course I would be just as bad with chocolate icecream so I just don't buy that :-X
-
I spend most of my time at home, so I am always bored. If I could do more things I would forget that Im thirsty or hungry. Im just too tired to do anything.
I think if you got up and did one thing each day you would feel better. I mean one thing you do NOT usually do. I clean house by doing one room at a time. It is not as big a project as it would be if I looked at the entire house at once.
-
Angie I purposely don't keep cold water or juice in the fridge because of the temptation. I totally love cold water and if its there I will polish it off in one sitting. Now I just have to stop drinking all the cold milk!
When I am cleaning I stick to one room at a time too. If I think about the whole house, it seems unachievable. I have been doing some things, but not alot. There is stuff all to do around here that doesn't cost an arm and a leg. Summer is approaching fast which for me means a heap less energy. At least now I can go swimming and can start water aerobics again.
-
Angie I purposely don't keep cold water or juice in the fridge because of the temptation. I totally love cold water and if its there I will polish it off in one sitting. Now I just have to stop drinking all the cold milk!
Yes, that is why I got rid of all milk and never buy it :( My mom used to bring over milk (she thought I was helping me out and kept forgetting I can't have certain things) and of course I didn't want to waste it .. but my dietitian got mad at me about it ... even though I didn't have a lot of money and couldn't afford to get things ...
I did appreciate my mom's help .. but MILK?? :( I ended up getting upset with my Dietitian til she understood my position. Now my mom no longer brings me milk. I think she finally understands. ;)
-
I concur with Zach and BigSky. I'm 6'7" and my dry weight is 229 kilos.(not a typo) I'm sure I'm the largest patient my center has ever dealt with. After a year on dialysis, my doctor is finally thinking out of the box and has figured out I'm not an 90 pound little ol' lady. (no offense to the 90# ladies) I typically gain 5 kilos (2%) between treatments and the techs are authorized to pull as much as 8 kilos (3.5%) for me. I've gained as much as 7.3 kilos over the weekend. With a .6 kilo rinse for 2 parallel kidneys, that's close to 8 kilos.
-
Heya Russ, dont feel bad amigo, the most i ever gained was over the New Year Holiday and it was 15 kilos :o it is so easy to do so be verrrry careful, i think i have broken records myself :-\
-
Holy shit!!! The most Ive gained is 7kg and it was only because my machine broke down and ER kept sending me home saying your ok. Then when I finally got to do a run incenter, they dialed in my fluid wrong, and only ended up taking off a couple of 100mls.
I dont see how a doctor would authorise an 8 kilo UF? I gain up to 4kgs which is really bad, I couldnt breathe if I gained that much.
-
Holy shit!!! The most Ive gained is 7kg and it was only because my machine broke down and ER kept sending me home saying your ok. Then when I finally got to do a run incenter, they dialed in my fluid wrong, and only ended up taking off a couple of 100mls.
I dont see how a doctor would authorise an 8 kilo UF? I gain up to 4kgs which is really bad, I couldnt breathe if I gained that much.
We're talking about two very different size people here.
Russ is 229 kg, he's much larger than you. aMbEr how many kg are you ... 60kg?
-
I was about 5 kilos over my dry weight Monday last week, and the nurse said she could only take off 4 kilos at a session.
-
Ya I guess it depends on the size you are overall on how much you can handle taking off? I can only handle 5kg max taken off (they told me they don't do more than 5.5kg in my unit max) in one sitting. I am 63.5kg and 5'5".
-
I was lead to believe that the old fashioned method of 500mls a day went out the window. I'm not sure I have ever meet anybody who actually complied to that anyway.
I'm of the understanding that 3% to 4% of your body weight is acceptable ie. 100 kg person could accumulate 3 - 4 kg of fluid, however if you weigh 60kg you would need to take off less fluid.
Again we normally feel when we have taken off to much fluid and know our own limits as some people can tolerate a higher UF rate.
-
That is different. How does the percentage system actually work? In my unit they just use the old system. I usually gain 4- 4.5kg over the weekend and during the week I usually gain 2-3kg.
Example would be if you had a dry weight of 50 kilos. Your acceptable weight gain by fluid would be 1.5 kilos (3%)during the weeks treatment. Such as M, W, F. Over the weekend F-M it would be 5% or 2.5 kilos.
The effects of fluid on a 50 kilo person and a 100 kilo person are completely different. Whereas taking off 5 kilos on a 50 kilo person is 10% if body mass and taking off 5 kilos on a 100 kilo person is only 5% of body mass.
I just went back and read the thread from the front. I must read to many sports sections from newspapers and jump to the back page first.
I completely agree with this and Zach and maybe someone on the second page, I did not get that far. Just the first and last page for me. Who says I jump to conclusions.
-
AngiesKidney, I don't understand why centers have rules like that (pulling 5.5 kilos max). These rules in some cases benefit the clinic and not the patient. It took them a year but I'm greatful my clinic is finally thinking out of the box as I'm 6'7" and 229 kilos. My larger mass naturally requires more fluid. I think most of the rules and guidelines are for more normal sized people. I"m bigger than the "average bear", as Yogi would say. This is why I drive a Suburban and not a Corolla. ;D
I plan on starting NxStage training in December and start DX at home by the end of the year. I'm hoping daily DX, 6x/week will help with my fluid issues.
-
It took them a year but I'm greatful my clinic is finally thinking out of the box as I'm 6'7" and 229 kilos. My larger mass naturally requires more fluid. I think most of the rules and guidelines are for more normal sized people. I"m bigger than the "average bear", as Yogi would say. This is why I drive a Suburban and not a Corolla. ;D
Yep. The body is made up of a majority of water. Bigger people tend to carry more muscle regardless of bodyfat. The more muscle one has the more water the body has in it and therefore with more muscle there is more room for excess water to be stored without encountering the same complications vs. someone who is smaller and carries less muscle.
