Can anyone give me some tips for dealing with severe cramping during and after dialysis? It is so severe that I have a hard time coping. The dr.s and staff are nice but I have not had any success.
Sounds like too much fluid is being pulled to cause severe cramping, adjust that. To get thru the cramp I have found an ice pack helps and a semi-professional vibrator, and sipping some water. Good luck it's a difficult balance to maintain.
You are much better off preventing the cramps in the first place. You will cramp up if too much fluid is removed during treatment. A big contributor to this is the accuracy of your dry weight and you wet weight. I have yet to experience a weighing procedure in any medical facility that takes into consideration the weight of your clothing. The closest they've come is "take off your shoes".
Since I started HHD 20 months ago, I've gotten far more precise in measuring my dry weights and wet weights simply through determining what my clothing weighs. I frequently wear heavy jeans and steel toe shoes. These and a long sleeve winter weight shirt can weigh up to 4.5 Kg or nearly 10 lbs. Medical staff rarely consider any of this weight when you weigh in for a treatment or even an annual physical, which can grossly distort your actual weight, especially for the purposes of determining what volume (weight) of flluid needs to be removed during your treatment.
Between treatments you will gain "fluid weight" and can also gain solid weight through eating. Which weight is fluid and which weight is solid, is hard to distinguish unless you are particularly rigorous with your diet. You may have to estimate your fluid gain between treatments but you don't have to guess what your clothing and shoes weigh through a simple weight undressed and weight dressed and measure the difference. Take this clothing weight with you and subtract it from your weigh in weight pre-treatment. Provided you already have an accurate unclothed dry weight, it should be easy to determine an accurate unclothed wet weight. That difference would be the amount of weight/fluid that should be removed during your treatment.
I don't remove more than 1.3 kg during a treatment as I still produce adequate amounts of urine with my polycystic kidneys. The difference between cramping and not cramping for me can be as little as .2 kg of fluid removal. My pajamas and slippers weigh 0.5 kg. If I didn't take the weight of these into consideration with my wet weight, I would be removing up to 0.5 kg of fluid that is not fluid but clothing weight, and I would be cramping mercilously. The dry/wet weight calculation errors that would be associated with street clothes, which weigh significantly more - steel toe boots can weigh up to 5 lbs or 2.3 kg, would result in a far greater risk of pulling too much fluid, and thus excruciating cramping, and the need for offsetting saline bolus' during treatment.
Put an end to inaccurately calculated wet and dry weights by getting weights for the shoes and clothing you wear for your treatments, whether at home or in-center.
I seem to have the worst leg and foot cramps at night even if I did not have any during dialysis. These cramps are severe and wake me up.I have to get up and try to move around until they calm down. I try to go back to sleep and they start again.Do any of you suffer with this problem. Why, and what do you do about it.
I experience lower leg cramps at night, especially when conducting a nocturnal HHD treatment. Even though I remove a limited amount of fluid per hour and per treatment, I am still prone to cramping in the area around the front and sides of lower leg, but not as frequently in the calve area. I will occassionally get cramps in the thighs, which are mercilous and require screaming into a pillow. I've also experienced cramping in the feet and ankles. I have noticed that excercise earlier in the day that can be limited to just brisk walking can trigger leg cramps later that night. Eating foods that tend to absorb a good deal of water, e.g. cereals, pastas and rice, can also trigger night cramps in the legs.
During most treatments, I am drinking ice water, and I find this helps prevent or resolve the cramping - though not immediately. During sleep you are naturally dehydrating yourself via breathing and not replacing that fluid loss by drinking as you would be during the day. I find that I am far better off drinking fluids before bed and through the night (when I wake up parched) and then having to get up an urinate than I would be getting awakened by painful leg cramps and trying to resolve those.
If you are drinking caffeinated beverages during the day, you are dehydrating yourself, as caffeine has diuretic properties. The same can be said for any alcoholic beverages. You think you are replenishing fluids with these beverages but you are stealing fluid as well. At the suggestion of my nephrologist I am taking a Calcium/Magnesium supplement to ease or reduce cramping but with all the variables associated with hemodialysis, it's hard to tell if I am getting any benefit. I got leg cramps at night before I started dialysis, usually the product of dehydration and exercise earlier in the day.