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| Redjacket 2006-08-12, 8:28 am |
| If itchy is that a sign of too little water intake ?
| |
| Judanne 2006-08-12, 4:26 pm |
| Or renal failure, or high levels of phosphate, or any one of a number of
other problems. Ask your doctor.
Judanne
"Redjacket" <Redjacket@yahoo.com> wrote in message
news:-bWdnY0KL_SXLEDZnZ2dnUVZ_uydnZ2d@adelphia.com...
> If itchy is that a sign of too little water intake ?
>
>
| |
| Redjacket 2006-08-12, 4:26 pm |
| So, in general then it is.
Thank you.
I see him on the 22nd
"Judanne" <judanne@westnet.com.au> wrote in message
news:44dddeb8$1@quokka.wn.com.au...
> Or renal failure, or high levels of phosphate, or any one of a number of
> other problems. Ask your doctor.
>
> Judanne
>
> "Redjacket" <Redjacket@yahoo.com> wrote in message
> news:-bWdnY0KL_SXLEDZnZ2dnUVZ_uydnZ2d@adelphia.com...
>
>
| |
| Judanne 2006-08-13, 2:25 am |
| But with renal failure, it's usually not a problem to have too little water
intake, the problems generally occur when there is too much water intake
because the kidneys can't get rid of it and it causes oedema. In severe,
untreated mode, this can cause heart failure.
Judanne
"Redjacket" <Redjacket@yahoo.com> wrote in message
news:YOSdncl-ms2AfEDZnZ2dnUVZ_omdnZ2d@adelphia.com...
> So, in general then it is.
> Thank you.
> I see him on the 22nd
>
>
> "Judanne" <judanne@westnet.com.au> wrote in message
> news:44dddeb8$1@quokka.wn.com.au...
>
>
| |
|
| Judanne,
Generally you would be right. There are patients who perspire so
heavily that getting dehydrated is a real possibility on really hot and
humid days. This has happened to me twice. The advantage to being this
way is that if I feel bloated from too much fluid, I can work out for a
good bit to lower my fluid levels. In addition, perspiration contains a
lot of potassium, so it can be useful for this purpose as well.
An example of what I am talking about is that back in May of this year,
I went to treatment and discovered that my access had clotted. So I
couldn't get my treatment that night. They made arrangements for the
declotting to occur, but not for 2 more days, and then I would get my
treatment 1 more day later, for a total of 5 days between treatments. I
had arrived at dialysis with a weight gain of 2.9 KG, about average for
me. I went home and rode the stationery bike for about 2 hours and
worked up a real good sweat. I hardly ate until I went back for my
treatment the day after the declot, 3 days later. My weight gain at
that time was 1.2 KG above what I had left at my last successful
treatment 5 days earlier.
Basically you have to figure out how YOUR body responds and act
appropriately. Obviously, it is better to err on the side of caution
until you know for sure.
Another thing to consider here is the physical fact that even if you set
the machine to take off no fluid at all, it will take off 0.5 KG per
hour just from natural osmosis across the membrane. It's not that the
treatment can't be done in this situation, it is just more work for the
staff, having to give saline to you during the treatment to help
maintain a good enough blood pressure.
Dave
"Judanne" <judanne@westnet.com.au> wrote in
news:44de9314$1@quokka.wn.com.au:
> But with renal failure, it's usually not a problem to have too little
> water intake, the problems generally occur when there is too much
> water intake because the kidneys can't get rid of it and it causes
> oedema. In severe, untreated mode, this can cause heart failure.
>
> Judanne
>
> "Redjacket" <Redjacket@yahoo.com> wrote in message
> news:YOSdncl-ms2AfEDZnZ2dnUVZ_omdnZ2d@adelphia.com...
>
>
>
| |
| Tom Scales 2006-08-14, 4:27 pm |
|
Can you cite a reference for this? We do hemodialysis as home and my wife's
normal setting is 1.2Kg. Assuming I add back in the 300 for the final
flush, she comes off the machine at 1.2Kg even after 3 hours.
Tom
"Dave" <Someboby@someplace.com> wrote in message
news:Xns981F4B573B39DSomebobysomeplacecom@66.150.105.230...