-
AngiesKidney, I don't understand why centers have rules like that (pulling 5.5 kilos max). These rules in some cases benefit the clinic and not the patient. It took them a year but I'm greatful my clinic is finally thinking out of the box as I'm 6'7" and 229 kilos. My larger mass naturally requires more fluid. I think most of the rules and guidelines are for more normal sized people. I"m bigger than the "average bear", as Yogi would say. This is why I drive a Suburban and not a Corolla. ;D
I plan on starting NxStage training in December and start DX at home by the end of the year. I'm hoping daily DX, 6x/week will help with my fluid issues.
Well take into consideration that my unit is a "Self Care" unit and is NOT near the hospital like the main unit is. The Hospital Dialysis unit takes off more than 5.5kg max. Anyone remember Jamie the magician (http://ihatedialysis.com/forum/index.php?action=profile;u=57) from my city? He always came in really heavy so they kept him at the hospital dialysis unit. He would have to have taken off 7kg on a regular basis. Of course that is really hard on your heart!
-
I am more so talking about the effects of fluid gains on the heart, not how much UF you can "handle". I would rather not say, but I am 94kgs at the moment. Was 87 but put on weight when I started nocturnal and got my appetite back. Have raised my dry weight 1kg in the last few weeks due to BP problems, which I dont think are weight related. On average I gain 3.5, sometimes more, sometimes less. I am trying to get it down to 3, then down to 2.5 but I am so freaking thirsty all the time and I have been used HAVING to drink lots when I had the transplant. There is absolutely no way I could stick to the 500ml per day restriction. I dont think its expected here. That is just totally rediculous. You would use it all up taking all the friggen pills, not having any left to "enjoy".
Lately I have been having some chest pain and palpitations, so I am getting a bit worried it is because of my gains. My partner and I are actually considering putting a lock on the fridge so I cant access the drinks in there, and just pour out my allowance for the day.
-
I am more so talking about the effects of fluid gains on the heart, not how much UF you can "handle". I would rather not say, but I am 94kgs at the moment. Was 87 but put on weight when I started nocturnal and got my appetite back. Have raised my dry weight 1kg in the last few weeks due to BP problems, which I dont think are weight related. On average I gain 3.5, sometimes more, sometimes less. I am trying to get it down to 3, then down to 2.5 but I am so freaking thirsty all the time and I have been used HAVING to drink lots when I had the transplant. There is absolutely no way I could stick to the 500ml per day restriction. I dont think its expected here. That is just totally rediculous. You would use it all up taking all the friggen pills, not having any left to "enjoy".
Lately I have been having some chest pain and palpitations, so I am getting a bit worried it is because of my gains. My partner and I are actually considering putting a lock on the fridge so I cant access the drinks in there, and just pour out my allowance for the day.
wow :(
Wasn't someone saying there is a way they can tell if you have too much fluid on you for your body size? Some kind of attachment for the machine? I don't know. But thought I heard something about something...
I can't even keep myself under my 1000ml limit ... but I know what you mean .. about being used to the transplant drink rule of drinking lots. I did that for 11 years and then now I have to limit myself? Crap .. :(
If you have fluid in your lungs (trouble breathing .. needing to cough a lot .. congestion) then that is one sign you have too much fluid on you. Another I get is the runs :(
-
There is absolutely no way I could stick to the 500ml per day restriction. I dont think its expected here. That is just totally rediculous. You would use it all up taking all the friggen pills, not having any left to "enjoy".
500ml per day is such an unrealistic goal. The only way I can see that happening is if you slept all day long. :-[ Even one 16oz bottle of water would put you over that goal. ::)
-
Angie, the same gadget that measures kt/v also assesses the fluid situation. However some doctors dont like it. Plus the last time I was on it I went flat, the worst one Ive had so far. And all along the fluid goal looked like it was pretty spot on. Obviously it wasnt! They ended up giving me a litre of fluid.
-
Angie, the same gadget that measures kt/v also assesses the fluid situation. However some doctors dont like it. Plus the last time I was on it I went flat, the worst one Ive had so far. And all along the fluid goal looked like it was pretty spot on. Obviously it wasnt! They ended up giving me a litre of fluid.
WOW! :o
I know nothing about how that works. But a whole 1000ml back? That is a LOT! (approximately equal to 1kg)
-
Yeh it was a lot. My BP went quite low I think.
-
Angie, the same gadget that measures kt/v also assesses the fluid situation. However some doctors dont like it. Plus the last time I was on it I went flat, the worst one Ive had so far. And all along the fluid goal looked like it was pretty spot on. Obviously it wasnt! They ended up giving me a litre of fluid.
WOW! :o
I know nothing about how that works. But a whole 1000ml back? That is a LOT! (approximately equal to 1kg)
One Time I was cramping so bad I had them give just over 1400cc's back that is nearly a bag and a half of saline. :o
-
Angie, the same gadget that measures kt/v also assesses the fluid situation. However some doctors dont like it. Plus the last time I was on it I went flat, the worst one Ive had so far. And all along the fluid goal looked like it was pretty spot on. Obviously it wasnt! They ended up giving me a litre of fluid.
WOW! :o
I know nothing about how that works. But a whole 1000ml back? That is a LOT! (approximately equal to 1kg)
One Time I was cramping so bad I had them give just over 1400cc's back that is nearly a bag and a half of saline. :o
Holy crap! How could they not notice when your BP was dropping that you were too dry? In my unit they take my BP every 30 min. That is how they know if my dry weight it not set right for that day. Of course they don't like to adjust my dry weight goal too often .. maybe once a week .. IF that ..
-
Angie, the same gadget that measures kt/v also assesses the fluid situation. However some doctors dont like it. Plus the last time I was on it I went flat, the worst one Ive had so far. And all along the fluid goal looked like it was pretty spot on. Obviously it wasnt! They ended up giving me a litre of fluid.
