Dialysis Dry Weight and Fluid Taking

 Saturday 2014-02-01

When I was first thrown on the dialysis chair, I was very ignorant, very sick and very trusting. The only thing I knew about dialysis was that it would make me better and I would feel cold. Any side effects were never mentioned. I thought all the discomfort, the pain and the cold were part of the deal and should be endured. Later, I found that much of it could actually be prevented and that medical people could only be trusted selectively.

The first thing I noticed was my fingers often stiffen up, and I couldn’t use my hand. I mentioned it to the med people in the Ward, no one seems to know what I was about. Then more things started to happen, my limps would cramp and locked up during the night, legs and feet were contorted like someone  suffer from polio, not to mention the agony and pain.

One day, the same thing happened when I was on the chair, was told perhaps too much fluid was taken. Fluid, what fluid? I didn’t know that fluid were taken, I thought they only cleanse my blood. I learned that my weight of the day was checked against something called dry weight, and anything extra was considered as excessive fluid and was taken. I could still pass urine, in fact they checked and I brought back to them 2.3 litre of it that I passed during a 24 hour period, hence no fluid was accumulating in my body. What they have done was severely dehydrated me and caused a lot of pain. 

By the way, whether a person has fluid in the body is easy to verify simply by checking the leg, the neck and listen to the chest.

What happened was a week after dialysis I put on 0.6 kg, another 2 weeks later 2 more kilos. My flesh gain was mistaken as excess fluid. Even though I told them my urine story again and again, and the fact that I had a urinary catheter in me for a few days, both my fluid in and out was recorded religiously, but nobody seemed to have bothered with this information.

When eventually the dry weight problem was settled, they told me they still need to take 500ml which is simply the amount given me on the chair – a drink, the prime and wash back. I was confused, but it sounds fair.

One day, finally I had the whole thing worked out. What I find was, even the prime was in me first, the volume of liquid including blood and prime on me remain unchanged, the drink would go through normal channels not directly into blood, the fluid taking is a continuous event, and the wash back happens in the last minute.   Thus, taking 500ml would mean that I was continuously being squeezed of my extracellular fluid in order to replenish the ones taken - in laymen’s term being “dehydrated” continuously and flooded in the last moment.

What they say that only take what’s given is not total truth. In order to preserve my precious urinary function, I put my foot done and requested 0 fluid taken and met with strongest objection. I had to insist on that I took full responsibility for my decision.  Eventually the UF goal was set the minimal that the machine could accept. The whole story was recorded in the medical sheet of the day and I was never asked back to that particular centre again.