Confused about kt/v doing 2 days a week

[wvgirl]

I am in center 2 days a week 3 hours each day. My doctor tells me my dialysis numbers are great, but since going on 2 days a week I feel like . I am slowly getting more tired, occational nausea and achy all over, especially my lower back and legs. I tell the doctor this, but he doesn't seem to hear me. My kt/v is 1.77, which is good but I have been reading on the NKF website that when doing 2 days it should be over 2. My protein is 3.5 and my level of nutrition measurement, I can't remember the name but said it should be over 1, was .44. hemoglobin is 10.3, which isn't too bad, but it seems I can tell a difference when it drops below 11. I think I need 3 days a week. I felt so much better when I did 3 days, but not sure exactly how to tell the doctor all this. I am afraid he already thinks I am a "know it all". He has several patients doing 2 days. Is that normal everywhere? I have a VERY long drive to dialysis and was so happy with the 2 days in the beginning, but I want to feel like I did before.

[jeannea]

It's unusual to do 2 days unless you still have some residual function. Maybe you can make an appt to sit down with him and really talk about the benefits and risks of 2 days and how you've been feeling.

[MightyMike]

Your albumin in other words protein should be 4.  If its at 3.5 that is considered malnutrition.  You should be eating more meats like chicken and fish and maybe some peanut butter can help.  As far as your hemoglobin most units won't start giving you epogen till your around 10 - 10.5.  I do believe you may want to demand they increase you to 4 hour treatments or 3 days a week at 3 hours.  But increasin your protein will help a lot because 3.5 is really low your doctor should know this if he doesn't I would seek a new doctor.  Best of luck.

[sullidog]

and if he won't listen find a new dr. Unfortunetly do to the new protocalls for hg you'll be lucky if your hg goes to 11 or abover

[wvgirl]

I have been getting epogen for 2 years. I went up to 11.3, so they didn't give it to me for a few treatments and down it went!! Been trying hard with the protein. I eat the bars, and try to force in some meat and even peanut butter, but I haven't had much of an appetite for the last few months. I am day 3 with no dialysis right now. Sundays are the hardest and I feel the worst. According to my body weight I am not supposed to gain more than 2.8 k. According to my home scale I have gained about 8 pounds. I am watching and measuring my fluids but the 3 days is hard!! I do have a gfr of about 6-7 now. Thank you all for the replies. It sure is hard learning to be a nephrlogist when you didn't study enough in high school!!  I feel like when I talk to my doctor he doesn't listen very well. Just keeps telling my labs are good. If I didn't ask for copies of them, I would know absolutely nothing, except what the dietician tells me. She is great. Told me my calcium was 7.3, and that the doctor should have me take a tums each day on an empty stomach. Ha!! When he came around he told me my calcium was fine. When I questioned him on it, he said to take a tums every day and he would recheck in 2 weeks. grrrrr I think I am going to have to go through the hassle of finding another doctor, which will be in another town because mine is the only one where I go, and finding another clinic in that town.