WOW! :o
I know nothing about how that works. But a whole 1000ml back? That is a LOT! (approximately equal to 1kg)
One Time I was cramping so bad I had them give just over 1400cc's back that is nearly a bag and a half of saline. :o
Holy crap! How could they not notice when your BP was dropping that you were too dry? In my unit they take my BP every 30 min. That is how they know if my dry weight it not set right for that day. Of course they don't like to adjust my dry weight goal too often .. maybe once a week .. IF that ..
Whenever my BP gets too low, it seems to only be when they do a standing BP after DX. My ears will ring and I feel woozie. Then I sit back down and if my BP doesn't come up in a few minutes, they'll give me a cup or 2 of water. If the water doesn't work, they give me a cup or 2 of broth. If broth doesn't work, they give me saline, which has only happened 2x in 14 months.
-
Angie, the same gadget that measures kt/v also assesses the fluid situation. However some doctors dont like it. Plus the last time I was on it I went flat, the worst one Ive had so far. And all along the fluid goal looked like it was pretty spot on. Obviously it wasnt! They ended up giving me a litre of fluid.
WOW! :o
I know nothing about how that works. But a whole 1000ml back? That is a LOT! (approximately equal to 1kg)
One Time I was cramping so bad I had them give just over 1400cc's back that is nearly a bag and a half of saline. :o
Holy crap! How could they not notice when your BP was dropping that you were too dry? In my unit they take my BP every 30 min. That is how they know if my dry weight it not set right for that day. Of course they don't like to adjust my dry weight goal too often .. maybe once a week .. IF that ..
I was on nocturnal in centre so you dont check BP overnight. I really dont know why I went flat, but then thats just me, everything weird happens to me.
-
I have over 4kg on me right now after the weekend and I have only slept 2hrs cuz I went to bed late and didn't want to sleep. I feel like crap and also feel heavy. I feel like a water balloon. I don't want to move but I must motivate myself. I wanted to wear these comfy pants that match this top I wanted to wear to dialysis but I haven't left to go to the laundrymat yet and dialysis in in an hour... oh well :(
At least it is only 4kg but I also at 400ml as runback (rinceback) and 300ml tea I bring in on the way there and also add another 200ml for the tea a patients husband brings me an hour and a half later. So that means almost another kilo added .. so it will be a hard day for me today at dialysis.
-
Don't drink all the extra. Just go to dialysis and munch on ice chips. No need to add to the problem. JMO
-
Don't drink all the extra. Just go to dialysis and munch on ice chips. No need to add to the problem. JMO
:2thumbsup; good advice ;D
I am so bad. I get antsy if I sit for 4 hrs and don't stick anything in my mouth. The ice chips DO work but they go too fast :P
-
Ice chips are fluid as well though. Its pretty easy to eat 200ml worth of ice. How on earth are you going to get 5L off? Max I can do in 4hrs is 3L and in 5 hours 3.5L and even then I have trouble.
-
Ice chips are fluid as well though. Its pretty easy to eat 200ml worth of ice. How on earth are you going to get 5L off? Max I can do in 4hrs is 3L and in 5 hours 3.5L and even then I have trouble.
Everyone is different .. I can handle between 4.5 - 5 max myself. It depends however if my dry weight goal is perfect or not ;)
-
Holy crap angie, what UF rate is that? Your max that is.
-
Ice chips are fluid as well though. Its pretty easy to eat 200ml worth of ice. How on earth are you going to get 5L off? Max I can do in 4hrs is 3L and in 5 hours 3.5L and even then I have trouble.
Everyone is different .. I can handle between 4.5 - 5 max myself. It depends however if my dry weight goal is perfect or not ;)
Yep, everyone is different. After a very busy weekend and being Tuesday, I pulled off 8kg today. This was a first for me. I felt fine afterwards. They monitored my blood pressure closely so that if it started going low they could adjust the fluid pull. My dialysate was 790 and my blood flow was 500, runtime is 5 hours. My standing BP after DX was 117/60.
But I certainly don't want to make a habit of gaining and pulling off so much fluid.
-
I have been doing quite badly on weekends, and this weekend in St. Thomas, US Virgin Islands was not different. I came to dialysis with 5.5 over my dry weight. The rule in our centre is that they do not take off more than 4 at any one time. So I came home heavier than my dry weight.
That means I have to be overcareful with my liquid intake.
Boy oh boy...........................
-
Holy crap angie, what UF rate is that? Your max that is.
No the max UF rate at my unit is 5.5kg but I don't like to max out like that because my BP drops.
I have been doing quite badly on weekends, and this weekend in St. Thomas, US Virgin Islands was not different. I came to dialysis with 5.5 over my dry weight. The rule in our centre is that they do not take off more than 4 at any one time. So I came home heavier than my dry weight.
That means I have to be overcareful with my liquid intake.
Boy oh boy...........................
Wow that will be a challenge. I know once when I was 1kg up I kept coming in heavy for the next 2 days :(
-
This weekend I set my record of 3.6 with the washback. looks like I'm a small potato compared to some of you. I try to keep it between 2-3 kg with the washback. I think I would die if I took off 4kg.
-
Holy crap angie, what UF rate is that? Your max that is.
No the max UF rate at my unit is 5.5kg but I don't like to max out like that because my BP drops.
I have been doing quite badly on weekends, and this weekend in St. Thomas, US Virgin Islands was not different. I came to dialysis with 5.5 over my dry weight. The rule in our centre is that they do not take off more than 4 at any one time. So I came home heavier than my dry weight.
That means I have to be overcareful with my liquid intake.
Boy oh boy...........................
Wow that will be a challenge. I know once when I was 1kg up I kept coming in heavy for the next 2 days :(
I mean your actual UF rate per hour, not total UF.