> Judanne,
>
<snip>
> Another thing to consider here is the physical fact that even if you set
> the machine to take off no fluid at all, it will take off 0.5 KG per
> hour just from natural osmosis across the membrane. It's not that the
> treatment can't be done in this situation, it is just more work for the
> staff, having to give saline to you during the treatment to help
> maintain a good enough blood pressure.
>
> Dave
>
| |
|
| For pre-dialysis patients, dehydration can be a problem - again, not as
much as one as too much water, but in general, most stage 1, 2, and 3
patients aren't so much at risk for dangerous sudden water overloads.
For example, I take a huge amount of Lasix each day, and during very hot
weather, dehydration is a serious risk for me (well, anyone, but me even
more so).
--
"Did Father shoot him? I will eat Grandfather for dinner."
- Helen Keller, on learning of the death of her grandfather
email: aripee at inanna . com
| |
| Redjacket 2006-08-14, 4:27 pm |
| I read you should not, but I had FUO and needed a multivitamin.
I think that stopped it.
2nd FUO this year !
"REP" <rep~@inanna.com> wrote in message
news:js0Eg.8151$kO3.1193@newssvr12.news.prodigy.com...
> For pre-dialysis patients, dehydration can be a problem - again, not as
> much as one as too much water, but in general, most stage 1, 2, and 3
> patients aren't so much at risk for dangerous sudden water overloads.
> For example, I take a huge amount of Lasix each day, and during very hot
> weather, dehydration is a serious risk for me (well, anyone, but me even
> more so).
>
> --
> "Did Father shoot him? I will eat Grandfather for dinner."
> - Helen Keller, on learning of the death of her grandfather
>
> email: aripee at inanna . com
| |
|
| Tom,
When you set a goal, that is what the machine will try to take off using
ultrafiltration, which is a negative pressure across the membrane,
refered to as TMP or Trans Membrane Pressure. The pressure is negative
because the pressure on the blood side is higher than the pressure on
the dialysate side. The machine changes the TMP periodically to reach
your goal in the prescribed time. In actuality, the removal numbers the
machine shows are calculated values. The machine does not actually
measure the amount of fluid removed. The program in the machine is
pretty close most of the time because it uses equations determined from
the performance of hundreds of thousands of treatments. The more data,
the less the error. However, as most patients will attest, the set goal
is not always where you end up. I have gone past my goal, once almost 3
KG,although I suspect that the machine was set wrong. I have also come
up short. Probably has to do with salt intake, but no studies to prove
this.
Now for what I said about the 0.5 KG per hour. When the TMP is zero, as
when no goal is set, osmonic pressure takes over. Osmonic pressure is
the natural pressure that two fluids in contact have between them due to
the different concentrations of the two fluids. If you have gone to
college and taken a first year Biology class, they do an experiment
using a single layer dialysis membrane. You fill the dialysis membrane
like a balloon using a saline (salt) solution. You tie off the end and
place the membrane into a beaker of deionized(pure) water. After a
couple of hours, but usually the next week, you will observe that the
balloon has swelled to as large as it can go. Because there was more
salt inside the membrane, the water flowed into the balloon in an
attempt to equalize the concentration. This is exactly what happens
when no goal is set. The Dialysate fluid and your blood have different
concentrations of many chemicals, causing a natural osmonic pressure to
develop. Note that only the water moves with osmonic pressure, as water
goes across the membrane freely while all the other chemicals,i.e.
Potassium, Calcium, etc., move so slowly without an increased pressure
that the amount removed is next to nothing.
Just to complete the picture some more, the ultrafiltration in dialysis
is used for two purposes. First, it allows for larger fluid loads to be
removed in a shorter time. Second, it accelrates the rate of removal of
the other chemicals you want to remove. Now, how much of the other
chemicals get removed is controlled somewhat by what chemicals and at
what concentrations they are present in the dialysis fluid. Hence a 3
gram K (potassium)dialysis fluid will remove less K than a 2 gram K
dialysis fluid, and likewise with the other chemicals in you system.
Obviously, this is suomewhat simplified and not into all out detail. I
learned all of this while in college, where I received a BS in Chemical
Engineering. Membrane Separations, which Dialysis is one form of, is
part of the major requirements for a BS in Chemical Engineering, and was
in fact my specialty. I went to college while I was a dialysis patient.
