Author Topic: Questions Part 42 (part b)  (Read 1558 times)

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Questions Part 42 (part b)
« on: August 30, 2009, 08:21:32 AM »
Leslie



Joined: 19 Jan 2003
Posts: 1

   
PostPosted: 19 Jan 2003 05:45    Post subject: Iron Sat    

I had near perfect labs this month except for my iron sat which droped to 21. My nurse said when iron sat drops below 25 they start an iron load. I guess its a Medicare rule, but isn't there a way to catch it before it drops below 25? I noticed that I had quie a few days this month when my hands feet and nose felt cold and I've been cold by the end of dialysis txs.

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Founding RN

Joined: 10 Jan 2003
Posts: 172

   
PostPosted: 19 Jan 2003 23:27    Post subject: Leslie
    
If monthly Iron studies are drawn, then the low Iron Sat could have been caught sooner and treated. But what you have to realize is that your clinic is going by the DOQI guidelines and it recommends that Iron Sats be treated if they fall below 25%.<
><
>What I found in my years as an anemia manager is that by the time the Iron Sat falls below 28%, your hct is falling so fast that it will usualy fall below 30% and take much longer for the EPO to
ing your hct back up into target range. (This then means that they increase your EPO dose which = more money for your clinic. ) I found this even more true with my elderly pateints. If I treated them with a course of IV Iron when they hit between 25-28%, their hcts didn't fall nearly as fast and I could easily
ing them back up into the target range.<
>the symptoms you describe may be from being anemic, a lower hct than what you are used to.


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Founding RN



Joined: 10 Jan 2003
Posts: 172

   
PostPosted: 19 Jan 2003 23:34    Post subject: Patient    

Chicken soup and Pickles are used more often for patients who cramp severely. I have used chicken
oth for patients who didn't want a needle put back in for more saline when their BP's were low. <
>The best way to avoid all this is to stand up and weigh before the needles are pulled incase you need some saline to get a low BP back up or are cramping. Pickles and Chicken soup are full of sodium and will just add to your thirst, something you have already discovered.<
><
>Sodium makes you retain fluid. (Fluid retained = increased BP.) It helps your body hang onto it and some patients who have a hard time removing fluid will cramp as the machine tries to remove the fluid.


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Kelli



Joined: 19 Jan 2003
Posts: 3

   
PostPosted: 27 Jan 2003 18:53    Post subject: Iron and Menses    

I have noticed a correlation with the fact that when I am given IV iron (an iron load) it causes my menses, which I have not had for months to start. Have you ever noticed this as being the case with some female patients? I have been to my gyn and she had no answers.

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debbie



Joined: 28 Jan 2003
Posts: 11

   
PostPosted: 28 Jan 2003 07:41    Post subject: iron and menses    

I have noticed that if I keep my Hb below 12 (uk levels, don't know how this compares elsewhere) then I get normal monthly menses, however as soon as it goes up I suffer continually and painfully. My neph doesn't agree with my theory but I monitor my epo doses and try to keep my iron levels up and then I can control my own situation. I also find that the week that I am bleeding I cannot get within .5kilo of my weight!

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Founding RN



Joined: 10 Jan 2003
Posts: 172

   
PostPosted: 28 Jan 2003 16:40    Post subject: Kelli    

Female patients have not shared this with me, but that does not mean that it doesn't happen. And this could also just be an individualized reaction too. Hard to say.<
>The most complaints I get is how the heparin affects menstral bleeding.

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Founding RN



Joined: 10 Jan 2003
Posts: 172

   
PostPosted: 28 Jan 2003 16:45    Post subject: Debbie    

Your observation is interesting. this is not a complaint that I have heard before. You may want to consult with your GYN on this. <
><
>As for not getting down to your DW when you are having your menses, this is normal as your body/ hormones work against you during this time to retain fluid. Work with it and be more aware of your sodium intake. After your menses, be sure that you try to get back down to your DW.

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Kelli



Joined: 19 Jan 2003
Posts: 3

   
PostPosted: 28 Jan 2003 18:48    Post subject: Debbi    

thank you for the feedback, but I didn't quite folow what you meant. You said in your first post that when your hgb is below 12 your menses is regular, but when its above 12 it is troublesome. Then in your 2nd post you said you keep your hgb up. Could you please clarify? My hgb usually stays at 12 something but I don't have a menses for months. When they give me an iron load, that seems to start my menses. My doctor doesn't seem to know a thing about any of this. Even my gyn didn't know anything.

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leadsag



Joined: 31 Oct 2002
Posts: 263

   
PostPosted: 30 Jan 2003 19:26    Post subject: cayane pepper pills    

What effect will taking cayane pepper pills have on dialysis? Have heard they are good for reducing BP and reduce blockage of artieries. Is it ok to take them even if you have not been told you have any blockage just as a preventative measure?

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Founding RN



Joined: 10 Jan 2003
Posts: 172

   
PostPosted: 31 Jan 2003 16:09    

Post subject: Leadsag    
I haven't heard of using cayenne pepper pills for BP control. It sounds like this would fall under a herbal therapy and if so, you really need to talk to your Dr about this or better yet, check with your Pharmacist. <
>Herbal therapies are being studied and are slowly being understood. What you do not want is an adverse reaction between your perscribed meds and your herbal alternatives.
« Last Edit: August 30, 2009, 12:12:13 PM by Administrator »
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