-
I mean your actual UF rate per hour, not total UF.
What is the difference?? ???
-
Total UF is the "total" amount of fluid you want to take off. UF rate is the amount of fluid taken off per hour.
For example, say you want to dial in 3 litres to take off and you are doing 4 hours. Divide 3L by 4hrs and you get 750ml per hour.
Get it now? Im surprised you dont know this considering you are in a self care unit!
-
The main problem is not BP or how much you can handle to take off. The main problem is that those of you doing 3 times in center a week removing 4 or 5 kilos each session are doing damage to your heart. You are ENLARGING your heart and you will suffer from it years down the road. Just ask me I did in-center 13 years and removed about 4 kilos every time and now I have a VERY enlarged heart. This is the one of the biggest problems we patients face is Cardio problems and that is what will "take" a lot of us. They can still dialyze our kidneys long after our heart stops, but would good would it do?
Now that I am home doing dialysis (ilovenxstage.com (http://www.ilovenxstage.com)) 5 or 6 times a week, I remove on average 1.0 to 2.0 kilos each time. Which is much better on your heart. I take off ALL the fluid the first 2 hours (my treatment is usually 2:25) in those two hours I am taking on average only .5 to 1.0 kilo off an hour which is very good and will NEVER cause me to go "flat" or pass out. When I eventually do Nocturnal I will be taking off so little every hour my body would even notice. For example if I am running 8 hours on Nocturnal, and I need to remove 2 kilos, well that is just 0.25 kilos an hour. :o Now imagine if I need to only remove 1.0 kilo in 8 hours. :o
I am not trying to turn this into a Nocturnal thread, it's just that I am trying to prove a point, removing 4 or 5 kilos in 3 hours is VERY bad on the heart and WILL indeed cause damage, if you do it many years. Like I said I am suffering the consequences of it now.
-
Total UF is the "total" amount of fluid you want to take off. UF rate is the amount of fluid taken off per hour.
For example, say you want to dial in 3 litres to take off and you are doing 4 hours. Divide 3L by 4hrs and you get 750ml per hour.
Get it now? Im surprised you dont know this considering you are in a self care unit!
My dialysis machine is different. We don't have dials to dial anything in :P lol
:angel; My Hemo is the Fresenius 2008K
I weigh myself ... and I already know my target for my dry weight is 63.5kg. Then if I go in and my weight is 66.7kg then I know I need to take off 3.2kg (3200ml)in the 3 and a 1/2 hrs I am on my machine. Then I also have to calculate the runback (or rinseback as Americans call it :P) which is 400ml so that brings it up to 3.6kg (3600ml) coming off. Then I must also calculate in my drinks that I have during dialysis ... the tea I bring which is 300ml and also the ice water or tea that someone brings me afterwards during my run is about 200ml. So now that brings me up to 4100 ... just like in this pic I attached. As you can see the UF Rate is 1170 if I have 4.1 taken off of me in 3:30hrs. The machine calculates this for me so I don't have to do any of the division you were talking about ;)
Actually they still haven't taught me everything there is to know for a self care unit :( Seems Canada is understaffed :'( :'( :'( :thumbdown;
66.7
-63.5
--------
3.2
+ .4
--------
3.6
+ .3
--------
3.9
+ .2
--------
4.1
Now that I am home doing dialysis (ilovenxstage.com (http://www.ilovenxstage.com)) 5 or 6 times a week, I remove on average 1.0 to 2.0 kilos each time. Which is much better on your heart. I take off ALL the fluid the first 2 hours (my treatment is usually 2:25) in those two hours I am taking on average only .5 to 1.0 kilo off an hour which is very good and will NEVER cause me to go "flat" or pass out. When I eventually do Nocturnal I will be taking off so little every hour my body would even notice. For example if I am running 8 hours on Nocturnal, and I need to remove 2 kilos, well that is just 0.25 kilos an hour. :o Now imagine if I need to only remove 1.0 kilo in 8 hours. :o
I am not trying to turn this into a Nocturnal thread, it's just that I am trying to prove a point, removing 4 or 5 kilos in 3 hours is VERY bad on the heart and WILL indeed cause damage, if you do it many years. Like I said I am suffering the consequences of it now.
Epoman, that post is sooo informative that I am going to quote you on D&T City with your permission. May I?
-
The main problem is not BP or how much you can handle to take off. The main problem is that those of you doing 3 times in center a week removing 4 or 5 kilos each session are doing damage to your heart. You are ENLARGING your heart and you will suffer from it years down the road. Just ask me I did in-center 13 years and removed about 4 kilos every time and now I have a VERY enlarged heart. This is the one of the biggest problems we patients face is Cardio problems and that is what will "take" a lot of us. They can still dialyze our kidneys long after our heart stops, but would good would it do?
Now that I am home doing dialysis (ilovenxstage.com (http://www.ilovenxstage.com)) 5 or 6 times a week, I remove on average 1.0 to 2.0 kilos each time. Which is much better on your heart. I take off ALL the fluid the first 2 hours (my treatment is usually 2:25) in those two hours I am taking on average only .5 to 1.0 kilo off an hour which is very good and will NEVER cause me to go "flat" or pass out. When I eventually do Nocturnal I will be taking off so little every hour my body would even notice. For example if I am running 8 hours on Nocturnal, and I need to remove 2 kilos, well that is just 0.25 kilos an hour. :o Now imagine if I need to only remove 1.0 kilo in 8 hours. :o
I am not trying to turn this into a Nocturnal thread, it's just that I am trying to prove a point, removing 4 or 5 kilos in 3 hours is VERY bad on the heart and WILL indeed cause damage, if you do it many years. Like I said I am suffering the consequences of it now.
