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  • Why am I so tired?

    I live and get treated in Pennsylvania. I've been on dialysis for 2 years now 3 times a week and feel run down everyday even a little on my off days too. Everyone else there feels like I do so are they doing something wrong at my dialysis center? How can everyone I read about on here feel so good afterwards when everyone I get treated with feel so bad? It's so bad that some people are getting off and killing themselves. BTW this is not a Davita center but a local hospitals dialysis center.

  • #2
    Re: Why am I so tired?

    greetings DialysisinPa, welcome to the forum. I'm just wondering if you all have the same nephrologist? something isn't right. mabe they're taking off too much fluid and you've become dehydrated, that can make a person very tired. are you anemic? ditto on that one.
    keep in touch and let us know if you get any improvements, sure hope so!
    CAPD (continuous ambulatory peritoneal dialysis)
    since 7/13/07 with 4 exchanges a day
    kidney function improved after 2 years
    presently at 2 exchanges a day :-)
    diabetic, not on insulin

    Comment


    • #3
      Re: Why am I so tired?

      If it is mainly universal, get the Kidney Council in for an audit. They have the responsibility for the quality of the work and are responsible to Medicare. You'll find their stuff posted on the bb in your lobby or where ever you guys come in and wait for processing.
      Good luck and God bless
      Cicero
      May God have mercy on us all

      CK

      Idiopathic globular membranous nephritis 1999-2006
      Feb 2006 Dx about 1-2 yrs before dialysis. Dialysis start 6-2006
      Chest Cath 4 mos in center hemo dialysis
      Fistula, button holes, self stick days 07-09 in center hemo
      Graft nocturnal hemo 4Q09 to present

      Comment


      • #4
        Re: Why am I so tired?

        Another place to get in touch with would be
        the ESRD network
        http://www.esrdnetworks.org/

        direct link to Pennsylvania ( ESRD Network4) is:
        http://www.esrdnetwork4.org/

        Hopefully they can look into this and find a solution quickly!

        Take care!

        Marina
        I received the GIFT OF LIFE on Nov 9, 2010 thanks to my wonderful donor Laura and her family!

        Comment


        • #5
          Re: Why am I so tired?

          Thanks for all the answers I'm gonna get on it this week and get to the bottom of it. We all have the same doc.I'll let you know what I find out.

          Comment


          • #6
            Re: Why am I so tired?

            Originally posted by dialysisinpa View Post
            I live and get treated in Pennsylvania. I've been on dialysis for 2 years now 3 times a week and feel run down everyday even a little on my off days too. Everyone else there feels like I do so are they doing something wrong at my dialysis center? How can everyone I read about on here feel so good afterwards when everyone I get treated with feel so bad? It's so bad that some people are getting off and killing themselves. BTW this is not a Davita center but a local hospitals dialysis center.
            Dialysisinpa,

            This is very common for in-center dialysis. What is more than likely happening is that they are removing too much fluid too fast. This not only causes blood pressures problems, but is very stressful on the heart. The in-center approach to this is to give you more fluid.... Now, you have just been sitting there for a 3 hour treatment to remove fluid ( and toxins) and they give you more fluid at the end of treatment.... What sense does this make... It is like a roller coaster ride....
            When you remove too much fluid or remove fluid too fast, the bodys response is for the blood pressure to drop. You may also feel nauseated and have a sick feeling for several hours. You may also experience head ache.
            There are three compartments in which fluid resides and must pass in order for it to be removed in dialysis. It goes from the tissues of the body - to cells - to bloodstream. When it reaches the bloodstream, this is what is being removed by dialysis.
            Problem: The body is only capable of removing a certain amount of fluid per hour since the bloodstream can only hold a certain amount... This amount is approx .400cc's (.4L) give or take a few hundred cc's per each individual depending on weight/height etc. So lets say it is 600cc's or .6L. If they are taking more than that off per hour, or lets say 1800cc's ( 1.8Liters) per treatment, then you may get the washed out horrible feeling. You are stressing not only the heart, but also your fistula/veins. It takes approx 1 hour for the fluid to move from one compartment to another in the body.

            I have been in-center and most people after their day off, are removing much more than the 1.8 Liters per treatment. They can remove as much as 5 liters or more in a 3 or 4 hour treatment. This is stressing the heart entirely too much.

            Also, do you know what your hemoglobin is ( red blood cell count) If this is low, then this may be another reason why you are tired. Are you receiving Iron?

