Dry Weight

[Lori1851]

Hello Friends,
Ok I have a question. The nurse at dialysis is tryin to change his dry weight. Every time they do this Dustin look like he has been to a concentration camp. You can see his ribs and he cramps terribly!!!! Dustin has always had high blood pressure I mean really high. They are thinking that they need to take more fluid off to drop the blood pressure. Dustin has had an issue with this for a long time. While in the hospital they addressed it after I bitched at them (sorry for the cussing). Dustin knows when he has fluid and knows what his dry weight runs. He doesnt like the manager their she isnt a very caring person. Thats another post! Soooo,,,,, any of you had this issue witht he dry weight? I will be waiitng for your replies. Thanks in advance.

Lori Indiana

[willieandwinnie]

Lori, they need to look at his medications. I don't understand this drying you out to lower the blood pressure. Len had the opposite problem when he was on hemo. If we dried him out to much his blood pressure would go screaming up. Maybe he is too dry??? Don't you just hate those royal nurses and their one size fits all attitude? I hope you get it worked out. 

[thegrammalady]

the nurse doesn't get to set your dry weight, that's the doctor's job. she also shouldn't be allowed to "push" his dry weight. watch what he leaves at between treatments. if you haven't eaten so much that you've actually gained weight the difference between leaving on monday (as an example) and arriving on wednesday is your actual fluid gain not the difference between your dry weight (nothing more than a guess) and your current weight. if you feel the goal is to high have them lower it. they aren't in charge you are. i track my weight gains very carfully and tell them what to take off. i'm loosing weight so my doctor and i discuss where to set dry weight and when to change it. i also wear the same slacks and shirt each treatment (doing my laundry between) because jeans weigh heavier than cotton slacks. talk to his doctor about adjusting bp meds.

[stauffenberg]

There are a hundred different possible causes of hypertension, but at dialysis centers the foolish practise is to assume that all high blood pressure is due to fluid overload, which is usually treated by reducing the dry weight regardless of the negative consequences for the patient.  Studying each patient's case individually would take too much time and trouble, so it is simpler just to operate on the 'one size fits all' philosophy.

[cris]

Lori,
we have had the same problem with our Mom during the first 4 months of her HD, guess we were still in the guess and adjustment stage then. But now, Mom and we tell the center what should be pulled-off from Mom, as she knows her body and we watch her intake and output. No nurse or technician can impose on us. The doctor comes everyday in the center but she only glances at each patient's chart and so with the nurse and tech. No in-depth analysis of the labs, etc. I can say our stand is doing (very) good for Mom. So far, eversince, she stopped having low and high blood pressures on treatment. Hope you find the solution.

[Bryce]

Hi Lorri, I also maintain high blood pressure about 150/100 despite all the pills that I take and every time I see my renal doctor she tries to tell me I need to get my dry weight down even though I don't have any swelling on my ankles. I have tried to get down to these weights but it leaves me feeling dehydrated and unable to get to sleep with my blood pressure no different. So as far as I'm concerned if Dustin feels he knows what his dry weight should be he should stick to that, because I doubt that fluid overload is his problem as I feel the same can be said for me.

[Lori1851]

Thanks everyone. Guess I will go talk to this manager personally. Dustin refuses to have to deal with her again after yday he wanted to knock her out. As you all said Dustin knows his body. He is in control of it and has been eating more to try and gain weight. He is 6'0 and weighs like 165 - 170lbs. When he was in teh hospital they said he needed to gain some weight so I know that can make a difference. Dustin has always had puffy ankles regardless of how much they take off . He is good about watching his sodium and fluid intake after being in teh hospital for 7 days from his seizues which praise the LORD he has not had anymore since on meds.