Any textbook on membrane separations will cover the details of how it
all occurs, but I must profess that to somebody without an actual
interest in the chemistry and physics, it would come across as pretty
dry reading, and there are many preparatory couses before you get to
Membrane Separations, including taking mathematics through Differential
Equations, a course that most students never approach.
If somebody were intersted in taking this further, I would be willing to
do this, but I doubt it. And yes, my interest in membrane separations
had to do with the fact I was on dialysis. My way to cope with the
whole situation was to learn as much as I could about the whole thing.
I have been dealing with dialysis or transplant for over 19 years, and I
really did not do well in the beginning when I knew nothing. Learning
about all this is how I came to terms with it.
If you have any more questions, please ask. If I know, I will tell.
Dave
"Tom Scales" <tjscales@gmail.com> wrote in
news:yU_Dg.16358$hu3.9325@tornado.tampabay.rr.com:
>
> Can you cite a reference for this? We do hemodialysis as home and my
> wife's normal setting is 1.2Kg. Assuming I add back in the 300 for
> the final flush, she comes off the machine at 1.2Kg even after 3
> hours.
>
> Tom
>
> "Dave" <Someboby@someplace.com> wrote in message
> news:Xns981F4B573B39DSomebobysomeplacecom@66.150.105.230...
> <snip>
>
| |
| Tom Scales 2006-08-14, 9:27 pm |
| Dave,
I understand the chemistry. I disagree that 0.5KG comes off even if it is
set to zero. Some comes off, but not that drastic an amount. I can verify
this with an accurate scale.
I realize you're also an experienced patient, but I'm the one running the
machine --- I'm sure of my numbers.
No need to reply -- best to agree to disagree.
Tom
"Dave" <Someboby@someplace.com> wrote in message
news:Xns981FB5EBF87CBSomebobysomeplacecom@66.150.105.230...
> Tom,
>
> When you set a goal, that is what the machine will try to take off using
> ultrafiltration, which is a negative pressure across the membrane,
> refered to as TMP or Trans Membrane Pressure. The pressure is negative
> because the pressure on the blood side is higher than the pressure on
> the dialysate side. The machine changes the TMP periodically to reach
> your goal in the prescribed time. In actuality, the removal numbers the
> machine shows are calculated values. The machine does not actually
> measure the amount of fluid removed. The program in the machine is
> pretty close most of the time because it uses equations determined from
> the performance of hundreds of thousands of treatments. The more data,
> the less the error. However, as most patients will attest, the set goal
> is not always where you end up. I have gone past my goal, once almost 3
> KG,although I suspect that the machine was set wrong. I have also come
> up short. Probably has to do with salt intake, but no studies to prove
> this.
>
> Now for what I said about the 0.5 KG per hour. When the TMP is zero, as
> when no goal is set, osmonic pressure takes over. Osmonic pressure is
> the natural pressure that two fluids in contact have between them due to
> the different concentrations of the two fluids. If you have gone to
> college and taken a first year Biology class, they do an experiment
> using a single layer dialysis membrane. You fill the dialysis membrane
> like a balloon using a saline (salt) solution. You tie off the end and
> place the membrane into a beaker of deionized(pure) water. After a
> couple of hours, but usually the next week, you will observe that the
> balloon has swelled to as large as it can go. Because there was more
> salt inside the membrane, the water flowed into the balloon in an
> attempt to equalize the concentration. This is exactly what happens
> when no goal is set. The Dialysate fluid and your blood have different
> concentrations of many chemicals, causing a natural osmonic pressure to
> develop. Note that only the water moves with osmonic pressure, as water
> goes across the membrane freely while all the other chemicals,i.e.
> Potassium, Calcium, etc., move so slowly without an increased pressure
> that the amount removed is next to nothing.
>
> Just to complete the picture some more, the ultrafiltration in dialysis
> is used for two purposes. First, it allows for larger fluid loads to be
> removed in a shorter time. Second, it accelrates the rate of removal of
> the other chemicals you want to remove. Now, how much of the other
> chemicals get removed is controlled somewhat by what chemicals and at
> what concentrations they are present in the dialysis fluid. Hence a 3
> gram K (potassium)dialysis fluid will remove less K than a 2 gram K
> dialysis fluid, and likewise with the other chemicals in you system.
