Wednesday, April 27, 2011

Well sometimes mistakes happen. For those of you familiar with the dialysis process, and how it all works, this should be understood. Every time I go to dialysis, which is three times a week, at 6 a.m., the first thing I, ( and all other patients do) is to weigh in. The reasons are several. Between treatments, when one has no kidney function, or least diminished enough to be a dialysis patient, fluid, in the any form, builds up in the body an is not properly excreted by the kidneys. This fluid buildup is measured by the added weight gain from one's "dry" weight one left at the treatment before (at least that is the goal). A dry weight is the lowest weight of ones body calculated by a number of things, a low but steady blood pressure, cramping, and other general well being issues. Between treatments, from one drinking and taking in other fluids from food, the body retains these fluids and the body weight increases. In my case, because I have no kidneys, and thus make no urine, the buildup can be measured almost to a one to one ratio. Except for my grand cheating with my sweating, that can be substantial, from my running and other physical activity. The weight gain between treatments is regular and steady. I usually gain between two and three kilograms, which is considered normal, each treatment. By having this amount to have taken off during the dialysis process, I don't get any of the side effects of low blood pressure or cramping that can accompany having too much fluid taken off in my three hour treatment.

Now the mistake was a simple one, and so basic, but important. After I weighed in I have the weight written down on a "flow sheet". Basically an intake sheet that takes in some simple information every treatment to log data for that day. That weight, as written down, determines, how much should be taken off for the day. In my case, today, I weighed in at 55.2 kilos, and my dry weight is 53.0 kilos. Simple math takes over and a fluid goal is put manually into the dialysis machine. In this case it should have been 2.2, unfortunately it ended up at 3.2. It wasn't discovered until my treatment was over, because, for the good or the bad, my body just does not have the violent reactions to going below my dry weight right away. I felt a tiny bit of cramping, and my blood pressure was a little low, but nothing where I or the nurses would be on alert. The extra fluid draw was not discovered until I was coming off the machine, and having my needles pulled. I felt okay and went home.

Later on I felt the extra weight more , as the afternoon wore on it was hard to stand for long periods, as I was light headed, and I felt more washed out than usual. I have needed to drink more water to get back to equilibrium. I feel bad, and not just physically, because I am usually very good about double checking these numbers myself while the nurses are putting me on. I am very serious about being aware of my own care and knowing what is going on. Today I just did not think. Shame on me. It will be okay though.


Anonymous said...

Austin, I am sorry you are still struggling.. Why is it taking so long for you to get a kidney?? My prayers are with you and I hope you
get one soon

Sarah Matuszynski Rose said...

It amazes me that you lead (by any standards) such an active, full life. You obviously own your kidney disease and not vice versa.