How is taking 0.5-1.0L off per hour BETTER? You can still definitely go flat at that rate. 1L per hour is an excessive UF rate and is no different to doing 1L per hour in centre over 3-4hrs. Obviously gaining only 0.5-1L is excellent as far as the heart goes, but ripping it off at 1L per hour absolutely can cause you to go flat.
-
As to what is excessive fluid removal depends all on the person. Personally 1L is not all that much in an hour. I can easily sweat 1L an hour off working out. Even when my kidneys worked and I had normal fluid balance it was easily to sweat off 2L or more while working out for an hour. So I really see no difference between sweating out 1L a hour over that of a machine taking off 1L a hour.
There is more to going flat than just fluid removal.
Studies have shown that many patients tend to heat up while on dialysis, which has been shown to cause people to go crash. They are not sure why this happens because the body is not actually doing anything physical that would cause the body to heat up. Shorter run time means less time the body heats up. Studies have shown fluid is removed much more easily and there are less episodes of people crashing or having low blood pressure if the machine dialysate temp is turned down. So I would think that the less run time that Epoman has produces less heat and combined with limited fluid removal it helps him from crashing. :twocents;
-
The main problem is not BP or how much you can handle to take off. The main problem is that those of you doing 3 times in center a week removing 4 or 5 kilos each session are doing damage to your heart. You are ENLARGING your heart and you will suffer from it years down the road. Just ask me I did in-center 13 years and removed about 4 kilos every time and now I have a VERY enlarged heart. This is the one of the biggest problems we patients face is Cardio problems and that is what will "take" a lot of us. They can still dialyze our kidneys long after our heart stops, but would good would it do?
Now that I am home doing dialysis (ilovenxstage.com (http://www.ilovenxstage.com)) 5 or 6 times a week, I remove on average 1.0 to 2.0 kilos each time. Which is much better on your heart. I take off ALL the fluid the first 2 hours (my treatment is usually 2:25) in those two hours I am taking on average only .5 to 1.0 kilo off an hour which is very good and will NEVER cause me to go "flat" or pass out. When I eventually do Nocturnal I will be taking off so little every hour my body would even notice. For example if I am running 8 hours on Nocturnal, and I need to remove 2 kilos, well that is just 0.25 kilos an hour. :o Now imagine if I need to only remove 1.0 kilo in 8 hours. :o
I am not trying to turn this into a Nocturnal thread, it's just that I am trying to prove a point, removing 4 or 5 kilos in 3 hours is VERY bad on the heart and WILL indeed cause damage, if you do it many years. Like I said I am suffering the consequences of it now.
Epoman, I'm starting NxStage in December but I didn't know nocturnal was an option with it. Why haven't you started nocturnal already? Do you need a partner to stay awake during the night to watch you?
-
Total UF is the "total" amount of fluid you want to take off. UF rate is the amount of fluid taken off per hour.
For example, say you want to dial in 3 litres to take off and you are doing 4 hours. Divide 3L by 4hrs and you get 750ml per hour.
Get it now? Im surprised you dont know this considering you are in a self care unit!
My dialysis machine is different. We don't have dials to dial anything in :P lol
:angel; My Hemo is the Fresenius 2008K
I weigh myself ... and I already know my target for my dry weight is 63.5kg. Then if I go in and my weight is 66.7kg then I know I need to take off 3.2kg (3200ml)in the 3 and a 1/2 hrs I am on my machine. Then I also have to calculate the runback (or rinseback as Americans call it :P) which is 400ml so that brings it up to 3.6kg (3600ml) coming off. Then I must also calculate in my drinks that I have during dialysis ... the tea I bring which is 300ml and also the ice water or tea that someone brings me afterwards during my run is about 200ml. So now that brings me up to 4100 ... just like in this pic I attached. As you can see the UF Rate is 1170 if I have 4.1 taken off of me in 3:30hrs. The machine calculates this for me so I don't have to do any of the division you were talking about ;)
Actually they still haven't taught me everything there is to know for a self care unit :( Seems Canada is understaffed :'( :'( :'( :thumbdown;
66.7
-63.5
--------
3.2
+ .4
--------
3.6
+ .3
--------
3.9
+ .2
--------
4.1
Now that I am home doing dialysis (ilovenxstage.com (http://www.ilovenxstage.com)) 5 or 6 times a week, I remove on average 1.0 to 2.0 kilos each time. Which is much better on your heart. I take off ALL the fluid the first 2 hours (my treatment is usually 2:25) in those two hours I am taking on average only .5 to 1.0 kilo off an hour which is very good and will NEVER cause me to go "flat" or pass out. When I eventually do Nocturnal I will be taking off so little every hour my body would even notice. For example if I am running 8 hours on Nocturnal, and I need to remove 2 kilos, well that is just 0.25 kilos an hour. :o Now imagine if I need to only remove 1.0 kilo in 8 hours. :o
I am not trying to turn this into a Nocturnal thread, it's just that I am trying to prove a point, removing 4 or 5 kilos in 3 hours is VERY bad on the heart and WILL indeed cause damage, if you do it many years. Like I said I am suffering the consequences of it now.
Epoman, that post is sooo informative that I am going to quote you on D&T City with your permission. May I?
Sorry angie, didnt mean to confuse you lol I dont have to calculate my UFR either, the machine does that. However, I know if I go over a certain rate, I will most definitely go flat or feel like total shit. At the moment anything more than 600-700ml/hr drops my BP. The only time I have done 1L or more per hour is in the HDU with them monitoring it and me laying upside down.
-
As to what is excessive fluid removal depends all on the person. Personally 1L is not all that much in an hour. I can easily sweat 1L an hour off working out. Even when my kidneys worked and I had normal fluid balance it was easily to sweat off 2L or more while working out for an hour. So I really see no difference between sweating out 1L a hour over that of a machine taking off 1L a hour.
There is more to going flat than just fluid removal.