Thanks again all!! I truely love you guys and gals

Lori/Indiana

[Ang]

cramps  and  too  much  fluid  removal  go  hand  in  hand,  has  dustin  managed  to  put  on  body  weight  at  all.
  i  put  on  about  8  pounds  in  the  4  months  after  xmas.

if  theres  no  body  weight  put  on,  then  his  base  weight  probably  needs  to  go  up  a  little.
to  alleviate the  cramps.

dialysis  is  supposed  to  in  theory  lower  your  bp  enough  for  you  to  go  off  bp  meds

[KICKSTART]

I do capd but all my blood pressure issues are put down to fluid overload as well . I am the same and know when im carrying to much fluid and have to say ,regardless of if its too much fluid or i am at my normal weight it doesnt change my b.p. at all.

[thegrammalady]

dialysis  is  supposed  to  in  theory  lower  your  bp  enough  for  you  to  go  off  bp  meds

HA!!! fat chance high blood pressure is how i got into this mess in the first place.

[aharris2]

Lori, You (Dustin) are in charge!!! You tell them what weight you want to go down to. Do NOT let them dictate to you. If you two feel that Dustin is "wet", then slowly challenge his weight downward, 0.5 kg at a time. If you feel he is too dry, raise your target weight a little. These units do not spend nearly enough time listening to make an intelligent decision for us. They don't know that Dustin is trying to put on weight or whether or not he just ate a feast and has a belly full of food. I am quite tired of idiots acting like they know best!

[keefer51]

I have had the same problem at my center now for four years. When i started to see the Mickey Mouse operation i was amazed. When i first started there were comments on wearing shorts every day. I told them they would add my clothing to my weight so the less the better. I told them when i was in the hospital and just started on dialysis i was naked with only a hospital gown on. Of course they lied and told me different but i proved it to the when i brought different sets of clothing in from my winter to summer. Some gave me 1.6 kilos more! I was sick a couple of times and lost weight. I am after them all the time about mine though. I read all my papers and only allow them to take more off if it is before a weekend. Don't let them do that. Their logic is asinine.

[flip]

At my 5 Star Center they always ask me at the beginning of each treatment how much I want to take off.

[thegrammalady]

At my 5 Star Center they always ask me at the beginning of each treatment how much I want to take off.

smart people

[Treasure]

Ooooh, so glad to see this subject because I was going to post about the same thing...

Before the sudden change in my kidney function, my blood pressure was quite low. It was low during all 4 of my pregnancies...it was low after I spit out the last puppy. I did not have a bp problem prior to my kidney problems.

All during the 8 years before dialysis, the docs claimed that high bp caused my kidney failure. I always maintained it was something else...and LOUDLY proclaimed this...up until they wheeled me in to get my transplant. After the transplant failed (about six weeks later), they figured out it wasn't the BP, but FSGS.

Back on dialysis again,  I have BP that tends to go through the roof-- when I'm on dialysis. I am on 4-5 BP meds at any given time, which only work for a couple of weeks, if at all.

Almost every Neph I encounter-- in-center or in the hosptial, claims that my hi BP is due to too much fluid. And despite all the evidence in my files that indicate otherwise, they still try to lower my dry weight at least once a week. I will usually say, no, no.... but they keep on pressuring me. When I let them lower me, I end up having chest pains and cramps...and sometimes projectile vomiting. And the end result on my blood pressure is that it shoots up in the 220/110 range.  This happens every time they lower my dry weight. And yet they persist.

The only doctor who has listened was the research neph in a study I participated in. I think she came to the same conclusion I had in the past-- adequate dialysis improves my BP, and nothing else will.  And by adequate dialysis, I mean, receiving more than 3 hours/3 times a week.  When I have done more frequent dialysis at home (NxStage) my blood pressure is usually perfect-- so much so that I don't need any BP medications.

Tomorrow they intend to dehydrate me again...but this time will be different. When I start cramping, I'm not going to hold it in, but gonna let the whole clinic know what pain I'm in  (thankfully, most of the patients sleep like the dead during dialysis...hehehe) . And, I'm going to make sure they document it, with my peppered comments.

It's so frickfracking frustrating!

[flip]

That's why I love my nurses.