            For all of those in-center -
            Also, with in-center, they are running people at entirely too high of blood flows. Sometimes 5-600 pump speed. This also can cause issues with your fistula/heart. The reason they do this is that they are required by CMS for you to reach a certain KT/v each month. Since you are only there for 3 or 4 hours every other day, they must crank up the blood flow to each this goal.
            The fact is that more dialysis and slower dialysis is much better for you. It is gentler on the body, and removes more of the toxins from the body. No head aches, no washed out feeling, no bp drops.
            The aggrevating thing is, the nephrologists know this. So why do they not offer it to in-center patients...The answer is, they must get you out in order for them to get the next patient in. Most in-center patients are not receiving opticmal dialysis, but rather adequate and sometimes not even that.
            Nost in-center patients will not question their nephrologist but rather take their word as what goes.... So for your own health, ask your nephrologists - ask them if the nausea, bp drops and washed out feeling is related to the high blood flows and pulling too much fluid off too quickly.....
            Research dialysis and how the settings affect you..... Do you want adequate just getting you by or do you want optimal?
            Is home dialysis possible for you?
            ______________________________
            PD - 13 Years
            3 Transplants
            In-Center Hemo - 6 Months
            NxStage - Since April - 06
            Facebook: Dialysis Discussion Uncensored

            ________________________________

            Comment


            • #7
              Re: Why am I so tired?

              Originally posted by M3Riddler View Post
              Dialysisinpa,

              This is very common for in-center dialysis. What is more than likely happening is that they are removing too much fluid too fast. This not only causes blood pressures problems, but is very stressful on the heart. The in-center approach to this is to give you more fluid.... Now, you have just been sitting there for a 3 hour treatment to remove fluid ( and toxins) and they give you more fluid at the end of treatment.... What sense does this make... It is like a roller coaster ride....
              When you remove too much fluid or remove fluid too fast, the bodys response is for the blood pressure to drop. You may also feel nauseated and have a sick feeling for several hours. You may also experience head ache.
              There are three compartments in which fluid resides and must pass in order for it to be removed in dialysis. It goes from the tissues of the body - to cells - to bloodstream. When it reaches the bloodstream, this is what is being removed by dialysis.
              Problem: The body is only capable of removing a certain amount of fluid per hour since the bloodstream can only hold a certain amount... This amount is approx .400cc's (.4L) give or take a few hundred cc's per each individual depending on weight/height etc. So lets say it is 600cc's or .6L. If they are taking more than that off per hour, or lets say 1800cc's ( 1.8Liters) per treatment, then you may get the washed out horrible feeling. You are stressing not only the heart, but also your fistula/veins. It takes approx 1 hour for the fluid to move from one compartment to another in the body.

              I have been in-center and most people after their day off, are removing much more than the 1.8 Liters per treatment. They can remove as much as 5 liters or more in a 3 or 4 hour treatment. This is stressing the heart entirely too much.

              Also, do you know what your hemoglobin is ( red blood cell count) If this is low, then this may be another reason why you are tired. Are you receiving Iron?

              For all of those in-center -
              Also, with in-center, they are running people at entirely too high of blood flows. Sometimes 5-600 pump speed. This also can cause issues with your fistula/heart. The reason they do this is that they are required by CMS for you to reach a certain KT/v each month. Since you are only there for 3 or 4 hours every other day, they must crank up the blood flow to each this goal.
              The fact is that more dialysis and slower dialysis is much better for you. It is gentler on the body, and removes more of the toxins from the body. No head aches, no washed out feeling, no bp drops.
              The aggrevating thing is, the nephrologists know this. So why do they not offer it to in-center patients...The answer is, they must get you out in order for them to get the next patient in. Most in-center patients are not receiving opticmal dialysis, but rather adequate and sometimes not even that.
              Nost in-center patients will not question their nephrologist but rather take their word as what goes.... So for your own health, ask your nephrologists - ask them if the nausea, bp drops and washed out feeling is related to the high blood flows and pulling too much fluid off too quickly.....
              Research dialysis and how the settings affect you..... Do you want adequate just getting you by or do you want optimal?
              Is home dialysis possible for you?
              Yes they dump water in me everyday because my BP drops too low and when I get home it gets low again.You're so right, I talked to them about it today and they said longer treatments may help with my problem and were gonna give it a try. I never really thought about home dialysis is it better?

              Comment


              • #8
                Re: Why am I so tired?

                I give up! I still have too low of blood pressure when I'm done then they squeeze water in to bring it back and I've been sick since Friday with low bp and dehydration symptoms. The only fix I see that would work are more regulations on these centers and routine State or Federal inspections to make sure we get proper treatments. Unless something like that happens we're all better off dead here.

                Comment


                • #9
                  Re: Why am I so tired?

                  Are there other centers you can transfer to in your area ?