>
> Obviously, this is suomewhat simplified and not into all out detail. I
> learned all of this while in college, where I received a BS in Chemical
> Engineering. Membrane Separations, which Dialysis is one form of, is
> part of the major requirements for a BS in Chemical Engineering, and was
> in fact my specialty. I went to college while I was a dialysis patient.
> Any textbook on membrane separations will cover the details of how it
> all occurs, but I must profess that to somebody without an actual
> interest in the chemistry and physics, it would come across as pretty
> dry reading, and there are many preparatory couses before you get to
> Membrane Separations, including taking mathematics through Differential
> Equations, a course that most students never approach.
>
> If somebody were intersted in taking this further, I would be willing to
> do this, but I doubt it. And yes, my interest in membrane separations
> had to do with the fact I was on dialysis. My way to cope with the
> whole situation was to learn as much as I could about the whole thing.
> I have been dealing with dialysis or transplant for over 19 years, and I
> really did not do well in the beginning when I knew nothing. Learning
> about all this is how I came to terms with it.
>
> If you have any more questions, please ask. If I know, I will tell.
>
> Dave
>
>
> "Tom Scales" <tjscales@gmail.com> wrote in
> news:yU_Dg.16358$hu3.9325@tornado.tampabay.rr.com:
>
>
| |
| Paul Bartram 2006-08-15, 2:26 am |
|
"Dave" <Someboby@someplace.com> wrote
> When you set a goal, that is what the machine will try to take off using
> ultrafiltration, which is a negative pressure across the membrane,
> refered to as TMP or Trans Membrane Pressure. The pressure is negative
> because the pressure on the blood side is higher than the pressure on
> the dialysate side.
I keep learning new things here. We have a mixture of machines in our unit,
Fresenious 4008S and earlier (non-VDU) models plus a couple of clunky old
Gambros that the staff are always having problems with. I ask questions of
the staff, and where possible they answer, but I sometimes wonder if even
they know all the widgets and gizmoes on the different models. I think it is
important that the patients have at least a basic knowledge of how these
machines work, because I've spotted mistakes on many occassions.
So, does anyone know of a web source that describes these machines and how
they work in detail? The manufacturers' own sites are more like sales
brochures, not much help. I'm one of those people who has a 'need to
know...' :-)
Paul
| |
| daniel.granot@gmail.com 2006-08-15, 8:28 am |
|
I know exactly where you're coming from Paul.
I am also one of those people who chooses to "own" their own health and
therefore attempts to understand as much as possible.
If you come across such a resource please let us all know.
Paul Bartram wrote:
> "Dave" <Someboby@someplace.com> wrote
>
>
> I keep learning new things here. We have a mixture of machines in our unit,
> Fresenious 4008S and earlier (non-VDU) models plus a couple of clunky old
> Gambros that the staff are always having problems with. I ask questions of
> the staff, and where possible they answer, but I sometimes wonder if even
> they know all the widgets and gizmoes on the different models. I think it is
> important that the patients have at least a basic knowledge of how these
> machines work, because I've spotted mistakes on many occassions.
>
> So, does anyone know of a web source that describes these machines and how
> they work in detail? The manufacturers' own sites are more like sales
> brochures, not much help. I'm one of those people who has a 'need to
> know...' :-)
>
> Paul
| |
| somebody 2006-08-15, 4:28 pm |
| Tom,
No need to agree to disagree. Many things that are taken as rules of thumb
in dialysis are rough estimates at best. They vary from patient to patient.
I am glad to see your diligence in making at least a mental note of
everything while you are operating the machine. As you undoubtedly know, you
can head off bigger problems by catvhing the little problems when they pop
up. Good Luck
Dave
"Tom Scales" <tjscales@gmail.com> wrote in message
news:KZ9Eg.567$Tg1.327@tornado.tampabay.rr.com...
> Dave,
>
> I understand the chemistry. I disagree that 0.5KG comes off even if it is
> set to zero. Some comes off, but not that drastic an amount. I can
> verify this with an accurate scale.
>
> I realize you're also an experienced patient, but I'm the one running the
> machine --- I'm sure of my numbers.
>
> No need to reply -- best to agree to disagree.
