Hi everyone, I see there has been alot of talk about blood pressure, I had my first hemo dialysis this week, I was in the hospital with my creatinine over 7. I have had one 2 hour and two 4 hours treatments. My blood pressure has been dropping too, I almost passed out today, I feel like I have been ran over with a Mac truck, but today I came home and ate me a bowl of shicken noodle soup and it brought it up some. I now take one less blood pressure Med. I was having bad stomach cramps too when my blood pressure droped, the nurse said this was normal for patient new to dialysis, I hope it works its self out. Sue
Sue, starting dialysis can be tough. In center HD is even tougher. Patients often do not feel great after treatments because of electrolyte swings and fluid removal. Do you have a fistula? If you do not I would try to get one, the quality of the dialysis improves dramatically with it…are you interested in home HD…it is quite easy to do and my patients really love it… Hang in there
I rememeber how awful and bad I felt on my first dialysis in-center…its quite hard for all starters, but along the way you’ll gain knowledge on how to care for yourself.
Next time don’t let yourself pass out, call the techs or nurse beforfe it happens…
Do you know how much fluid they removed at each tx?
Don’t give up just yet… It can take a while to start getting comfortable on hemodialysis and to start feeling better. As you gain experience, you will know more how much you can drink, and how much you can eat (and when). Keep to the fluid limit to avoid cramps and low blood pressure, and if you have been on a pre-dialysis renal diet, you may have to start eating more (check with your dietician though). Most people who reach dialysis have taken a number of years to get there, and it can take 6 months before you really start feeling better once you do start dialysis. It’s not an overnight improvement for most people.
Some people do find that they don’t feel very good on dialysis if they eat a meal too close before dialysis, others have no problem with that at all. Trial and error is the only way to find out. If you do have low blood pressure, among other things they do for that, try not eating or drinking from a couple of hours before treatment or during treatment.
Also, when you start dialysis, you start with a more or less generic dialysis prescription, and various parameters can be adjusted as you go along and you get monthly blood work done, or as symptoms appear. Potassium in the dialysate bath is a frequent one that needs to be changed. So if you have things like tingling, itching or whatever, tell them, and be persistent about it without being obnoxious. Dry weight is another, because your initial dry weight is more or less a best guess. There are also different types of dialyzers.
quote]Keep to the fluid limit to avoid cramps and low blood pressure,[/quote]
Even if you are completely compliant with fluid gains, you will still cramp/crash if they take too much fluid off! If you see that you start to feel bad during tx., an unnatural feeling like a pressure on your body, it is usually because your goal (amount of fluid removed) is set too high. You must learn to be aware of your dry weight and goal and take control by letting your doctor and staff know if they are taking too much fluid off. This takes practice, but I have learned how to do it and have never ever again in years of dialysis had a cramping/crashing episode.
When I first started dialysis, I thought the doctor and staff knew how to properly assess my dry weight and goal and put my trust in them. I had low fluid gains , but still had terrible incidents. One day I asked my neph how he knew what my dw and goal should be and he replied that it is, “just a guess”.
After discussing the matter with other educated patients, I learned the correct way to assess myself. One’s weight changes all the time just as a non-kidney patient’s weight changes. So, you are the best one to determine what your dw and goal should be at each dialysis. There are key things to assess. Don’t know if we have had a previous thread on same. Try a search. But if it is not there, we can start a new thread and review.
You are so right- the machine becomes Dracula lol when the tx is not balanced, but really it is not the machine, but the wrong tx peramiters and/or prescription.
