Iliostomy and Dialysis

RECAP My Mother is a Home Hemo Patient with an illiostomy. She has had multiple problems with dialysis for the past 5 years most caused from dehydration and electrolyte imbalance

Finally! The doctor listened to me regarding my mothers illiostomy. This is the 3rd time she has been put in the hospital due to severe dehydration. When I got her to the hospital, her stomach was on fire, and her BP was 58 over 40. They loaded her for 2 days with fluids, I was scared to death she was going to suffer from volume overload. They tried 3 times to do a stick cath to get a sample from her bladder, (she still produces a small amount of urine) and her bladder was dry. This was after 2 liters of fluids had been pumped into her. They finally gave up on the urine sample and focused on the dehydration. She was somewhat stabilized after 2 days so I went home for some sleep. They called me after 6 hours and told me she was in ICU, her BP was not stabilizing. So I went back to see what was going on. She had flatlined because her BP dropped so low. They revived her, but she had no idea any of this was going on. She was pretty much unaware of anything that had happened. By the time I got to ICU, they were trying to get her set up for dialysis. I walked in to find the techs had her hooked up to a dead graph and could not figure out why they could not get blood.

I showed them the graph they were suppose to be using and they finally were able to successfully canulate and get things started. Her BP was up to 78/50. While on dialysis, there were no fluids drawn, other than rinse back. They had the machine set to pull .5 liters, what it should take to prime and rinse back. The final draw was actually only .3 by the end of dialysis. They had given her an additional .6 because her BP kept dropping. While all of this was going on, she was needing her ostomy bag emptied because it was filling with fluid. This happens usually after dialysis but because there was so much going in, it became very active. After all was completed, she weighed 73.4 Kilo. She started at 74.2 Kilo. Remember, they were not drawing any fluids. Her weight should have been the same if not more. She put out 1.2 Kilo in fluids during dialysis. When I told the Dr this, it was like a lightbulb going off over his head. I have been telling him for 4.5 years that the ostomy was putting off fluids and should be considered when determining her fluid draw during dialysis. He kept saying it had no impact. Guess what. It does now. He finally realized that what SHE experiences from dialysis is an overabundance of fluid release thru her ostomy. She daily outputs more fluid thru her ostomy on a normal day than I do thru my bladder daily. Those of you out there who have an ostomy bag...keep talking to your doctors about the amount of fluids you pass thru your ostomy. IT DOES MAKE A DIFFERENCE. She is to no longer draw additional fluids during dialysis, only ultrafiltration.

Just a note to all of you IHD veterans who advise and share with us caregivers and newbies. It is your support and advice that gave me strength to stand up to these doctors and tell them what they should already have known. Fluid is Fluid. It doesn't have to come thru the urinary tract to be disposed of.

EDITED: Thread moved to proper section: "Dialysis: General Discussion" jbeany, Moderator