Cramps

[cassandra]

.https://homedialysis.org/news-and-research/blog/32-heading-off-the-dreaded-cramp

[kristina]

Many thanks, Cassandra for posting this most interesting article for us to learn more about cramps.
I have noticed that there were cramps in the beginning when I started with dialysis, especially when I was too ambitious and tried to have too much "water taken off"...  these days I always eat during my dialysis-session a portion of my home-made potato-salad with pickled gherkins and olives, mixed with olive oil and cider-vinegar and fortunately I have had no re-occurrence of cramps & hopefully it stays like that because the experience of such a cramp is quite horrendous...
Thanks again from Kristina.

[Charlie B53]

I used to get terrible cramps both during treatments and afterwards while I slept, even many many hours later.  I have an early seat time and get off by 11.  Those days I cramped I would be cramping during sleep that NIGHT, almost 18 hours later.

Somehow I managed to reduce my fluid intakes enough that I rarely ever even near a 3 kilo take-off, and I have since not had another cramp.  I cannot say not ever, as I have made the mistake a few times of taking the Wife for Chinese.  Error.  Seems hidden MSG drives me to drink far more than my normal reduced fluids, and I end up taking off 3 kilos, or slightly more.  Yea, cramped again.

I theorized the loss of circulating volume perhaps 'thickens' my blood.  Heart function is labored, I get even more exhausted than a more normal treatment. And this thickening persist until circulating volume is restored somewhat, either through re-absorption of fluid lost in the tissues of the body or dietary intake.

I noted this article makes reference to PAD. I continue to have this, it does not go away.  I have many stents in both sides of my groin to restore much of the lost flow to my legs and can walk again.  However, there is most likely much restrictions elsewhere within the leg muscles which very well could contribute to cramping, especially while circulating volume if reduced and thickened.

Electrolytes need more testing. I can easily understand an imbalance occurring with large take-offs. I would suspect the balance swings over to the 'plus' side with the reduction in blood volume.  I have no idea how to correct this easily.

For me, keeping my fluid gains under 3 kilos works.  More time will tell.

[lulu836]

For me, keeping my fluid gains under 3 kilos works.  More time will tell.

Three works for me as well on "weekends" but I much prefer aiming for 1.5 or 2 on regular days.  What really gets me sometimes when I am just borderline on 3 is the .5 rinseback. 

[Charlie B53]

Do we NEED .5 rinseback?  How about a .25 or .3

What IF we didn't get all of our blood back from the filter/dializer? 

I've always been needle-phobic so I never gave blood at any of the many blood donor programs.  I'm told they can take a pint without causing major problems.  But there is a time limit before a person can donate again.  Got to give the body time to replenish.  So there must be some number of an allowable 'loss' that wouldn't hurt us.

Knowing this may help us on those days when we come in a bit 'heavier' than we anticipated.  And really want to avoid those cramps.

[lulu836]

I have asked that question many times.  Especially on the "weekend" I would like to have some "wiggle room" i.e., a couple or three extra tenths below my dry weight in case I give in to temptation.  I am told that the clinic has rules about the maximum amount of fluid to be taken from a patient.

 At my clinic the nurses are very cooperative with challenges.  They worked with me recently for about 5 weeks while I attempted to get my dry weight down to a more realistic figure (no pun intended).  I started this journey a couple of years ago with a LOT of fat weight.  With surgeries, physical therapy, dialysis  and a lot of stress I dropped a considerable amount of that fat weight.  Even after that I went into fluid overload evidenced by very realistic hallucinations and over 3 days in the hospital, the dialysis unit took off 6 more kilos of excess fluid.  Since then I have dropped 2 kilos more. 

Back to the main topic, there are times when I have been given back too much during the rinseback.  That upsets  me because that means I have missed my goal through no fault of my own.  Different nurses have different ideas of what color they are seeing in the tubing as a gauge of how much blood is left in that tubing.

[Charlie B53]

That color thing should get boiled down to a spefic quantity.  These guessing games don't cut it.

Most often my clinic sommehow pulls my weight down about .3 under my set dry weight.  This isn't a problem but my next visit instead of counting from my dry weight they use that last ending number.  So instead of saying I am 2.1 over they add that other .3 and claim I am 2.4 since last treatment.  I suppose they are correct, I did gain that much, but I am NOT that far over as they then add the rinse back to that making 2.9.  Starting to get to scarily near that 3.0 and cramping.

I suspect they are attempting to use that last ending weight as my new dry weight.  I don't know if I am so ready for that yet.

[lulu836]

I don't think that their criterion for you is the correct way to go.  Seems to me they are trying to push your dry weight way down too quickly.  That I know of that weight is a constant and  in my case is only changed after consultation with the head nurse and my neph when he makes clinic rounds and me.  If I happen to get a little under for the day, that's my "wiggle room" until the next session. 

[Charlie B53]

LOL  Yeah, it's like Nurse is taking away that wiggle room.

I am still trying to lose a bit of weight.  Just not trying very hard.  Once the weather finally warms and I can manage to get outside in the yard I will lose.