Fatigue after dialysis: anything to do?

[jonah]

Wondering if anyone has had same? Fatigue after in-center dialysis, much worse than pre-dialysis uremic fatigue. I am in week 10 of fistula dialysis (2/week, 3h/session). An hour after treatment, heaviness, grogginess, stiff shoulders, fever-like. Tired but cannot sleep til 1 or 2.  I sleep 10 hours, on and off, and wake up with same. Day 2 groggy and napping. No nausea, no pain. Day 3, ½ day, same, start to feel normal, but tired by evening.  Then time for another treatment.

Neph says “numbers looking good,” “you’ll get used to it” but I haven’t. Senior tech tried eliminating EPO or Heparin some days, to see if I was allergic, no change. Even after 40-minute session once day (infiltration, had to stop), felt same fatigue. “Some people never get used to it” is what I have heard. Anything else I can do (diet? Meds?) advice appreciated.

[cassandra]

Hi Jonah, I'm sorry you feel so washed out, but it is quite 'normal'. Mainly cos 'they' don't know your dry weight yet. How is your BP? If it's low, you could be too dry. Do you suffer cramps?

Love and luck, Cas

[kristina]

After my dialysis-treatments I always feel washed-out and tired and I only start feeling a little better
when I go outside of the air-conditioned dialysis-centre and breath fresh air again...
... I always make a point of standing outside in the fresh air for a few moments and breath deeply the fresh air and that always revives me ...
Best wishes from Kristina.

[PrimeTimer]

Maybe the blood pump speed plays a factor. They run my husband at 380 and take about 2-2.5 liters of fluid off of him in 4 hour sessions. He goes 3x week. He says he feels his best just after a treatment so goes straight to his job afterwards. I would imagine even the stress of sitting in a chair with needles in your arm would wear a person out. I read most get use to it but dialysis patients are real troupers. I know my husband sure is. There is no strength quite like the strength that dialysis patients have. Kudos!

[jonah]

thank you for the responses. No cramps, BP good, dry weight: I don't vary but a kilogram between sessions. still dragging along....

[Fabkiwi06]

How's your protein intake? I know the recommended albumin level is over a 4.0, but I know I personally start feeling tired when I let it get below a 4.3.

[Simon Dog]

Sleep?

[OlManRivah]

I've been going on dialysis for about 6 years.  I always feel washed out after leaving the Center.  Next day I feel OK.

[Charlie B53]

Since starting Dialysis I have always been tired.  I am getting pretty good at taking naps.  Never as good as my Dog.  But I'm working on it.

Since starting Hemo I do want that nap very much.  Some days I have too many errands and don't get it.  Other days, Mondays especially, I head straight home.  Dog is waiting for me to get under the covers with me.  He is more or less 'teaching' me how to nap.  I think.

Depending on how much water they pull off at a time, I think makes a big difference for me.  We haven't taken enough to cause blood pressure drops, but I have had night-time leg cramps twice.  We backed off a tenth K since then, so hopefully what we now have for a dry weight should be very close to correct.

Diet can be extremely important.  That's about all I know about diets.  I am still learn those things I should have so much and that I GOT TO take my Binders.

Many of us have an awful lot to learn yet.  To bad Dialysis doesn't come with a training manual with all this spelled out clearly and seperated into useful Chapters.    Wouldn't THAT be Nice?

[Michael Murphy]

After some sessions I go home to nap for 2 to 3 hours, or I feel fine and just go about my business.  Recently I had a heart attack and now during recovery I am starting a cardiac rehab program right after dialysis.  I am wondering if regular exercise will help with the problem.  I start the 18 of January.  If will post a status in the beginning of February how it's going.

[iolaire]

I dialyze in the afternoons so when I get home its after dinner (but I still eat) and I can wind down quickly.  When I dialyze in the mornings generally I feel like I have a low grade cold, I can still work and the like but feel like I should not make heavy decisions and like I'm a bit out of it.  But I will say when I'm traveling and have fun stuff to do I feel fairly washed out for about two hours after the treatment but then we get out and start sightseeing and I'm ok the rest of the day as long as its not a extremely long day.

One question I have, what is your routine when you are tiered?  Are you doing things throughout the day that would ware your out and help you sleep?  I could see the side effects having more of an effect if one was not active and busy outside of dialysis. (As seen in my days after dialysis on when traveling (fairly good) versus at work (more washed out).

[KatieV]

I was always fatigued after dialysis - didn't matter when in the day it was, I was wiped afterwards.  I work full-time, so I ended up on the evening shift (5-9).  I'd finish up, drive an hour home, and collapse in bed. 

Now I'm on NxStage at home; it's pretty much the same routine, I just swapped the order of driving & dialysis.     I actually end up coming off later, usually head to bed about midnight.  On a regular basis, I'm finding that my body is tired, but my brain is not.  And I have trouble settling down to sleep (drives my husband nuts!).  It's a very weird feeling!

