Saturday, December 11, 2010

Figuring out my dry weight

Yesterday, as I was on my way from Grene to NephroPlus, I felt a familiar sensation. My head suddenly felt cold and I could feel tiny droplets of sweat on my head. I felt slightly giddy and weak. It wasn't very bad. But I knew it could get worse if I didn't do anything about it.

I asked my driver to go to a snack center nearby. I rushed in and ordered an Idli. It came pretty fast. I quickly ate the Idli and could immediately feel better. Not totally normal, but definitely better.

I then got dropped at NephroPlus and sent my driver to bring me a soft drink. I then sat down in a chair, set the air-conditioner to a comfortable temperature and took a few deep breaths.

Slowly, I regained composure and felt normal.

What was this? It could have been one of two things - hypoglycemia or hypotension. I cannot say for sure which.

Hypoglycemia is a condition where the sugars in the blood go down suddenly and you have exactly these symptoms. Diabetics experience this sometimes if they have taken too much of the sugar-lowering drugs.

Hypotension, on the other hand, is something which people lucky enough to be on dialysis sometimes have. Let's say you have been eating well and eating healthy food like sweets and fried food. Your weight increases. Now, when you go for your next dialysis session, this can be misconstrued as fluid weight and the good folks (aren't they all?) at the dialysis unit try to pull it off. Now, this results in the amount of water in the blood actually going below what it should be. This causes thickening of the blood and reduces its pressure.

This can result in the symptoms I had, as well.

So, knowing your 'dry weight' is key. I knew my dry weight had gone up a little but I was in a little bit of denial. I somehow wanted to convince myself that my daily swim is helping me reduce weight. What I did not realize is that my regular cola binges are not helping matters. Hence, the hypotension.

But then, if it was truly hypotension, maybe, I shouldn't have felt better with the Idli. But then, I did have cramps in the last hour of my dialysis and I also had a little bit of a cramp in my hand that afternoon.

So, I am really not sure what it was. All I can say is I really enjoyed the full bottle of Thums Up that morning!



3 comments:

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Karthik said...

Hi sir,
Could you please tell the way how to measure the dry weight of a patient? The conventional way.
Usually during dialysis even when 2.5 to 4 litre is removed the bp is ~160/80 like that, means when higher weight is removed the conductivity was made higher by the tech like 14.5 to 14.8 to prevent cramps & hypotension. Generally maintaining conductivity 14.

Im so afraid that too much weight removed will lead to chills & tiredness which happened 2 times & tech had to come home and administer additinal saline & injections when water was removed more than what the BCM machine predicted. Even by 0.5kg caused this effect. Currently BCM not available due to lockdown.

Kamal D Shah said...

Unfortunately apart from BCM, dry weight measurement can only be done indirectly. If you are having symptoms like cramps and hypotension then you need to adjust your dry weight up by 0.5 kg at a time. If you are feeling breathless even with moderate fluid weight gain, then you need to adjust your dry weight down by 0.5 kg at a time.