New to the board and I have a question

[DialysisGuy99]

My name is Kevin I'm from Chicago and I have been on dialysis for 3 years.  I do well with my numbers and clearance, but I have one problem:

Adding up my fluid to my dry weight

Is there a way to add the amount I drink to my after treatment dry weight? Any help is appreciated.

Thanks and God bless you all.

[Charlie B53]

This can be a tough number to figure out as most everything we eat has moisture in it. Fluids alone can be much easier to figure. If you have ANY residual function and urinate at all that can allow you that much more total daily fluids, but with most people that residual function often ends.

Large amounts of fluid removal should be avoided if at all possible as they tend to 'shock' all of the body's system, especially the muscle cramps associated with large take-offs, but can, and will cause cardiac stunning, leading to possible severe problems.  We are all individuals, many can tolerate moderate take-offs far better than others.  I must be a wimp, somewhat.  When I have been overly thirsty and end up 3 or more kilos over my legs cramp and give me problems for the next 24 hours where some people don't even notice a thing. My clinic tells me of patients that come in way more than 5 K's over regularly, so I expect them to be very exceptional people.  I don't even want to try that much take off.

A very safe rule of thumb is one liter a day intake over anything you excrete.  Whether you excrete through urination or sweat, fluid loss is fluid loss.

BEWARE of dehydration.  Getting sick, either vomiting or diarrhea, you can go well under your dry weight and get in serious trouble way too quickly.

[Michael Murphy]

What Charlie b53 said covers most of the dry weight conundrum.  Several important lessons some food is really a fluid, ice cream and jello and watermelon come to mind. One of my fellow patients went to a summer picnic just after starting dialysis, he ate most of 2 watermelons and gained 10 kilos.  The other thing to track is solids, if not eliminated before weigh in they will be counted  as fluid gain.  If you are constipated make sure to tell the person putting you on since all the backed up solids count as fluid.  If I am backed up I only allow 2kilos since I know I will soon eliminate the weight.  Learn to judge your body, if you still produce urine, salty food will have you gain fluid.  Remember it’s your body and if you listen it will tell you what is going on. Good luck.

[GA_DAWG]

Another thing is to wear clothing of approximately the same weight each time. If you go in with an extra lb of clothes from the last time, they are going to try to take off that weight.

[Paul]

As has been said, watch your food. Most meat and vegetables are about 70% water! I am a bad boy, usually close to 4 litres takeoff (not good). I tried reducing my drinking, not a lot of success. Then I got stomach problems and didn't eat much, but drank loads, trying to flush the bug out. Despite the extra liquid in, my takeoff dropped to nearly half. Since then I have been trying to eat less to reduce the water level.

[Charlie B53]

I avoid eating much of anything that has flour in it for two reasons.
One, I do not need the additional carbs/calories.
Two, I do not need the stool hardening/constipation/weight which my clinic sees at my weight in as water weight gain and wants to take that much more off, leaving me under my dry weight after I finally have a healthy BM.

I also avoid much more than a couple of bites of cheese for the same reasons above.

These couple of changes in my diet along with seriously attempting to limit portion sizes I have managed to lose 100 lbs in two years.  Unfortunately prednisone caused me to regain 40 of that but in this last year I have again lost 15.  Yea Me!   Currently losing almost a pound a month.  I figure I got almost 2 years worth left to lose at this rate. 

Hope I can keep it up.  My Harley ought to accelerate just a bit quicker if/when I do!

[Michael Murphy]

Charlie when you are bricked, I like that dicription over constipated.  Tell the clinic that fact so they remove less fluid.  The lack of movement should not lead to going below your dry weight.  It’s important not to use it as a excuse but it does help to say no to too much fluid removal.

[Paul]

Tell the clinic that fact so they remove less fluid.  The lack of movement should not lead to going below your dry weight.  It’s important not to use it as a excuse but it does help to say no to too much fluid removal.

Your nurses or techs need convincing when you want less? The nurses in my clinic always ask how much you can tolerate and never go over that. If you go well over your dry weight and decide you cannot tolerate the necessary takeoff they suggest you book an extra session (doctor has to approve). They will advise, they will tell horror stories about what will happen if you stay over, but if you decide to drink three litres between sessions and only take off two, they will do what you ask.

[Charlie B53]

I like the term 'Bricked'.  It's a good description and a whole lot easier to spell than constipated.

I'm 64, since having problems in my teens and 20's caused by eating too much fast food, i.e. hamburgers, and a lack of adequate vegetable matter, I have been more regular than rain.

An old Dr at the VA Seattle told me once,

Prehistoric man did not eat processed foods. If it comes in a can or a box we most likely should not eat it as it is loaded with salt or sugar, plus all those words listed in the ingredients that are unpronounceable, i.e., chemicals.  Do we really want to eat that?

Many mornings I start my coffee, go out in the garage as I don't smoke in the house.  There are a number of days I have to butt my smoke easly and head for the bathroom or risk a serious mess.  Throughout my working life I burnt calories and consumed almost double what most 'normal' people ate.  Just before bed I would have a second BM.

Dialysis changed all that.  Once a day, most days, with an occasional skipping a day depending on what I have, or more appropriately have Not eaten.  Rarely am I 'Bricked' but those few times I am it is most likely brought about by being 'dry'.  Raise my dry weight, drink a bit, and the problem resolves itself.

I often wonder if we are not causing our own problems in attempting to set a dry weight too low.  As I still have some residual kidney function I see a huge difference in that function with a lower dry weight.  I plan on having another discussion with the Clinic Dr and Head Nurse.

I have to laugh, Head Nurse nick named me 'Dr' because I have learned far more than the average patient.  We occasionally have little discussions in the 'Why's of some of the bodily symptoms related to Dialysis.  She is impressed.

[DialysisGuy99]

I think you guys have me confused, I guess what I'm trying to ask is the amount that we drink how do you add it to your dry weight?

[GA_DAWG]

The point being made is that it is more than just what you drink when determining fluid. It is also the fluid included in the food you eat, as well as assessing how much fluid you lose through urinating, sweating and the like. As to sheer water weight, one gallon of water is approximately eight pounds. So one quart would be approxiamtely two pounds or one kg.

[cassandra]

Hi Kevin do you mean the amount of fluid added to your UF? So that you end up at the end of your treatment at your excact dry weight?


If you drink a small cup they are usually 125 ml, a polystyrene small beker usually 150. A ceramic beke 150-200 ml.


If you drink 2 small cups, just add 250 to total volume to be removed (Total UF)


The techs in clinic might know the volume of your drinks.


So there is no point adding it to your dry weight after treatment. You'll have to add it to total UF.


If you decide to eat a large KFC during D, you will have to add that total weight to yourself/dry weight.
When you've vomited it all out before you weigh, of course you won't have to.


Love, Cas












Sp mod Cas

[Michael Murphy]

The guy in the seat next to me hammered what you eat can effect your dry weight when I started.  When he started D the first weekend he went to a picnic and as he said destroyed better part of two large watermelons.  He gained over 10 kilos that weekend.  His reward was having to go have Dialysys every day that week yup 6 times.