                  They need to re-evaluate your dry weight, because it sure sounds like they're pulling way too much fluid.


                  Take care!

                  Marina
                  I received the GIFT OF LIFE on Nov 9, 2010 thanks to my wonderful donor Laura and her family!

                  Comment


                  • #10
                    Re: Why am I so tired?

                    No more close by. I can barely walk up 3 steps to get in my house i'm so weak I can't do anything. Even the next day they must be taking too much.

                    Comment


                    • #11
                      Re: Why am I so tired?

                      Update: Thank you so much everyone, especially Marina you probably saved my life. I made them check and adjust my dry weight now I feel so much better. For any readers having this same problem I was getting too dehydrated and felt like I had a bad hangover 24-7.

                      Comment


                      • #12
                        Re: Why am I so tired?

                        Originally posted by dialysisinpa View Post
                        Yes they dump water in me everyday because my BP drops too low and when I get home it gets low again.You're so right, I talked to them about it today and they said longer treatments may help with my problem and were gonna give it a try. I never really thought about home dialysis is it better?
                        Home Dialysis is Much Better... You are in control, You are on your own schedule, You do not have to drive to a clinic..... Not to mention that your diet should be liveral since you are dialyzing more. Also, you are able to run at a lower blood flow level and have longer treatments...two things that are uncommon if you are in-center.
                        With the longer treatments, you will be removing more toxins from the body and you will feel much much better. If you are on blood pressure meds currently, you more than likely will be off of all of them within a week.

                        Have they ever spoken to you about home dialysis? They are required to by law, but this often gets overlooked.

                        Slow that blood flow down to under 400 ( more if you can ) and spread that treatment time out.....This is much gentler on the body. You would be suprised how much better you will feel. It is like night and day.....

                        You are your best advocate.....

                        Any questions...fire them away.....

                        ///M3R
                        ______________________________
                        PD - 13 Years
                        3 Transplants
                        In-Center Hemo - 6 Months
                        NxStage - Since April - 06
                        Facebook: Dialysis Discussion Uncensored

                        ________________________________

                        Comment


                        • #13
                          Re: Why am I so tired?

                          Thanks M3Riddler, that makes sense and I will keep that in mind. I'm still getting use to feeling good again and I'm happy with the way I feel now. I don't know if I can stick myself but I imagine you get use to it. I know a young person that slept during home dialysis then had a leak and bled to death. So there is pros and cons to both.

                          Comment


                          • #14
                            Re: Why am I so tired?

                            Originally posted by dialysisinpa View Post
                            Update: Thank you so much everyone, especially Marina you probably saved my life. I made them check and adjust my dry weight now I feel so much better. For any readers having this same problem I was getting too dehydrated and felt like I had a bad hangover 24-7.
                            Oh my goodness. It is a good thing that you had them check and adjust your dry weight. I'm glad that they got it under control and you feel a lot better. Do you take anything to help with this? Does krill oil help?

                            Comment


                            • #15
                              Re: Why am I so tired?

                              Originally posted by dialysisinpa View Post
                              Thanks M3Riddler, that makes sense and I will keep that in mind. I'm still getting use to feeling good again and I'm happy with the way I feel now. I don't know if I can stick myself but I imagine you get use to it. I know a young person that slept during home dialysis then had a leak and bled to death. So there is pros and cons to both.
                              Dont wait for your nephrologist to up your dry weight. This is something you should become familiar with. If you wait on your nephrologist, you can be waiting much longer than needed to up the dry weight. Meanwhile you are suffereing...
                              You should learn and get involved in your care as much as possible. Learn what the labs mean and how to control/determine dry weight.
                              When you see trends that you bp is dropping during traetment... more than likley they are pulling too much fluid off too fast.
                              I believe I posted before that the bloodstream can only hold a certain amount of fluid so if they are going beyond that limit per hour, it is going to give you that washed out feeling as well as put stress on the heart.
                              Another way to tell if you are pulling too much fluid off or that you are approaching your dry weight is that your pulse will start to go up. If you see your pulse going up over 90 during your treatments...this is a good indication that you need to stop pulling the fluid or at least lower the amount per hour.
                              This is something your nephrologist should be well aware of.
                              Remember...you are your best advocate and information is power.... You should be part of every decision that is made with your treatments instead of the nurse just reading what the nephrologist writes down each week/month or however often they do their rounds.
                              Dialysis should be geared towards the individual and adjusted likewise.

                              ///M3R
                              ______________________________
                              PD - 13 Years
                              3 Transplants
                              In-Center Hemo - 6 Months
                              NxStage - Since April - 06
                              Facebook: Dialysis Discussion Uncensored

                              ________________________________

                              Comment

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