Studies have shown that many patients tend to heat up while on dialysis, which has been shown to cause people to go crash. They are not sure why this happens because the body is not actually doing anything physical that would cause the body to heat up. Shorter run time means less time the body heats up. Studies have shown fluid is removed much more easily and there are less episodes of people crashing or having low blood pressure if the machine dialysate temp is turned down. So I would think that the less run time that Epoman has produces less heat and combined with limited fluid removal it helps him from crashing. :twocents;
Sweating and UF-ing on dialysis are completely different. When you go flat on Dx, it is because the fluid shifts in the cells cant replace lost fluid into the bloodstream as quick as it is being removed.
-
You dont need anyone to watch you overnight Russ. It might not be the same in your area but over here, you go home on day time dialysis for a couple of months (sometimes less) and then you will be bought in for 2 nights to train for nocturnal. There isnt a great deal of a difference as compared to day time Dx. Just a few little things. Again I dont know if NxStage is different, I am guessing you might need alot more fluid bags. The important thing is that you are keeping an eye on any weight loss or gain, and your BP. We are not to run at a UFR of more than 400ml/hr so you dont go flat. I am a little sceptical though, as I have gone flat on nocturnal once, I am just glad it was at the hospital.
-
Sorry angie, didnt mean to confuse you lol I dont have to calculate my UFR either, the machine does that. However, I know if I go over a certain rate, I will most definitely go flat or feel like total shit. At the moment anything more than 600-700ml/hr drops my BP. The only time I have done 1L or more per hour is in the HDU with them monitoring it and me laying upside down.
Well I can handle 1 - 1.5L/hr easily. Everyone is different. I don't know if you are smaller than me (I am 5'5" 138lbs) but I just know what I can handle.
-
You dont need anyone to watch you overnight Russ. It might not be the same in your area but over here, you go home on day time dialysis for a couple of months (sometimes less) and then you will be bought in for 2 nights to train for nocturnal. There isnt a great deal of a difference as compared to day time Dx. Just a few little things. Again I dont know if NxStage is different, I am guessing you might need alot more fluid bags. The important thing is that you are keeping an eye on any weight loss or gain, and your BP. We are not to run at a UFR of more than 400ml/hr so you dont go flat. I am a little sceptical though, as I have gone flat on nocturnal once, I am just glad it was at the hospital.
I may be out of luck in doing nocturnal with NxStage as nobody in the Chattanooga area offers nocturnal training (on any type machine) at this time.
-
Sweating and UF-ing on dialysis are completely different. When you go flat on Dx, it is because the fluid shifts in the cells cant replace lost fluid into the bloodstream as quick as it is being removed.
I am sure there are some finer points to it and I agree they are different, however only to the degree of the process IMO.
The results end up being the same for too much fluid being removed, and not being replaced, which results in reduced blood volume. Cramping, nausea, low bp.
From my understanding one process is where the blood takes its fluid from the interstitial space (dialysis) and the other is where the interstitial space takes if from the blood (sweating).
-
As far as I know, fluid can move from tissue to your blood at a maximum of 400 ml per hour. So if you UF rate is bigger than that you are always going to lose fluid from your plasma as the body can not shift it fast enough from the tissue. This is what causes your BP to drop as your blood actually loses volume. If you are well balanced you will have a similar pre and post BP.
-
Ya mine drops near the end but since I am no longer on BP meds it doesn't drop below 100/60
-
As far as I know, fluid can move from tissue to your blood at a maximum of 400 ml per hour.
Is this a fact or is this what you are let to believe? Can you tell me how you came across this information?
-
Sorry angie, didnt mean to confuse you lol I dont have to calculate my UFR either, the machine does that. However, I know if I go over a certain rate, I will most definitely go flat or feel like total shit. At the moment anything more than 600-700ml/hr drops my BP. The only time I have done 1L or more per hour is in the HDU with them monitoring it and me laying upside down.
Well I can handle 1 - 1.5L/hr easily. Everyone is different. I don't know if you are smaller than me (I am 5'5" 138lbs) but I just know what I can handle.
Holy crap angie, I dont even know if they allow UFs that high here, unless its in HDDU. I am bigger than you, and have low BP at the moment. I still dont go over 700ml though, even thats too much, makes me feel like Ive been hit by a truck.
-
As far as I know, fluid can move from tissue to your blood at a maximum of 400 ml per hour.
Is this a fact or is this what you are let to believe? Can you tell me how you came across this information?
I found this site which is good at explaining how dialysis works. This is the link to the rate fluid moves between cells.
http://www.nocturnaldialysis.org/lowbp.htm
-
As far as I know, fluid can move from tissue to your blood at a maximum of 400 ml per hour.
Is this a fact or is this what you are let to believe? Can you tell me how you came across this information?
I found this site which is good at explaining how dialysis works. This is the link to the rate fluid moves between cells.
http://www.nocturnaldialysis.org/lowbp.htm
EXTREMELY good link!! :thumbup; :2thumbsup; :thumbup; :2thumbsup; :thumbup;
-
I found this site which is good at explaining how dialysis works. This is the link to the rate fluid moves between cells.
http://www.nocturnaldialysis.org/lowbp.htm
Thanks AlasdairUK. Very informative link. :thumbup;
-
As far as I know, fluid can move from tissue to your blood at a maximum of 400 ml per hour.
Is this a fact or is this what you are let to believe? Can you tell me how you came across this information?
That number is still true for some. That was evidently one of the reasons patients were told not to drink more than 1-1.5 kilos between treatments. So that fluid transfer between interstitial space and the blood was kept in check.
However it doesn't take into account that patients are over-hydrated and have a greater blood volume than normal at the start of dialysis. Also that larger patients have more interstitial space to release fluid from and therefore are able to release more than 400ml per hour back to the blood.
This makes it important that patients, especially those that drop bp, be monitored with a crit-line or similar machine to make sure they are at a true dry weight and that the fluid is coming off in a manner that does not drop blood volume too fast for the interstitial spaces to release fluid back into the blood. This does not seem to be a common thing done for many patients.
