Tuesday, October 23, 2007

Fluid restriction

The human mind is amazing in many ways.

Let me give you an example.

Most patients on hemodialysis are on a restricted fluid diet. They can have only limited amounts of water, juice, drinks, ice cream - basically anything that is water at room temperature. Most patients are allowed to have only a liter of fluids a day.

This is because the kidneys of patients on dialysis do not work as required and do not remove the excess fluid from the body. Whatever excess water collects in the body manifests itself as a weight gain. So, if you have had 1 liter more than what your body has lost, it will show up as 1 kg additional weight.

When I was on Peritoneal Dialysis, I had no fluid restriction prescribed (as most PD patients). This is because PD is good at removing water and it removes it continuously. I used to measure my weight every morning and I never gained any weight.
This meant that PD was removing all the water I drank.

On PD I could also measure how much water was being removed per day and it was never more than 2 liters a day. This meant that I was not drinking more than 2 liters of water a day.

Now, I'm on Hemodialysis. Daily nocturnal home dialysis. I dialyse for 6 to 8 hours every night of the week (Except Sundays). I have to check my weight before dialysis to check how much fluid is to be removed and after dialysis to see how much was removed.

So, there is this monitoring of how much I've gained per day. That screws things up in an unimaginable way.

Let me explain.

Have you heard about Lenz's Law? Lenz's law states that induced e.m.f. opposes the change in flux producing it.

In lay man terms, whatever the flux (don't bother about what this means) tries to do, the induced e.m.f (again, don't bother) opposes it.

The mind follows Lenz's law in a way.

Whatever the mind is told to do, it opposes it. If the doctor tells you don't have sweets, the mind will want to have sweets in a way like never before.

I am not supposed to have too much water. I will want to have water like never before.

When I was on P.D, there was no checking, no monitoring. So, it was all ok. I had only about 2 liters a day.

Now, I'm on HD. I need to make sure I don't drink more than 2.5 liters so that too much water does not have to be removed during dialysis. I cannot drink less than 3 liters and that too restricting myself. Not allowing myself to have water whenever I feel like. And thinking about it all the time.

Can you believe it? I am actually drinking more water than I was when there was no restriction and I still feel terrible about having a restricted fluid diet!

The amazing human mind.

2 comments:

Anonymous said...

Hi Kamal, its me Jax from yahoo... My father was on dialysis and they restricted his fluids too and I BELIEVE with all my heart that THAT is what caused him to die. When he was not restricted, he was able to still urinate even with dialysis. His doc never restricted his fluids, but the nursing home did. I called his doc who called the nursing home and tried to stop the restricting but for some reason, the nurses and nurses aides kept equating dialysis with restriction. The more the restricted his water intake, the worse he became. He hated dialysis and it was our goal to get him strong enough to come home and then switch to the PD, but he never made it.. you are lucky to have the choices.
Im really enjoying your blog and will be looking forward to meeting you when you come to the states.
jackie

Tivona said...

Well said.