Low blood pressure!

[julian230]

Good evening everyone! Hope everyone watched the presidential debates,  really interesting stuff... !
A question to people, what does it mean when you have low blood pressure? My blood pressure has been 89/57 . Also when I stand , I sometimes get dizzy and have a minor blackout , but than as I keep walking it gets better. Anyone else have this problem? andddd one more thing, is a low blood pressure while on dialysis an accurate monitoring for taking liquids off .

[Wallyz]

It's  amonitor of how much has been taken off, not if you are down to your dry weight.
Your vascuklar system has blown up like a funny shaped water balloon, and the dialysis just took a bunch of water out.  Low blood pressure means your vascular system is still stretched out, so if you had a lot of water on, you will feel low BP before you pull all the water off that you need to.

[julian230]

Thats odd , because today I "only" pulld off 3.5 , and last time I pulled off 3.8 without a problem, and sometimes I think maybe I'm gaining weight..

[Zach]

For hypotension, some Nephrologists prescribed ProAmatine (midodrine hydrochloride).

[julian230]

Well it's not a permanent thing. Its really low for awhile after dialysis , and of course , when I drink i steadily goes back up again.

[G-Ma]

I'm on nothing that would lower it but always under 90/50, generally 85/50 or 78/50 so we have to watch more how I feel so if too much fluid comes off I too black out or major headaches and that's even if only .2 too much.  Drives nurses crazy but neph said don't worry about the count so much in me as I generally feel great and only have to pull about .6 on NxStage.....  

[julian230]

I'm on nothing that would lower it but always under 90/50, generally 85/50 or 78/50 so we have to watch more how I feel so if too much fluid comes off I too black out or major headaches and that's even if only .2 too much.  Drives nurses crazy but neph said don't worry about the count so much in me as I generally feel great and only have to pull about .6 on NxStage.....  

Same here. I'm not on any blood pressure medication , and in fact , because my pressure was running so low all the time they discontinue it. The thing that makes me upset though is when they turn me off because my pressure is too low! So I'm running around wondering "ok... so do I gain weight , or did they not take it all off??" its so frustrating.

[G-Ma]

When I was in center nurses would turn off withdrawel until BP stable to my numbers and then turn on again and we usually were able to "baby" me to my dry weight...if they ran me straight through is when I had so much trouble...I wouldn't let them just turn it off as I didn't want to run into too much fluid trouble either.

[julian230]

You were lucky than . Usually when my pressure drops , it stays that way , even if they turn me off , even when they start giving me fluid back , my pressure still runs low !  And of course i'll be like "I feel perfectly fine!" and they'll be like "policy blah blah". Robots. But I suppose they want to be safe. Just annoying.

[Ang]

julian230


you  and  i  are  in  exactly  the  same  boat,  i  have  this  exact  problem  for  about  month  or  so  before  that  for  about  6  weeks  my  bp  would  not  drop  under  100,before  that  this  current  situation  reared  its  head  and  stayed  for  about  4  months  i  reckon.

all  the  nurses  thought  it  was  fluid  related,  it  seemed  to  rear  up  once  i  start  doing  any  form  of  exercise.

still  none  the  wiser  as  to  why,the  neph  would  say  raise  your  ibw,nobody  can  explain  why  it  was  happening,i  got  a  heart  test  done  but  that  came  back  ok,something  about  ventricles  when  filling,thats  to  be  expected  on  dialysis  patients  so  all  the  pros  keep  telling  me.

it  pisses  me  off   that  nobody  can  give  me  a  definitive  answer.
any  info  you  come  across,  it would  be  appreciated  send  it  my  way  if  you  can.
oh  yeah  i  feel  fine  during  and  after  dialysis,later  when  i  get  home  sit  down  and relax,  thats  when  i  start  to  feel  washed out

[Zach]

You were lucky than . Usually when my pressure drops , it stays that way , even if they turn me off , even when they start giving me fluid back , my pressure still runs low !  And of course i'll be like "I feel perfectly fine!" and they'll be like "policy blah blah". Robots. But I suppose they want to be safe. Just annoying.

