'Fluid Overload' cost us a patient

[Bajanne]

Last week when I went to dialysis, I was shocked and saddened to hear that a patient on my shift had passed away.  She had gone to visit some daughters in the US (that is where she had started dialysis), was seemingly in good health(for a dialysis patient) and was to be gone for a month.
I asked a nurse what had happened and she said that she had fluid overload and her heart and lungs were affected.  Someone else recently told me it was pneumonia.
I am posting this to encourage all of us, especially those on haemodialysis, to be careful with this fluid challenge.
I remember when we lost Jamie from Canada, in the early days of IHD.  He would be 7 and 8 kilos over his dry weight regularly.  That was a wake-up call for me.
Please care yourselves.

[Romona]

  I am sorry you lost someone. It is lick a punch in the gut when people going through the same things kidney patients do die.

[willieandwinnie]

Oh Bajanne, I was sadden to read this and you are right, that is a wakeup call if there ever was one. 

[RightSide]

I am so sorry you lost a comrade in the battle against this disease. 

Fluid management is vitally important.  For those who can still urinate somewhat, cutting sodium intake to below 1000 mg daily can really help.  I've cut my sodium intake below even that, down to the point that my blood test shows my blood sodium level to be slightly below normal.  At that level, fluid management is MUCH easier.

[Rerun]

Good reminder, thanks Bajanne and sorry about your friend.

               

[monrein]

I too have seen this happen and it's an awful thing.  A nurse got really angry with a patient in our centre one time because she was so overloaded and was always coming in like that.  I talked to the nurse about how harsh she had seemed with the patient and to my surprise the poor nurse started to cry quietly and said she'd seen several patients over the years do this to themselves with salt and fluid and the deaths were so difficult because they were unavoidable.   She felt so helpless that it turned into quite a harsh approach that really "looked" uncaring but it was in fact just the opposite.

[jpearce]

Overloading is so easy!!! but the problem is with me my body handles it in 6 months i've gone from 92 kilos to 108 I feel the difference but the dr. continue to increase it because " my body handles it" I don't cramp or get sick when they take 5 kilos off 

[Chris]

I remember getting pneumonia while on dialysis twice, I hated that feeling. I had fluid overload once because they forgot to tell me to come in on a different day  due to holiday schedule and it was a long way till next dialysis, that was a bad feeling also, bu it was just a bad feeling all around at my first dialysis center.

I wish they had those 8 oz cans of soda back then which would have helped me more with fluid restriction.

[kitkatz]

Overloading is so easy!!! but the problem is with me my body handles it in 6 months i've gone from 92 kilos to 108 I feel the difference but the dr. continue to increase it because " my body handles it" I don't cramp or get sick when they take 5 kilos off 

The same thing has happened to me over the past year. Just up the weight over and over. I cannot believe I am as heavy as I am now.

[jpearce]

Overloading is so easy!!! but the problem is with me my body handles it in 6 months i've gone from 92 kilos to 108 I feel the difference but the dr. continue to increase it because " my body handles it" I don't cramp or get sick when they take 5 kilos off 

The same thing has happened to me over the past year. Just up the weight over and over. I cannot believe I am as heavy as I am now.

Are you finding it's becausse of hemo did you have more  control when you did PD? I go for my assessment on wed this week to se if I can get PD

[kitkatz]

I have never done PD so I cannot answer your question.

[nick]

Bajanne  sorry for friend lost, yeah that is our wake up call.. just like what happen to me last year... so strange i been dialysis monday then i got water on my lungs the other day i drink 500ml on that time then i cant breath my friend told me lets go to hospital iam getting pail unconscious my BP went to down not stable so they put me on emergency dialysis  they told me its a FLASH EDIMA? what is that can anyone explain it

[kidneydoc]

Wow sorry to hear that. Always remember you have to be more careful when you are outside of your normal routine.

Visiting friends vacation etc.

Never take chances once you notice any difficulty breathing in a dialysis patient that is an emergency. Never wait until the morning... Never wait until someone comes home or wait to see if it gets better. If you difficulty breathing then you need help now!.

[Melissa]

Bajanne  I am so sorry to hear about your friend.  What sad news.

Nick, I had an episode of Flash Edema 3 years ago - super scary.  It is when excess fluid suddenly enters the lungs, mine was due to a very sudden increase in blood pressure which forced the excess fluid into my lungs.   In my case I had been traveling, and was not getting down to my dry weight at the unit I visited - partly due to the fact that I had lost a couple of pounds and partly their fault.  I had shortness of breath, and complained but noone addressed it.  A week later I woke up in the middle of the night gasping for breath and coughing fluid.  I could not speak, so I could not call for help.  My neighbor had taken a sleeping pill so I couldn't wake her up - drove myself to the hospital!!  Just in time too....
I also ended up with pneumonia after that episode.
Keep track of your fluids closely, and once you know how you feel when you are overloaded and what you can handle you can ask them to take a little more off.  I have a problem keeping weight on, so I am always asking them to challenge me a bit.  I'd rather risk a low blood pressure than having that edema....
glad you are ok.

[Stacy Without An E]

Sorry for your loss at the clinic.  Those are hard to take.

We have a guy I call J.K. Simmons Guy (he's a somewhat larger version of the actor) and the doctor had to force him to come in six days a week because he would always come in 7-8 kilos over.  Even on my worst day I couldn't reach those levels even if I tried.  He always gets cramps and is standing and doing the Cramptacular Dance to alleviate them.  Often I hear him getting off early because his body can't take this see saw of fluid removal.

Fluids don't seem dangerous, but if the fluid isn't removed you could drown in your own toxins.

Unfortunately, J.K. won't listen to anyone and he'll most likely suffer endlessly, or until the end is reached.

[RichardMEL]

Stacy gives an example which I really don't understand. I mean I understand him but I do not understand guys like he describes that just don't seem to be able to understand or adhere to the fluid (or diet) restrictions that are so important - specially in hemo.

I mean I would have thought it would even be as simple as "I don't want to cramp again!" and KNOWING that it's the fluids that are doing it to think "Well gee, if I drink less I might not cramp and things will be more comfy for me" - yes, there are times when I am DYING to down a bottle of ice water... but I know that for the short term enjoyment of that I could well pay at the next session if I put on too much. I can't remember the last time I had to take off more than 3kg and I don't think I've had a cramp for about 6 months(and that was because we unwisely decided to take the dry weight down.

It just seems so destructive to me when I see guys like this.. when this is something you CAN control (not easy sometimes I absolutely understand!) but it is one of the few things you CAN do something about.. and some people just refuse to... and the consequences could be deadly.. and that's sad in my view.