A true dry weight (ideal) is a weight where one would be without kidney failure. Meaning that after dialysis if one was to work out they could sweat a liter off without having any affects of low blood volume (low bp).
-
You made an important point, BigSky.
Also, with the more modern dialysis machines, there is UF modeling, where the UF automatically changes from higher to lower throughout the treatment to help the body adjust in the transfer between interstitial space and the blood.
And remember, with some high flux filters, setting the UF below 300 ml/hr is not recommended due to backfiltration concerns.
-
A true dry weight (ideal) is a weight where one would be without kidney failure. Meaning that after dialysis if one was to work out they could sweat a liter off without having any affects of low blood volume (low bp).
Really? But they seem to like to get you at a weight just at that point where your BP starts to drop .. that is what I found anyway
-
Some Kidney machines allow you to be profiled in which means you can take the fluid of more gentle at the end of dialysis. So no cramps or feeling sick. I have most of my fluid taken off in the first two hours. But just now I am trying to keep my fluid intake to a bare minimal because of the pain in my leg while on dialysis.
-
Some Kidney machines allow you to be profiled in which means you can take the fluid of more gentle at the end of dialysis. So no cramps or feeling sick. I have most of my fluid taken off in the first two hours. But just now I am trying to keep my fluid intake to a bare minimal because of the pain in my leg while on dialysis.
How's it doing, Kev? Is the pain only while on dialysis, or is it chronic, and dialysis just makes it worse?
-
I have been having a very hard time recently. Earlier this year, I was only gaining 1.5 - 2 kilos between sessions. All of a sudden, my liquid gain is 4 - 5 kilos. The problem with this is that I am experiencing cramps, low blood pressure and dizziness. I am trying hard to restrict my fluids, but it has gotten really difficult for me. I asked them to up my dry weight, but the last session I still had the problems. In fact, for the last three sessions they did not even remove all of the liquid.
It is as if I have to start from square one and learn to regulate my fluid intake.
-
Been there, done that, too. I thinkt he body self regulates and will grab all the fluid it can sometimes. I find I have to adjust my habits to make up for it. Sometimes you have to start over and look at what you are doing. Remember your body goes wonky because of dialysis.
-
Yesterday my nice nurse ran me through all the profiles on the machine. Very cool really! She said "I like to use profile 6" (the one that stops and starts, and takes the most off earlier so you end up taking hardly any off).. it was interesting to see the chart with the different profiles and what they do. Good idea really!
-
Yesterday my nice nurse ran me through all the profiles on the machine. Very cool really! She said "I like to use profile 6" (the one that stops and starts, and takes the most off earlier so you end up taking hardly any off).. it was interesting to see the chart with the different profiles and what they do. Good idea really!
Those UF controls are very good. I use #3.
-
Yesterday my nice nurse ran me through all the profiles on the machine. Very cool really! She said "I like to use profile 6" (the one that stops and starts, and takes the most off earlier so you end up taking hardly any off).. it was interesting to see the chart with the different profiles and what they do. Good idea really!
I wish MY Nurses would go through all the profiles with me. I have just barely seen them but I know they are there. The UF profiles .. I don't have one. It is the same throughout the 3 1/2 hrs I am on. I only have a sodium ramp.
-
Well my nurse said to me that they in general only use the main profile (as in a consistent UF rate).. some seem resistant to use any other profiles (I have no idea why) but my nice nurse ihas a lot of experience in Dialysis and she knew immediately to use profile #6 for me and it worked pretty well I have to say.
-
Sodium modeling, as well as Ultrafiltration modeling are usually determined by a Doctor's order, so Nurses (except a Nurse Practitioner) might be reluctant to make those changes. Unfortunately, some Nephrologists don't want to be bothered with the variations.
-
I use the Fresenius 5008 hemodiafiltration dialysis and you do not have sodium modelling as you receive replacement fluid.
On my machine there are three profiling options:
1) starts taking off fluid at the highest rate and drops off on a continuous basis throughout. Used on people who have stable BP.
2) starts taking fluid off at the highest rate, but keeps the rate for each hour and drops down for the next hour. Normally used on people who tend to have there BP drop as keeping the same UF rate for each our allows the BP to stabilize.
3) the stop, start approach to taking off fluid. Used on diabetics who release fluid from tissue to plasma at a slower rate than non diabetics. The stop in UF allows fluid from the tissue to move into the plasma. If you kept taking off fluid then you would cause the blood volume to drop and the BP would crash.
-
Interesting. I'm not a diabetic though they always ask. My nurse did mention the "fluid moving" thing which was one reason to have it stop for 30 mins (well, what my machine did was start at 2500/hour for 30 mins, then 100 for 30 mins, then 2000 for 30 mins, then back to 100 for 30 mins, and so on)... so it doesn't quite stop, though 100mils/hour for 30 mins is only 50 ml taken off in that time, which is next to nothing.
-
I use the Fresenius 5008 hemodiafiltration dialysis and you do not have sodium modelling as you receive replacement fluid.
On my machine there are three profiling options:
1) starts taking off fluid at the highest rate and drops off on a continuous basis throughout. Used on people who have stable BP.
2) starts taking fluid off at the highest rate, but keeps the rate for each hour and drops down for the next hour. Normally used on people who tend to have there BP drop as keeping the same UF rate for each our allows the BP to stabilize.
3) the stop, start approach to taking off fluid. Used on diabetics who release fluid from tissue to plasma at a slower rate than non diabetics. The stop in UF allows fluid from the tissue to move into the plasma. If you kept taking off fluid then you would cause the blood volume to drop and the BP would crash.
