Why am I swollen

[SweetyPie]

Hello all
Lately I have been removing all my fluid at treatments but i have noticed the next day my eyes are already swollen! I can feel it a bit in my feet and hands as well. The doctor has me set on 42.5 but for a few weeks now I told the techs to remove until 41.3 because most of the time when i come in im at 42.6 kg!! The doctor had a problem lowering my weight because my blood pressure is low. But i rather feel dry than swollen because when I am swollen I dont have an appetite its weird.

[kristina]

Hello, could it possibly be that you still "hold" too much water ? What do your doctors say about it now? How is your BP right now and what do your doctors say about your BP?
Good luck and best wishes from Kristina.

[Charlie B53]

Does your clinic have that hemocrit sensor that detects the water level of the blood flow?

This neat little unit should help indicate if your blood fluid level is still to 'wet' and that more fluid may still need to be removed.  However, if your BP's are dropping that would stop fluid removal as they would not want to further lower your pressures dangerously.

Lady a couple chairs down from me has chronic low pressures.  IIRC she is taking a med that is supposed to help increase pressures.  You would need to talk to your Dr's about this

[Cowdog]

Are you symptomatic when your blood pressure drops. I run very low BP during the treatment but I don't have the symptoms associated with low BP so I continue with my pull rate.
Everybody doesn't fit the values expected in their book!!

[SweetyPie]

The thing is i start of with low pressures. And im not symptomatic ever. I have to beg the nurses to keep pulling because i feel fine. I told them that I was very swollen last treatment and my weight wasnt even up much. They ley me pull how much i wanted. But i still gave some fluid left

[Charlie B53]

Is it possible that you have lost weight?  An amount of body fat and replaced that fat with water?  This may require an adjustment to your Dry Weight, so to remove that excess water.

'Challenge' your Dry Weight' but I suggest you go slowly and in small amounts, like only one-half kilo.  If that does not cause you any problems after a few treatments then try another half.  You will soon know if you have gone too far.

Stay careful.

[GA_DAWG]

It may be that given how small you are, they are afraid it would quickly go over the edge when your BP is low. Their first instinct is going to be to cover their behind. I'm lucky in that our techs will ask before they stop pulling and if you give them the right answer as to how you feel, they let it continue. Of course, we have a group that is really experienced, and knows which patients to listen to and which ones try to fool them.

[SweetyPie]

I do think I have lost weight. Its funny also because every 30 min after my bp shows up they ask me " are you okay??!!" Lol like they seriously cant believe im up with such a low bp. But yeah i will actually try removing a little bit at a time a test to see exactly where my dry weight is because being swollen is not fun. My legs feel heavy and i am short of breath

[CatonTheRoof]

Are you consuming a good amount of protein?    If your albumin levels go too low because of a bad diet, it does not matter how much liquid is removed out of you,  or that you don't drink much water...  your cells won't be able to retain the intracellular water and will let it loose free around the body.   Thus, causing edema.

Other two reasons:    You're eating too much sodium?    have you checked this?

The other reason,  do you take by any chance calcium channel blockers for your blood pressure?    Dyhydropine CCBS (this class specially)   to which Amlodipine and Nifedipine belong, tend to cause edema by their action mechanism.    If you're taking one of these drugs and is causing you edema, you might be able to talk with your Nephrologist, so he reduces the dose or changes your drug regime.

Good luck!

[SweetyPie]

Albumin levels are within range. And i have completely stopped eating out. Whatever I eat is made so i know how much sodium is going inside what foods. I think its weight loss to honest

[SweetyPie]

Just a note, today my mom said my breath smelled like ammonia. This used to happen way back when I wasnt on dialysis but my health was at a bad place. Do you think this has anything to do with my swelling?

[CatonTheRoof]

If it is smelling like ammonia, you're probably underdialyzed.  You're in Hemo three times a week?   What are your BUN levels? 

The ammonia and the edema don't go directly connected, but they could both indicate that the dialysis treatment you're receiving is not enough.

In the meantime,  I suggest you to do feet baths with epsom salts.    Just submerge your feet (up to knee level)  in hot water mixed with a cup of epsom salts.    The epsom salty water will absorb a bit of fluid out of your body.   Keep the feet inside for 30 minutes each session, once per day.    Do it at night time,   because at night most of the water that you're retaining will have gone down to the feet by action of gravity  (all the walking and sitting you have been through during the day).

[SweetyPie]

Wow I never knew about that. Feet bath might help thanks for the tip!
I do not know my BUN levels where can I find it? I usually check my labs on davita but they only have albumin, hemoglobin, phos and potassium levels on there. To make matters even worse tomorrow is Christmas and they are cutting everyones time to 2 hours.

[GA_DAWG]

You may have to go to your neph for BUN levels, though maybe one of the nurses can access it. It is not a part of the normal report we are given each month. I remember that just before I wound up in the hospital to start this whole thing, the acid levels got so high, and the reflux so bad, that it had made a hole in the roof of my mouth.