That's why you may want to try ProAmatine right before your hemodialysis treatments. It raises blood pressure during dialysis, so you can remove the fluid.

[julian230]

julian230


you  and  i  are  in  exactly  the  same  boat,  i  have  this  exact  problem  for  about  month  or  so  before  that  for  about  6  weeks  my  bp  would  not  drop  under  100,before  that  this  current  situation  reared  its  head  and  stayed  for  about  4  months  i  reckon.

all  the  nurses  thought  it  was  fluid  related,  it  seemed  to  rear  up  once  i  start  doing  any  form  of  exercise.

still  none  the  wiser  as  to  why,the  neph  would  say  raise  your  ibw,nobody  can  explain  why  it  was  happening,i  got  a  heart  test  done  but  that  came  back  ok,something  about  ventricles  when  filling,thats  to  be  expected  on  dialysis  patients  so  all  the  pros  keep  telling  me.

it  pisses  me  off   that  nobody  can  give  me  a  definitive  answer.
any  info  you  come  across,  it would  be  appreciated  send  it  my  way  if  you  can.
oh  yeah  i  feel  fine  during  and  after  dialysis,later  when  i  get  home  sit  down  and relax,  thats  when  i  start  to  feel  washed out

I definitely will send you info . I've realised that technicians just follow the rules , and the head nurses seem to be in charge of everything . The thing is , I kept having low blood pressure and so they would raise my dry weight , up until a point when I said "Look , I drink ONE glass of water , and I feel bloated and I FEEL i have too much water on board" , which they would say "sorry , but your pressure drops, so therefore we can't lower your weight yet". Finally I told my nephrologist and he said "lets try taking over extra , and see if it goes any lower on your weight". Lo and behold! I was , of course, right. That day , they took off 8.8 extra pounds of fluid! I swear , some of these technicians should see how the PATIENT FEELS and not how the pressure is dropping. They should say "Do you feel ok? do you feel like your going to faint?" and the patient should be able to say "no , i feel perfectly fine". Hell , I went to dialysis in Missouri (I live in Texas) , and my pressure was like 86/50 and you know what the techs said? "If you feel fine , we will just keep you running and pulling of fluids" .. Why the hell can't they be like that at other units?! They treat me like I don't know if I feel well or not , and on TOP of that , they aren't the freaking ones who are walking around with 3 -4 , or even 8 pounds of fluids. They should GROW a HEART and realise the patient is the best person to assess themselves.

[devon]

Julian,  why do I have such huge confidence in you!?    You sure are persistent at getting your head around this issue!  You inspire me!

My BP is generally low after taking off my usual 5.5-6.5 kilos of fluid.  Sometimes it's lower than others and I have to sit for a while to let it build back after being disconnected.

If it is remaining low for you, like in the days between dialysis, that may be due to something else.  My doc who treats me for hypertension believe I should be just above the level that standing quickly should make my light-headed.  I don't think he would be upset by low BP more than high BP.  However, you don't want to risk it being so low as to create a hazard, like from falling down in a faint.  If that's the case, you need treatment.

Best of luck to you and thanks for bringing this up!

-Devon

[cherpep]

I used to take blood pressure medicine to lower my blood pressure.  Now, I take the midodine to increase my blood pressure.  I went through a lot of what you are going through, and nobody had been able to tell me what's going on.  It just seems that by the end of my session, my blood pressure drops - regardless how much fluid I'm taking off.  I've tried increasing my dry weight, but the blood pressure still drops.  If the top number gets down into the 60's, that's when I really feel it and have to stop the treatment.  Otherwise, if the top number stays at 70 or above, I'm OK.  I get light-headed and dizzy, but that's one of the great things about dialyzing at home on NxStage - I control it myself - and I just have to walk across the room and not out the door into a car, yadayadayada.

My doctor was concerned and sent me to have a heart echo - I was really nervous.  But no abnormalities showed up, so the heart is functioning OK.  Some mornings after, my blood pressure is so low that I start to throw up if I'm moving around too much.   The Midodine really doesn't help a lot, but it does increase it a little - enough to keep the treatment going. 

I look forward to what others have to say about this, because right now we do not know what is going on.