Wow an amazingly awesome and INFORMATIVE post!! I would love to read MORE of THESE!! :clap; :2thumbsup; :2thumbsup; :2thumbsup;
-
When I was having low BP problems I tried profile 5 which was UF at 100ml/hr for 30 mins then 950ml/hr for 30 mins and so on. It did make a difference. However I am surprised that I held up during the 950ml UFR.
-
We have the new Fresenius machines. I tried profile 3 the other day. I like the profiel that takes it all off at the beginning and lets the body recover at the end of the run.
-
We have the new Fresenius machines. I tried profile 3 the other day. I like the profiel that takes it all off at the beginning and lets the body recover at the end of the run.
Same here. :)
-
We have the new Fresenius machines. I tried profile 3 the other day. I like the profiel that takes it all off at the beginning and lets the body recover at the end of the run.
That's the one I want to try but they don't wanna let me play with my settings without the Neph saying which one to do and give the ok after looking at enough BP drops over a 2 month time period.
-
We just go the new fresenius machines about 3 weeks ago. Previous to that we were using a brand called Braun.
I always was coming into the unit with 3-4 kilos on. My blood pressure would be a little high sometimes but would lower by the end of treatment. Lately, after the new machines I was coming in with 1-2 kilos on. Now the past week and a half I've come in under 1 kilo and my blood pressure is sky high. It is still high even after dialysis. I think today it was 146/113....I think, thats afterwards.
That just seems crazy to me. I can't believe how little I put on and still have high blood pressure. All I've had today to drink is half a bottle of mt dew.
I think 3-4 kilos in pretty normal for most people. Every now and again I hear my nurses talking and I've heard people coming in with 8-12 kilos. I don't see how someone can do that during the weekend, on the weekend maybe.
-
my husband used to gain 3-4 during the week, and 5 -7 on the weekends...he was miserable. Then he found out if he goes outside and works very hard for a few hours every day, then works out for another hour, he sweats enough to double what he can drink and he goes in at 1.5-2.5 during the week, and 3-4 for the weekend. And we will have the prettiest lawn on the block!! ;D
-
And we will have the prettiest lawn on the block!! ;D
Talk about a silver (or in this case, green) lining! :)
-
under 4 is good for me, working on 2.5. I'm in an apartment building so i miss sitting back and admiring the lawn i used to cut and trim, now it looks bad after 16yrs., well it looked bad the very next yr.
-
a weigh around 45.6 kg between that a 50, sometimes 60kg , how much water do you think I should be drinking during the week / weekend? Also , If I ate nothing , and only drank water... wouldn't that mean I have more freedom in drinking what I want because my weight wouldn't go up so much? Totally opposite of my quesiton on the other board, but if someone could answer it , that would be cool,
-
a weigh around 45.6 kg between that a 50, sometimes 60kg , how much water do you think I should be drinking during the week / weekend? Also , If I ate nothing , and only drank water... wouldn't that mean I have more freedom in drinking what I want because my weight wouldn't go up so much? Totally opposite of my quesiton on the other board, but if someone could answer it , that would be cool,
Am I reading this right? Your dry weight is 45.6kg but sometimes you weigh in between 50-60kg?? No that can't be right ??? That would be like 10+kg gain!
As for your second question.. isn't that kind of moot.. if you don't eat you'll waste away (and if your IDW really is 45.6 that's pretty darn lean for a strapping young lad?!) well you won't get enough nutrients in to keep you going. I suppose if you missed the odd meal (not recommended) you wouldn't put on as much, but remember this just means over time you'd probably lose body weight (as opposed to fluid weight) which probably isn't good for you in the longer run when the aim is to maintain a healthy IDW. I understand what you're saying (trust me I would do anything I could to be able to drink more!!! :) ) but this would not be a healthy way to approach it IMHO.
-
If you are working out, you need the calories and the protein to maintain/build muscle mass. Otherwise your body will start "cannibalizing" muscles for calories & protein.
BTW Nepro makes a great post-workout recovery drink!
-
Also , If I ate nothing , and only drank water... wouldn't that mean I have more freedom in drinking what I want because my weight wouldn't go up so much? Totally opposite of my quesiton on the other board, but if someone could answer it , that would be cool,
As you said your other thread you want to gain weight not lose it.
If you are working out, you need the calories and the protein to maintain/build muscle mass. Otherwise your body will start "cannibalizing" muscles for calories & protein.
BTW Nepro makes a great post-workout recovery drink!
Very good point Trikkechickk about muscle mass. And consuming protein after a workout is very important.
I use one of the other renal supplements, Novasource Renal after workouts and after hemodialysis. Pretty much the same as Nepro, but without the sugar alcohol. I also use Zone Perfect bars and Whey protein shakes.
8)
-
I'm stealing Zachs words from a while ago. You need to make sure that you eat enough protein and calories in a day. I used to cycle 11 miles to work and then to dialysis and ride home after haemo. It is really important to watch your diet and eat enough protein, which can be tricky, so dring protein shakes or eat protein bars.
There is a lot of information on the board already, I followed Zach's advice and it kept me fit and health until I had a transplant.
All the best,
Alasdair
-
Well, I hit one of my high numbers after my weekend in Las Vegas. I didn't have dialysis for 4 days. I went Wed,Thur and didn't have until Tues, Wed before i got back on my usual MonWedFri. I weighed in at 6kg above my dry weight. They took off 4kg and the next morning i had 2.4kg on so I was back on stream. I think I only had that kind of gain once before.
-
I'm stealing Zachs words from a while ago. You need to make sure that you eat enough protein and calories in a day. I used to cycle 11 miles to work and then to dialysis and ride home after haemo. It is really important to watch your diet and eat enough protein, which can be tricky, so dring protein shakes or eat protein bars.
There is a lot of information on the board already, I followed Zach's advice and it kept me fit and health until I had a transplant.
All the best,
Alasdair
Alasdair,
Good to see you on the board.
And thanks for the kind words.
8)