Author Topic: Questions Part 47 (part b)  (Read 2487 times)

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Questions Part 47 (part b)
« on: August 30, 2009, 03:58:57 PM »
Jill



Joined: 26 Feb 2003
Posts: 3

   
PostPosted: Mon Aug 18, 2003 7:57 am    Post subject: K    

I want to eat high K before tx so it will be dialyzed out. I am only talking about eating a small amount of a high K fruit or veg, but eating it at a strategic time so it will get dialyzed out. When is the best timing to do this such as one hour before a tx starts etc?<
><
>Does eating right before a tx affect labs if it is lab day? Because I tried this last time and my K was 6.5. Labs are on Mondays. My K was retested the following Mon. and it was 5.4.

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high pulse



Joined: 01 Aug 2003
Posts: 6

   
PostPosted: Mon Aug 18, 2003 8:21 am    Post subject: high pulse    

I think I may of figured out what my problem is. I run for 4 hours on a striaght 140 sodium. I have tried sodium modeling and Uf porfiling one time. They were a little gentler in some ways and I wanted to try it again, but the cond. alarm kept going off and the repair tech never came to fix it. <
><
>But what I think I figured out is, I am only 116 pounds and I urinate very litte now. Whereas most all patients are told they can gain 2 on weekdays and 3 on weekends, I've also read that all patients should gain is about 2-3% of their body weight. Now that I urinate less that should mean I must drink less. Even 2 may be too much for me. But I feel I must drink 2 -3 something or I would not be able to feel normal. When I drink less than that, I feel dehydrated and weak. So its either feel dehydrated, weak and thirsty or feel bloated, a little nautious and a little achey. <
><
>I tried taking .1 less off and my standing up pulse was 125. Probably if I took off .3 less it would come down even more. But if I do I will not be able to drink that .3 inbetween the next tx. I feel I need that .3 as I need every bit of fluid I can get. So the question is, does a high pulse have damaging effects? And why is my pulse 90-100 during the tx when everyone elses is 80-90?

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Founding RN



Joined: 10 Jan 2003
Posts: 172

   
PostPosted: Mon Aug 18, 2003 6:12 pm    Post subject: Jill

If your run is at least 3 hours long, then if you eat your higher K+ food 2-3 hours before, it should be available in your blood stream and be dialized out during your run.<
><
>Yes, eating a high K+ food an hour or more before dialysis can start to show up in labs drawn pre run. I would advise you not to do this on a day that you know labs are to be drawn on.

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Founding RN



Joined: 10 Jan 2003
Posts: 172

   
PostPosted: Mon Aug 18, 2003 6:23 pm    Post subject: High Pulse    

There are a few patients out there who just run a higher pulse. But I am concerned that you may not have enough fluid for the machine to take off and your body is under more stress due to that. Since you say you can't tolerate more than a 2-3 kilo gain, then maybe you need to drink some fluids in the fisrt 2 hours so that you have fluid for the machine to pull. You can play around with it and see how you feel.<
>Also try the sodium modeling again if you are on another machine. It is worth the try. You may also need to have a staff person you trust check that the sodium modeling is set right. The condo on the machine should not be alarming.<
><
>The other question I have for you is how long after your run does your pulse stay above 100? How do you feel? Can you feel your heart pounding, feel faint, short of
eath? Most patients recover in 15-30 min after their run. If yours remains high, and you expereince any of the symptoms I described, then I would suggest that you consult with your Dr. who has access to all your records.

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high pulse



Joined: 01 Aug 2003
Posts: 6

   
PostPosted: Wed Aug 20, 2003 6:27 am    Post subject: high pulse    

What do you mean by not having enough fluid for the machine to pull? I am gaining 2-3. According to my body weight I am gaining a little more than I should. I always drin a cup of water as soon as get on as I am still thristy from lunch. Then about 2 hours into the tx I am thristy again and I have another cup of fluid. This is all added to my goal in the beginning plus rinseback, so my goal is set from 2.5 - 3-5. <
><
>My pulse goes above 100 anywhere from the middle of the tx towards the end of the tx. I can feel pressure on my heart and it beats faster, but it stops doing this after tx.

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Founding RN



Joined: 10 Jan 2003
Posts: 172

   
PostPosted: Wed Aug 20, 2003 9:25 am    Post subject: High Pulse    

It was not clear just how much fluid you have for the machine to work with. It appears that your high pulse is your body's reaction to having the fluid pulled off and is a stress response. Some patients have this and there really isn't that much that can be done. Like I said, if this continues to be a problem, you need to consult with your Dr. But everything you describe indicates that your body is expereincing stress from dialysis, the fluid removal and the high pulse is one of those symptoms. <
><
>As long as it quickly resolves after your dialysis, then you should be o.k. If it doesn't, then there may be other factors and you need to see your Dr.

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Polly



Joined: 21 Aug 2003
Posts: 4

   
PostPosted: Thu Aug 21, 2003 12:44 pm    Post subject: side cramps    

When I was on my first or second session of dialysis I got the most terrible side cramp. I had only been on the machine for a little while when this happened so it was definitely at the beginning of the tx. It was so painful I coudnt even call out for the nurse. What causes this? It's never happened again after years of txs.

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Founding RN



Joined: 10 Jan 2003
Posts: 172

   
PostPosted: Thu Aug 21, 2003 12:48 pm    Post subject: Polly    

You are not the only one to notice this. I don't think we really know what causes these cramps but I have thought that it might be fluid shifting from the abdominal area. Older patients seem to carry more of their fluid in that area and often will say they are having chest pain when in fact it is fluid shifting from the tissues into the circulatory system. Glad it hasn't happen to you since.