[smartcookie]

Have you started new medicines recently?  How is your hemoglobin?  Sometimes a drop in hemoglobin will make you tired, even if it is still "in range" for a dialysis patient.  Have you been sick with a cold or anything recently?  Are you sleeping at night? 

[SteveGus]

For me it's both tiredness and a hollow/dry feeling.  Carbohydrates and B vitamins seem to help.  I take a nap, which often helps with the tiredness, but the hollowed out, dry stomach feeling is often worse the longer I sleep. 

[Charlie B53]

Most every day I have my coffee with graham crackers and a few ginger snaps.  Then it's off to treatment.

Most treatment days I am hungry and tired by the time I get home.  Some of those days I'm too tired to eat, straight to bed for at least 3 hours.  Days that I do eat it is more like a 4 to 5 hour nap.  Maybe the food raises my blood sugar and knocks me out.  I don't care.  I''m tired.

[kitkatz]

I worked as a special education teacher for 15 of the 18 years I have been on dialysis.  So when I finished school, I would run home, change clothes and go to a four hour session of dialysis.  After ten years I went on nocturnal dialysis from 7pm to 2 am.  I was fatigued from work and then add dialysis tired on it and I was wiped out.  I did it for fifteen years.  I know what tired is.

[Riki]

When I was doing morning treatments, I'd get home around lunchtime, have a small bite to eat, then nap the rest of the afternoon.  I'd get to a point where I'd need to lay down or I'd probably fall down.  I called it the Dialysis Doze.  I routinely chat with my best friend around lunchtime every day, and a few times I've said to her, "okay, dialysis doze is coming on, I'll talk to you later."  She thought it was funny, though she's seen me after dialysis, and she understands that I do get tired.

I started doing evenings back in September.  I still might have a small bite to eat after I get home, but I don't nap.  I try to stay up until after the Late Show is over (cuz I need my daily dose of Colbert *G*).  Sometimes I don't make it.

Someone once told me that a four hour dialysis session puts the body through the same workout as a 5k run, so we're going to be tired afterwards.  The washed out feeling kind of comes with it, especially if you've been taken below your dry weight.  If you're new, they may still be trying to figure out what that is.  You might want to pay attention to how much fluid you are taking in, and how much you are peeing, if you still pee.  If you still pee a good bit, then they could be drying you out.  Sometimes it is just a matter of letting your body get used to the routine, or maybe you could do what some of us did and get a later shift, or try home hemo when you're ready, so that you can just go to bed when you're done if you want to.

Many of us have an awful lot to learn yet.  To bad Dialysis doesn't come with a training manual with all this spelled out clearly and seperated into useful Chapters.    Wouldn't THAT be Nice?

I actually did, back when I first started dialysis, back in 1991.  It was a binder, done up with tabbed chapters, with info on just about anything you'd need to know while on dialysis, either hemo or PD.  It also had info on the more common causes of kidney disease and kidney failure, along with a chapter on what happens when you get the call, what happens after the transplant surgery, and info on common antirejection meds.  It was called Living with Kidney Disease, and it was provided by the Kidney Foundation of Canada.  I hear they've recently updated it, but they only give it to new patients.

But I will say when I'm traveling and have fun stuff to do I feel fairly washed out for about two hours after the treatment but then we get out and start sightseeing and I'm ok the rest of the day as long as its not a extremely long day.

I've never really thought about it before, but now that you've mentioned it, I do the same thing when traveling.  If there's neat stuff to do after dialysis, I try to push through the tired feeling.  My best friend, who lives in NYC and I go to visit from time to time, has discovered that she can cheer me through it, though I do remember sitting in a restaurant with my head on my hand, trying to stay awake until our food came. *G*

[Charlie B53]

 :shy;I still have some residual kidney function and still make a bit less than a liter a day.  This depends upon my hydration level, or 'dry weight'. 

When the clinic had my dry weight too low my kidneys wouldn't make much urine, if any.  And the more water they took off of me during a session the more tired I was afterwards.

As a Physics Major I figure that the blood thickens a small amount as the water is removed during Dialysis.  This causes the heart to have to work harder pumping the slightly thickened blood.  We get seriously tired.  The more water removed the more thickening, the more work load placed on the heart, the more tired we get.  This effect can last as long as it takes for the circulating blood volume to reconstitute, gaining water from bloated flesh and/or the foods and liquids we take in.

I have noticed when I am VERY careful to restrict my total fluid intake between sessions, the less weight gain, the less amount the clinic has to take off during a session.  Less take off the less tiredness i have afterwards.

Try to reduce your fluid intake even more and see if it makes this much difference for you also.

Also note; a much smaller person can have a much smaller circulating blood volume than a much larger person such as I.  Taking 2 1/2 K's off of me may be fine but a very small person this may be a sever shock causing extreme exhaustion.

Stay very aware of you fluid gains.







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