Could Use Some Ideas About my Dad - Passing Out

[dadsindialysis]

Hi there -

My name is Deb, and I'm from PA.  My dad just started in center dialysis about 4 weeks ago.  Please bear with me, as I'm sure I don't know all the right information.  This is all so new, and I cold really use some experienced input.

To start - Dad is 71, has high BP, heart issues, and diabetes - all of which have culminated in kidney failure.  He's also recently been diagnosed with Pulmonary hypertension.

Just before Christmas, he had the surgery to do the fistula in his arm.   By new years, he had retained so much fluid that he was unable to breathe and ended up in the ER.  This turned into a 10 day hospital stay, and the only way they could finally get rid of the fluid was to put the catheter(?) in his neck and start his dialysis earlier than originally planned.  So they dried him up.

He came home and started his in-center dialysis on MWF.

This was fine for 3 weeks, until last Monday when, before even getting hooked up to the machine, he passed out cold.  Dropped like a stone with no memory of it happening.

He's been in the hospital ever since (9 days now) because he's passed out 3 more times.  All they know is that his BP has a sudden drop and he's out.  They can't figure out what is causing it.  He can't even feel it coming.

The first time it happened was 2 days AFTER a treatment.  It's happened twice DURING dialysis, and it happened between sessions as well.  They even took him off his heart and BP meds and it still happened.  There doesn't seem to be any rhyme or reason for it!!

So I guess I'm asking if any of you have ever heard of or experienced anything similar.  It's getting really frustrating and it's so scary!

I'd really appreciate any thoughts that you have.  Thanks so much!!

Deb

[RichardMEL]

Welcome Deb!

That situation seems quite worrying with your dad! While it is true that dialysis often lowers blood pressure (and thus patients are often told to not take BP meds the day of treatment) for him to have a low BP and pass out even before being hooked up seems to suggest that whatever is going on is not specifically related to dialysis itself. Now of course, it could be anything to do with his various conditions and age - or a combination thereof. I'm really not certain what to suggest - they clearly are trying the obvious courses of action to try and sort out the situation. It must be very worrying for you though!!!

Maybe one of the real docs on here (Paging hemadoc - stat!!) might have some thoughts.

I really hope this can be solved very soon !!!

[greg10]

..
To start - Dad is 71, has high BP, heart issues, and diabetes - all of which have culminated in kidney failure.  He's also recently been diagnosed with Pulmonary hypertension...
He's been in the hospital ever since (9 days now) because he's passed out 3 more times.  All they know is that his BP has a sudden drop and he's out.  They can't figure out what is causing it.  He can't even feel it coming...

Welcome to the forum and I am sorry to hear about your dad's condition.
Your dad must have seen a cardiologist in the hospital and have they not considered that PH (Pulmonary hypertension) may be causing him to pass out?  Does your dad get better with oxygen or other PH treatments?  From what I have read, a graft or fistula may actually worsen PH : "It appears that patients with end-stage renal disease (ESRD) acquire endothelial dysfunction that reduces the ability of their pulmonary vessels to accommodate the AV access-mediated elevated cardiac output, exacerbating the PH. "
http://www.ncbi.nlm.nih.gov/pubmed/16970730

[tyefly]

  Thx  Greg10      great information.....  I hope that helps.... 

[thegrammalady]

this past summer i got very dizzy and light headed while at the county fair. it was extremely hot and they decided i was dehydrated. i had been having dizzy spells for some time and they decided it was because my blood pressure would drop. since the county fair episode got me hauled off in an ambulance they just decided to keep me and run every test imaginable. they decided my blood pressure was dropping because i had been dehydrated for quite some time. they were apparently taking off too much fluid during dialysis. i get to carry more fluid weight, which means i can drink more. if they rule out heart and neurological problems they may need to raise your father's dry weight.

[*kana*]

Has he had an Echocardiogram to diagnose the Pulmonary Hypertension?  What is his right sided pressures?

[dadsindialysis]

Thanks for the responses.  I'm just at my wits end.  It's so upsetting.

He had both an echo and a catheterization to diagnose the PH.  It seems like everything started after he got the darn fistula surgery.  I'm not sure what the pressures were, but he said they were very high.  I'm pretty sure they raised his dry weight about 6 pounds 2 sessions ago.

I was just hoping to hear that this is something that sounded pretty common. 

He's also absolutely exhausted after dialysis.  Is that normal 4 weeks in?

Thanks again,
Deb

[carol1987]

Hi Deb... in my experience... I was exhausted after dialysis even 4 weeks in... and I am only 48 with the ESRD being my only medical condition...

[talker]

Wow another cliff hanger.

What been happening here, any resolve show up?

talker

[jo]

Hi there -

My name is Deb, and I'm from PA.  My dad just started in center dialysis about 4 weeks ago.  Please bear with me, as I'm sure I don't know all the right information.  This is all so new, and I cold really use some experienced input.

To start - Dad is 71, has high BP, heart issues, and diabetes - all of which have culminated in kidney failure.  He's also recently been diagnosed with Pulmonary hypertension.

Just before Christmas, he had the surgery to do the fistula in his arm.   By new years, he had retained so much fluid that he was unable to breathe and ended up in the ER.  This turned into a 10 day hospital stay, and the only way they could finally get rid of the fluid was to put the catheter(?) in his neck and start his dialysis earlier than originally planned.  So they dried him up.

He came home and started his in-center dialysis on MWF.

This was fine for 3 weeks, until last Monday when, before even getting hooked up to the machine, he passed out cold.  Dropped like a stone with no memory of it happening.

He's been in the hospital ever since (9 days now) because he's passed out 3 more times.  All they know is that his BP has a sudden drop and he's out.  They can't figure out what is causing it.  He can't even feel it coming.

The first time it happened was 2 days AFTER a treatment.  It's happened twice DURING dialysis, and it happened between sessions as well.  They even took him off his heart and BP meds and it still happened.  There doesn't seem to be any rhyme or reason for it!!

So I guess I'm asking if any of you have ever heard of or experienced anything similar.  It's getting really frustrating and it's so scary!

I'd really appreciate any thoughts that you have.  Thanks so much!!

Deb

Hi Deb,

Did you find out the cause? My mom experienced this again today for the 3rd time, but in her case, it happens during dialysis. We are so stressed out here trying to find out the cause. I hope your dad got used to dialysis and is feeling better.

[Michael Murphy]

I'm well frankly fat.  I am loosing about 1 kelo every two to three weeks so I am getting smaller.  When I started dialysis i weighed 150 kilos.  The doctor set my dry weight at 146 kilos so they pulled a lot of fluid off of me.  They also limited me to 40 oz of water in a day.  This went on for a month. I went for my first monthly checkup at the doctors office and my BP was 75 / 45.  I was hustled off to the medical groups urgent care center for four hours of IV's to raise my BP up.  It was still low so I insisted on going home.  The next treatment my dry weight was raised to my current weight and the treatments became much easier.  It turns out I naturally still eliminate all the fluid i ingest so my dry weight is generally set a kilo lower then my current weight.  It turns out your dry weight is not a exact science and is generally set by watching for low BP to see they went to far.  The reason they seem to be so aggressive is that excess fluid can kill,you and low BP generally does not.