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debbie



Joined: 27 Jan 2003
Posts: 11

   
PostPosted: Fri Aug 22, 2003 6:51 pm    Post subject: bones....    

I have been having considerable bone and joint pain for some time now and having little luck with getting it sorted...apparently it's quite normal for dialysis patients to suffer this. However earlier this week I saw the dentist who took x-rays, he then referred me to a collegue of his who said that he felt my x-ray was showing that I had osteoporosis in my jaw and therefore he would recommend to the renal team that they do some body scans to determine the general state of the rest of my bones.<
>I am obviously quite unhappy about this outcome and worrying what will happen from here, I am only 29 and have been on dialysis for 10 yrs.<
>

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patient



Joined: 29 Oct 2002
Posts: 137

   
PostPosted: Sat Aug 23, 2003 8:15 am    Post subject: bone and joint pain    

debbie, <
>Can you describe more of what you mean by bone and joint pain? I am achey too, but for me it's an off and on kind of thing. I'd like to know how much is dialysis related and how much is related to lack of exercise. <
><
>When I get off the machine, that's when I feel the creakiest. It's like the tx sucks all the lu
ication out of my bones and joints. But then, after I rest and eat, I feel better again. I never seem to know what is causing what. And when fluid buids up that's another time I feel creaky.<
><
>Have you felt worse after x number of years of dialysis?

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debbie



Joined: 27 Jan 2003
Posts: 11

   
PostPosted: Sat Aug 23, 2003 9:00 am    Post subject: bone pain    

Hi,<
> I can't walk sometimes because my joints and bones are so painful, it makes no difference what I do, it evens hurts to lie or sit as well. It has been worse in the last 18 months or so. I have had a parathyroidectomy as well and wonder if that contributed........

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Founding RN



Joined: 10 Jan 2003
 />Posts: 172

   
PostPosted: Sun Aug 24, 2003 5:04 am    Post subject: Debbie    

I wish this wasn't so common among dialysis patients, but it is. This problem is because in order for the body to get rid of phosphorus it has to bind with calcium to be excreted from the body. If there isn't enough in your blood, then it robs your bones. And if your phosphorus is too high, then you itch! That is why it is so important to take those binders! Vit D analogs like Calcitriol, Zemplar and now Hectorol, help to control this along with your PTH levels. But for some patients there comes a time when even these meds don't work and the PTH gets out of control, it makes all this even worse and a partial or even a total parathyroidectomy is the only solution. <
><
>Please consult with your Dr. about this problem and solutions that are tailored to your particular needs. Make sure that you are taking an adequate amount of calcium and make sure you take those binders. Your Calcium levels need to be monitored so they don't get too high. Your dietician can help with calcium and phosphorus in your diet.

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patient



Joined: 29 Oct 2002
Posts: 137

   
PostPosted: Sun Aug 24, 2003 8:47 am    Post subject: bones and joints    

Do you mean that all dilaysis patients will have these problems after years of dialysis and will eventually need a para., or only if everything is not managed properly?

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Founding RN



Joined: 10 Jan 2003
Posts: 172

   
PostPosted: Sun Aug 24, 2003 11:55 am    Post subject: Patient    

Yes, all dialysis patients have varing degrees of osteoporosis, some worse than others. Being inconsistant with your binders and diet just speeds up the problems for many patients. And yes, the longer you are on dialysis, the more your chances of having bone and joint problems like this seem to increase. I wish it wasn't so, but it is. That is why staff are always telling patients to take those binders and watch their phos. intake. <
>By doing your part to take care of yourself, you can help minimize this problem and keep major problems at bay.<
><
>It is another good reason to keep yourself healthy and try to go for a transplant.

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patient



Joined: 29 Oct 2002
Posts: 137

   
PostPosted: Mon Aug 25, 2003 3:38 am    Post subject: bones and joints    

It makes me sad that I've been on dialysis all this time and none of my staff have educated me about this. Of course I know to take my binders and what it could cause if I didn't. But I feel betrayed that I haven't been told the full truth of my condition..just one more thing I'm kept in the dark about. I really dislike that about the medical profession. Are there any other long term affects from dialysis and after how many years do they occur?<
><
>How does transplant make for better bones and joints? Aren't the immunosuppressant drugs hard on the body in other ways? I've heard of patients needing hip replacements after transplants.

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Founding RN



Joined: 10 Jan 2003
Posts: 172

   
PostPosted: Mon Aug 25, 2003 5:06 am    Post subject: Patient    

Other complications really depend on what caused the renal failure in the first place and each individuals health and response to their co-morbids. For example, diabetic patients are more likely to develop circulatory problems and their blood vessels to become
ittle. They also become more susceptible to infections that usually result in amputations. <
><
>As for the staff not educating, I suspect that most of them were not even educated themselves about all this. <
><
>Transplant drugs have vastly improved in the years I have been in dialysis. As I have not worked in the transplant field, I can't give you detailed answers. Your Dr should be able to help you in that area better than I can. But by getting a transplant, your kidney does act like your old one did, making the hormones needed to regulate your bodys functions, like BP, making red blood cells, etc. <
>As for hip transplants, this is usually from being on dialysis for years and the damage from osteoporosis from the renal failure.
"Like me, you could.....be unfortunate enough to stumble upon a silent war. The trouble is that once you see it, you can't unsee it. And once you've seen it, keeping quiet, saying nothing,becomes as political an act as speaking out. Either way, you're accountable."

Arundhati Roy