[Ang]

in  my  unit  when  my  bp  falls  ,  i  have  to  tend  to  nurses  individually  cause  if  it  falls  to  far 85/60  some  nurses will  do  whatever  they  need  to  do,when  i  query  why"my  nurses  licence  on  the  line"

others  who  trust  me  do  as  i  ask  then  then  trust  write  accordingly  on  my  file"patient  requests??

[elvisxm]

I had this same problem for awhile, and in my case it was because my dry weight was changing, and the technicians were not adjusting my dry weight up.  My bp dropped during sessions, but also the day after.  I would black out several times a day, especially when I first stood up no matter how slowly.  I also tended to lose my voice if I did much walking.  My doctor's nurse practitioner was the only person to really listen to my issue.  She had me get an echocardiogram, which showed no heart damage but gave them a future baseline, and then immediately had my dry weight increased.  That fixed the issue, and the next time I had something similar again, the clinic was much faster about upping my dry weight another half kilo without much prompting.

[Jay72]

It's  amonitor of how much has been taken off, not if you are down to your dry weight.
Your vascuklar system has blown up like a funny shaped water balloon, and the dialysis just took a bunch of water out.  Low blood pressure means your vascular system is still stretched out, so if you had a lot of water on, you will feel low BP before you pull all the water off that you need to.

Not sure if I am reading this wrong but I thinkl most peoples BP is higher with fluid on and when you take even a bit too much over your BP will drop,  I have to say I have never had a low bp pre dialysis, but certainly after.  Espically since I am still trying to establish my dry weight.

[kidney4traci]

I agree with you Jay... that's my understanding too.

[TynyWonder]

I noticed that cherpep mentioned that when her BP went too low and she was up and moving around, she would throw up.   I do that exact same thing, throw up!!!!!   Does anyone know why a person tends to throw up when their BP does go too low?   I have never understood that never been told why a person does throw up?   Very interesting............

[Ang]

the  main  reason  i  guess  the  vomitting  is  from  eating  large  quantities of  food (again  its  hit  and  miss  like  ibw)

if  your  eating  when  your  bp  goes  low  your  body  becomes  unstable  for  more  of  a  better  word,  then  you  get  up  and  move  around,your  body  is  gonna  react  to  the  movements.
every  body  reacts  to  this  differently.

my  bp  has   gotten  as  low  as  85/60,when  this  happens  i  don't  eat  anything   and  just  a  few  iceblocks.

hope  this  helps

[TynyWonder]

the  main  reason  i  guess  the  vomitting  is  from  eating  large  quantities of  food (again  its  hit  and  miss  like  ibw)

OK, thanks for your explanation!   However, I have sat here and thought and thought what "IBW" could mean and can't for the life of me imagine what that could stand for???  Could you please tell me what IBW stands for?   (I have an idea but don't want to sound stupid so I don't want to just make a guess)  Thanks again!

[Ang]

IBW- ideal  base  weight

what  your  weight  should  be  once  you  start  dialysis.


hope  it  helps  tw

[TynyWonder]

ooooohhhhh OK, thanks!   I'm glad now that I did not take a guess because I would have been wrong!     Thanks again Ang!

[cherpep]

the  main  reason  i  guess  the  vomitting  is  from  eating  large  quantities of  food (again  its  hit  and  miss  like  ibw)

if  your  eating  when  your  bp  goes  low  your  body  becomes  unstable  for  more  of  a  better  word,  then  you  get  up  and  move  around,your  body  is  gonna  react  to  the  movements.
every  body  reacts  to  this  differently.

Food doesn't explain it for me, unfortunately.  When it's at its worse is in the morning.  I do dialysis right before bed, sleep through the night, and then have this 'throwing 'up' problem in the morning as I'm showering and getting ready for work.  I haven't eaten anything yet.  Actually, most times I haven't eaten anything since dinner around 6:00pm the night before - so we're talking about 13 hours later. 

[thegrammalady]

remember dry weight is nothing more than a guess, it's not cast in cement. and as for policy, blah, blah, blah, tell them to shove it in whatever way makes them listen. they don't get to do anything  you don't want them to. you are the one in charge and don't let them forget it!!!!!