>
> Tom
> "Dave" <Someboby@someplace.com> wrote in message
> news:Xns981FB5EBF87CBSomebobysomeplacecom@66.150.105.230...
>
>
| |
| Tom Scales 2006-08-15, 9:26 pm |
| Agreed. I am a big advocate for home-hemo. It is a HUGE difference to the
well being of the patient.
Tom
"somebody" <somebody@someplace.com> wrote in message
news:IkpEg.13623$gY6.3165@newssvr11.news.prodigy.com...
> Tom,
>
> No need to agree to disagree. Many things that are taken as rules of
> thumb in dialysis are rough estimates at best. They vary from patient to
> patient. I am glad to see your diligence in making at least a mental note
> of everything while you are operating the machine. As you undoubtedly
> know, you can head off bigger problems by catvhing the little problems
> when they pop up. Good Luck
>
> Dave
> "Tom Scales" <tjscales@gmail.com> wrote in message
> news:KZ9Eg.567$Tg1.327@tornado.tampabay.rr.com...
>
>
| |
|
| Home Hemo would be an option for me if I had somebody to perform the
treatment. As it turns out, the unit I attend started the Nocturnal shift
in the unit itself. I haven't felt this good in many years. In the
states, Home Hemo is either done 3 times a week for 4 hours or 6 days a
week for 2 hours, with few exceptions. Now that I have had 8 hour
treatments, I will never do less unless I can't get the 8 hour treatment,
the difference in how I feel is so dramatic. There have been a couple of
patients who have tried to go back to 4 hours and returned to the 8 hour
shift after only a couple of treatments. Nocturnal is not for everyone,
though. There have been patients who have tried it but didn't like it for
one reason or the other. I still recommend trying it if it is available.
I don't know if you can push your time to 8 hours on Home Hemo, but I would
inquire about it.
Dave
| |
|
| I won't say you will never find this information, but I think it is
unlikely. Machine architecture is considered a trade secret, including
the operating system.
My unit is using the 4008's as well, although in the last week they have
replaced half of the machines with new ones, for which I haven't checked
out the Model # yet.
Dave
"Paul Bartram" <p.bartram AT OR NEAR optusnet.com.au> wrote in
news:44e1649c$0$22362$afc38c87@news.optusnet.com.au:
>
> "Dave" <Someboby@someplace.com> wrote
>
>
> I keep learning new things here. We have a mixture of machines in our
> unit, Fresenious 4008S and earlier (non-VDU) models plus a couple of
> clunky old Gambros that the staff are always having problems with. I
> ask questions of the staff, and where possible they answer, but I
> sometimes wonder if even they know all the widgets and gizmoes on the
> different models. I think it is important that the patients have at
> least a basic knowledge of how these machines work, because I've
> spotted mistakes on many occassions.
>
> So, does anyone know of a web source that describes these machines and
> how they work in detail? The manufacturers' own sites are more like
> sales brochures, not much help. I'm one of those people who has a
> 'need to know...' :-)
>
> Paul
>
>
>
| |
| Tom Scales 2006-08-16, 4:28 pm |
|
"Dave" <Someboby@someplace.com> wrote in message
news:Xns982145630F0CSomebobysomeplacecom@66.150.105.230...
> Home Hemo would be an option for me if I had somebody to perform the
> treatment. As it turns out, the unit I attend started the Nocturnal shift
> in the unit itself. I haven't felt this good in many years. In the
> states, Home Hemo is either done 3 times a week for 4 hours or 6 days a
> week for 2 hours, with few exceptions. Now that I have had 8 hour
> treatments, I will never do less unless I can't get the 8 hour treatment,
> the difference in how I feel is so dramatic. There have been a couple of
> patients who have tried to go back to 4 hours and returned to the 8 hour
> shift after only a couple of treatments. Nocturnal is not for everyone,
> though. There have been patients who have tried it but didn't like it for
> one reason or the other. I still recommend trying it if it is available.
> I don't know if you can push your time to 8 hours on Home Hemo, but I
> would
> inquire about it.
