Anxiety during treatment

[jessshar]

Twice now in the past week I have been called back to the dialysis center because my Dad is having anxiety problems. Last week I got there and gave him his pill (.25 xanax) and he seemed to improve. But tonight it did not even help. He seemed to get worse and worse. And as much as I know I shouldn't have I let him get off the machine early. He only got in 2 hr and 45 min- a full treatment for him is four hours. He was practically in tears and ready to remove the needles himself. Nothing I said or did seemed to help calm him down. I think maybe he suffering like this because of the holidays. They have changed everyones schedule to try to give everyone Christmas and New years day off and he has seemed to suffer more with memory problems since his kidneys failed- so things aren't what he is used too.

I am planning on calling his Doctor first thing in the morning to see what else I can do for him. I want him to be comfortable during his treatment. And just as important I don't ever want to take him out early again-EVER. Its too important for him to stay for the full treatment. Plus I don't want him to think he can get me to take him home early too(try to take advantage of the situation) I'm not saying he will but I wouldn't put it past him; he never wants to go. But I always make him.

I understand it can be difficult to sit for four hours. So do you guys have any suggestions on what may help him stay calm during treatment? Is it normal for people to have anxiety like this during treatment? His pulse was racing even after the pill. His bp was 95/52 (low for him) and pulse was 102( he usually is around 80) Maybe I can give him the pill right before he starts treatment? Any suggestions or advice would be greatly appreciated.

[girliekick]

i think its a good idea to take the pill before he goes to the center, make sure the staff knows. Ask doc if there are diff meds that may work better. Hemo pulls out some meds. Good luck wish i was of more help.
Girl

[jbeany]

Does he have anything to keep him occupied during the treatments? 4 hours of TV alone is not enough.  Can you call him on a cell or have someone stay with him?  Have you tried the Benedryl that knocks most people out so they can just sleep thru treatments?

[jessshar]

Thanks for your suggestions. I talked to his Doctor this morning and they suggested I give him a pill before he starts and leave one with them in case he needs one during treatment. We will see what happens on Tuesday. I'm going to stay with him for a bit when he starts to make sure he is ok during the treatment. This may sound mean but I do not want to stay with him during the whole treatment because I don't want him to become reliant on me being there through out the whole thing. I'm his primary caregiver and this is the only time I have to myself during the week. I get twelve hours off a week to see my kids, husband, shopping etc.

I will see if I can get him to start reading again. I agree that four hours is a long time to be occupied with TV alone. I will think about the Benadryl. I don't like to mess with his sleep cycles. In the past we switched his time he went in because he would nap during treatment and then wake up bight eyed and bushy-tailed at three in the morning! So far the night time treatment has worked out well for him.

Every day I thank God I have him in my life but I also thank God for this website! I have learned so much from coming here and it helps so much being able to post and get such great feedback from others going through dialysis. Thankyou all so very very much.

[Bub]

I really was glad to see this topic posted.  I too have had something close to panic attacks during treatment and have once or twice demanded to be taken off early.  The charge nurse wanted to know why so she could chart it and the best I could describe it was  the heebie jeebies.  I had a xanax prescription for al while as a sleep aid, but had it canceled and was given trazadone to help me sleep.  Never had enough to use at dialysis although I really thought every one should have a xanax before treatment.

I wish I had some helpful advice, but not sure what to tell you.  Good luck.  I admire you for the loving care you are providing your father.

[girliekick]

I agree you should take some time for yourself, there are lots of things that can cause anxiety during a treatment, so make sure you are listening real close. IE make sure he feels safe, and as if he has a good re-pore with the staff.
Good Luck
Girl

[mikey07840]

I had panic attacks while getting dialysis two times in the hospital. I did not know that they were panic attacks, I had never had them before. I was given a prescription of 0.5 mg of Xanax to take 15 minutes before each dialysis treatment. I take it every time and have not had a problem since I started taking the Xanax. I only take it before dialysis.

I hope this helps.

[jdwills83]

I am glad to see this posting as well. I first complained of anxiety when I started coming off treatment early because of it.  First my doctors assistant prescribed me an anti-depressant for me to take all the time.  This did not go over well with me because I was not having anxiety all the time. Most of the time my anxiety didn't start till my blood pressure started dropping while I was on treatment.  Now I have nothing for anxiety and the nurses don't really seem to care that I coming off early all the time.

[karen547]

I'm glad someone brought this up! I have experienced Panic Attacks at dialysis as well! First my blood pressure will plunge real low, and then the sweating and heart racing begins. After that I start to cry sometimes.... embarassing yes. I was prescribed Prozac, and that did help for awhile, but I found that it didn't help all that much as it is an anti-depressant which I know can be used as both that and an anti-anxiety pill, but for me it just wasn't cutting it. I asked my Primary Doc to give me Lorazepam, and that seems to help quite a lot better.
I take 1mg prior to treatment and I haven't had a panic attack in sometime!

[Epofriend]

Several have noted that, first, their blood pressure begins to drop. Is the anxiety attack your body's way of noting that you are in a crisis - too much fluid being removed? Consider it. Dry weight determination is an elusive art.

[jessshar]

Thanks everyone for all the input!!! He describes it as the "heebie jeebies" too. We both have a good relationship with everyone who works there. I make sure I have a good relationship with anyone who has anything to do with his medical care. His health is too important.

It did happen again last night during treatment. He was fine until about a half an hour before he was supposed to get done. They called me and I could hear him demanding I come get him! When I got there they had already giving him another pill and he seemed to calm down when I showed up. We will figure out when is the best time to "Juice" him up( thats what he calls it)

Thats a good point about too much fluid being removed. This is something that has only started happening recently and his BP does get low during the treatment. As a matter of fact we recently had to take him off of two of his BP meds because his BP was starting to stay quite low all the time. I will keep you posted! Thanks for all the help guys!!!

[sullidog]

I've had the same problems, I also get wrestless legs on dialysis as well. Doc put me on 1 mg of clonopen which helps but makes me sleepy.
Troy

[MattyBoy100]

I always suffer anxiety and panic towards the end of dialysis...

I have no explanation for it and am glad someone put this thread up.  My doc referred me to a psychiatrist as he thought it was down to me not being in control cos I was sat in a chair for 4.5 hrs.

I think he just fobbed me off cos he didn't have an answer.  The psychiatrist put me on an anti depressant which seems to help but it just makes my attacks milder!

I will ask him for something stronger now.  Glad I am not the only one suffering this as it seems totally irrational at the time and I have no way of controlling it!

M

[RichardMEL]

very interesting. There seems to be a corelation between his low BP and the panic attacks. low BP is usually a sign that you're too dry (ie: too much fluid off) so perhaps they need to reassess his dry weight. Maybe do a crit line on him, or just bump it up. Has he been eating more lately that he may have put on more body weight(specially over the holidays)?

I agree with the others too - you need the time for yourself as much as he needs dialysis time. It's not being mean to leave him (and hell sitting at D is boring enough for us - for a caregiver it would be sheer hell of boredom!!!).

I'd investigate stuff like his dry weight rather than just trying to band-aid it with a med like xanax - I mean clearly there's a cause and I reckon that should be looked into because something's changed and as others have postulated it could well be related to too much fluid being taken off.