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  • Cramps

    What causes cramps during and after treatment. I suffer with cramps really bad and then my blood pressure drops.

  • #2
    They have taken too much fluid off you during treatment. If you start to cramp during treatment ... make sure that you tell your tech/nurse. They can stop the machine for a while. And they can also give you some fluid to help ease the cramps.
    Make sure that they have calulated your dry weight correctly. Have you lost weight since you started ? If so ... they the need to re-calcute your dry weight.
    Also we have known Techs that have set the machine for longer than they were supposed. Learn your settings ... and check them everytime. Don't completely trust your techs ... because they will lie right to your face

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    • #3
      DWALLAD,

      This is very common with in-center dialysis but very preventable. Yes, they are removing too much fluid per hour or during the entire treatment. Normally, someone will start to cramp 1.5 hours or more ( towards the end) of the treatment. This is normally because the blood flow is too high and they have set the ultrafiltration to remove too much fluid too fast. The bloodstream can only hold a certain amount of fluid at a given time. So no matter how much they tell you higher blood flows are better, this is wrong... Your bloodstream can only hold approx 400 cc's ( gtive or take per individual) of fluid at a given time. If the machine is set to remove more than this amount, you are going to feel the effects ( approx 1.5 hours or more into the treatment) You will cramp, perhaps nausia ans well as the washed out feeling and low bp.
      A few ways to prevent this is the following.
      1. Do not remove more than 400-700 CC's per hour ( and that is pushing it)
      2. Lower the bloodflow to 400 or under ( they will tell you faster is better, but this doesnt remove the larger molecules such as phosphorus. Only additional time will remove the proper amount of phosphours, therefor there is usually a net gain between treatments.
      3. Watch your blood pressure. If you see your bp starting to drop, this is a classic sign that you are beginning to reach your dry weight.
      4. Monitor your pulse. When your pulse rises to 90 or above, this can mean that you are dry and have reached your limit for removal of fluid from the bloodstream. When this happens, have them turn the ultrafiltration off.. wait for your pulse to fall and your blood pressure to go back up. Then you can turn the ultrafiltration back on to remove additional fluid that has equilibrated back into the bloodstream from your tissues.

      Also, take charge of your own dry weight. Learn what to look for. As you know, you are not the same weight for a month. You can go up an down many times with your dry weight. Most nephrologists only see you once a month and then will change your dry weight. Thats all and good, but what about the other 29 or 30 days of the month where it can change. Dry weight is something that the patient should have no problem learning how to control by measure what they drink and monitoring the bloodpressure and pulse. Adjust accordingly when you start to feel symptomatic..

      Hope this helps...
      3.
      ______________________________
      PD - 13 Years
      3 Transplants
      In-Center Hemo - 6 Months
      NxStage - Since April - 06
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      • #4
        Quellitall seems to help alleviate cramping in most patients.

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