>
> Dave
That's really cool. We run overnight as well, but since we don't have a
monitored machine, I have to get up occasionally to check it. We usually run
4 hours, which works very well for her. One advantage of home hemo is that
rather than 3 days a week, it is every other day, so there are extra
sessions per month compared to 'normal' in center.
| |
|
| Yeah, really cool. My KT/V now runs above 3.0 and my recovery time after
treatment is less than the time I hold my needle sites. I no longer
have to take binders for the phosphate in my diet, and in fact the
restrictions have been lowered. Also, for those days when I have been a
bad boy, you know with too much fluid, The length of the treatment
minimizes the usual affects of a crashing blood pressure and feeling
like you got run over by a truck. Note that these revelations are just
for me, but most other patients have had similar experiences.
Dave
"Tom Scales" <tjscales@gmail.com> wrote in
news:tnJEg.1927$bZ6.1590@tornado.tampabay.rr.com:
>
> "Dave" <Someboby@someplace.com> wrote in message
> news:Xns982145630F0CSomebobysomeplacecom@66.150.105.230...
>
> That's really cool. We run overnight as well, but since we don't have
> a monitored machine, I have to get up occasionally to check it. We
> usually run 4 hours, which works very well for her. One advantage of
> home hemo is that rather than 3 days a week, it is every other day, so
> there are extra sessions per month compared to 'normal' in center.
>
>
>
| |
| chris thame 2006-08-17, 4:28 pm |
| Is this available in the UK?
On 16 Aug 2006 22:21:49 GMT, Dave <Someboby@someplace.com> wrote:
[vbcol=seagreen]
>Yeah, really cool. My KT/V now runs above 3.0 and my recovery time after
>treatment is less than the time I hold my needle sites. I no longer
>have to take binders for the phosphate in my diet, and in fact the
>restrictions have been lowered. Also, for those days when I have been a
>bad boy, you know with too much fluid, The length of the treatment
>minimizes the usual affects of a crashing blood pressure and feeling
>like you got run over by a truck. Note that these revelations are just
>for me, but most other patients have had similar experiences.
>
>Dave
>
>
>"Tom Scales" <tjscales@gmail.com> wrote in
>news:tnJEg.1927$bZ6.1590@tornado.tampabay.rr.com:
>
| |
|
| I don't know, it is not available everywhere here because they have
trouble getting dialysis staff to work overnight. Of course, my opinion
on this is they are looking in the wrong place. They want only
experienced dialysis nurses and techs, but they would find more nurses
if they would ask nurses that work the overnight shifts in the ER or on
the Floors in hospitals, train them for a while during day shifts and
then bring them to nocturnal. Just my opinion.
Talk to somebody at your unit. I they don't know, ask them to look into
it for you.
Dave
chris thame <chris.thame@dialstart.net> wrote in
news:pkv8e2ldhmjcqprsm6do9b2uglnrtesoha@4ax.com:
> Is this available in the UK?
>
> On 16 Aug 2006 22:21:49 GMT, Dave <Someboby@someplace.com> wrote:
>
after[vbcol=seagreen]
a[vbcol=seagreen]
just[vbcol=seagreen]
the[vbcol=seagreen]
Nocturnal[vbcol=seagreen]
or[vbcol=seagreen]
had[vbcol=seagreen]
hour[vbcol=seagreen]
who[vbcol=seagreen]
can[vbcol=seagreen]
have[vbcol=seagreen]
of[vbcol=seagreen]
so[vbcol=seagreen]
>
>
| |
| Paul Bartram 2006-08-17, 9:28 pm |
|
"Dave" <Someboby@someplace.com> wrote
> [Overnight dialysis] I don't know, it is not available everywhere here
because they have
> trouble getting dialysis staff to work overnight. Of course, my opinion
> on this is they are looking in the wrong place. They want only
> experienced dialysis nurses and techs, but they would find more nurses
> if they would ask nurses that work the overnight shifts in the ER or on
> the Floors in hospitals, train them for a while during day shifts and
> then bring them to nocturnal. Just my opinion.
They are just doing the preliminary work needed to introduce it in
Queensland (Aus). They have surveyed all the patients to see how many would
be prepared to do nocturnal HD, but I have not heard what the results were.
The staff were less than enthusiastic, I do know that. Besides the increased
stress of having to adjust to a 24 hour spread of shifts, they are worried
about personal safety and that of their vehicles, which have to be parked on
the street (mine was stolen from there last year!)
Paul
|
| |
|
|