Thanks everyone for your help, me give up? NEVER!!! I will beat this thing, I couldn’t find the thread on blood pressure. aif my stomach starts cramping and I feel kinda dingy then I call them right? I mean I can’t see the read out on the front of the machine because I am on the side of it, the one they did in the hospital I could watch and see my blood pressure, they take it every 30 minutes, I can feel it tighten on my arm. I did drink some chicken noodle soup when I got home and it made me feel better, I learned that from the boards. When the nurse got excited with my blood pressure she gave me extra saline to bring it up, I don’t know exactly how much they were tqking off, in the hospital they did 3 kilos I think and at the center they were going for 3 but had to back down to 2. something, I may be wrong, I will make a note tomorrow on this. I can’t do Home Hemo because I can’t hardly use my right hand from a stroke and my husband is scared to poke me with the needles, he is afraid he wil hurt me. and ai can’t do PD because my diabetes is too bad, I had a graft put in my arm. They have trouble with one of the needles, they tell me it is not where it should be and is further inside my arm, but the other needle goes in fine. My veins were too small for a fistula. I will really be needing you all. They thought I was gonna be like I didn’t know anything at all about it but I had them fooled thanks to the dialysis boards. I go in at 6 in the moring and there is not that many there for that shift but plenty of nurses and aides around so I don’t think my blood pressure should of had a chance to go that low. I will be more elert tomorrow. It feels funny not to be peeing all the time now, I do alittle and that is it, does everyone do that and also I got dirrea.Talk to you soon. Hugs Sue
You become educated one step at a time, Sue. You sound like one tuff Cajun so I know you are going to get there lol! As far as seeing the machine screen, you begin by telling your staff that you would like the machine turned towards you. I had many staff fight me on this. They couldn’t comprehend a patient wanting the right to be a participant in the tx, because the majority of the patients, sadly, are dependent. Also, many staff don’t want to go out of their way to turn the machine as it’s a little more work for them. But you just have to remain firm and get an understanding with them that you will be participating in “your” tx. If you have the hassling type staff they’ll begin to see in time that you are serious. Good type staff are happy to turn the machine. You may have some of both. So, you just have to decide that you win and stand firm on this.
In time, you will begin to know all the settings on your machine sort of like you do your oven. It’s simple…any patient can do it if they are so inclined to learn. We can walk you through it.
I will finish answering your post in a separate post as I am out of time for now.
I have only been on dialysis for around 8 months so those first times are pretty fresh in my mind also. My urine output has diminished considerably over this time but still wee a bit (more out of habit I think than anything). I had a lot of diarrhea for the first 4 months or so especially doing Nocturnal, but that has settled right down now.
All the best with it. 8)
I’ve always wondered why other patients get diarrhea? Never had it at all.
My blood pressure didn’t drop today like it did the last time, but it was on its way and the nurse was there. I had a different problem this time, I was clooting on the top of my dialysiser and on the bottom, I only had an hour left and the alarm was going off, they had to take the dialysiser off and put on a dry pack or something like that, I was asking all kinds of questions like why did my blood clot up and they said it happens and it is not a rare thing for that, they put some heperin in the dry pack and took for ever to get started again, she kept messing with the hose. The girl thqt took my dialysiser to the back came back and told them there was blood clotted on the bottom of it last time too that she noitced, one nurse told me they will use more heparin the next treatment with my dialysiser, they reuse so I will have the same one back and if it does it again I will have to have a new one put on. They told me I gained 3 kilos from day before yesterday and that was way too much, I didn’t think I had drank that much,they took 2.something off me today and said I did good and got it all off. I am asking questions all the time and some act like they want to answer and then there are a couple that act like I should just site there and be a good girl and don’t worry about anything.Theree is not one machine turned where a patient can see what is happening on the front of the machine and if they turned it where ai could see it they would not be able to get to the front, the machines and chairs are that close to each other.I just want to know what the hell they are doing, that is my blood clotting up, so is this a normal thing to happen, oh when my blood pressure was dropping I knew right away because my stomach started cramping alittle but not bad likethe other day and I didn’t get dirhrrea today. I wish we had spell check on here cause ai know I mispelled words. I go in at 6;30 and there are only a handful of patients so those nurses have plenty of time to keep a closer watch on the machines, one came up and was messing with the settings and I asked her what she was doing and she said she was setting the blood pressure alarm that I was on an older machine, the newer ones you don’t have to set, so I wonder how long mine was not set. I am going to give myself more time before I sound too pushy, I don’t want them not to like me, but then I don’t want them screwing with me either. So please guys help me out here, what was going on today??? She even asked me if I wanted to finish the last hour and I told her yes, I wanted all the time I could get, they had problems again getting one ofthe needles in, it was against the wall she said, a couple of them acted like they had never seen a graft like mine.Sue
Cajun Sue wrote:
I can’t do Home Hemo because I can’t hardly use my right hand from a stroke and my husband is scared to poke me with the needles, he is afraid he wil hurt me
I wonder if the staff started buttonholes on you, if your husband might be able to stick you, because once buttonholes are established, they don’t hurt? Just a thought.
At any rate, as a moderator of this board, I need to remind you that this is home dialysis central, and we need to keep the discussions to home dialysis. There are other places, like the Life Options message boards at http://www.lifeoptions.org or the dialysis_support email list on http://www.yahoogroups.com where there is more general discussion about all types of CKD treatment, including in-center hemo, from folks who have been there and can tell you all about it.
For those of you that were helping me please email me. I am sorry I bothered anyone.Sue