What are the reasons for high pulse, during or at the end of tx, and what are the interventions?

Maybe someone screwed up... and maybe they don't intervene because they're bad people and they don't want to help you. Or maybe, just maybe, your just making a mountain out of a molehill. Dialysis is a physically demanding treatment. If you read all the contraindications of dialysis, you would realize that by allowing dialysis treatments to commence on your body YOU ARE TAKING A RISK!! Not everything that happens to you in dialysis is a screw up. In fact, I would bet less than 1% is a screw up. It's just a side effect. Science can only do so much along with your staff. If your so unhappy and nobody can do it right, why don't you do it yourself, smarty pants??

Come on!!!! I perceive a legitimate area of concern or inquiry. Not evceryone has a high level of knowledge of physiology and may have lots of questions. Taking charge of one's care and becoming informed are just good practice and most centers welcome it! Side effects do exist, but, for instance--if too much weight comes off (and this is not necessarily a screw up), there is decreased blood volume, and as a compensatory mechanism, the heart pumps faster and harder. There could be other physiologic explanations too, but it seems to me, noone's questions should be looked at as "automatic criticism" or am I missing something here?

quote:

or am I missing something here?[/B]

Glad you asked... see this topic (click the link below) that the "patient" posted on and decide for yourself. Mind you, this is one good example of SEVERAL. Just have a look at the few main topics in the technical forum now and you'll catch on.
http://www.renalweb.com/ubb/Forum9/HTML/000456-2.html

Riiiiight, perhaps you were not feeling too well on 1/13 and 1/14 (There are some pts sincerely interested in every aspect of their dialysis treatments and who choose to educate themselves in an effort to minimize treatment-associated risks) -- let me ask you this. So that pts do not interfere with "technicians", will you, or someone, start a site for pt/other's use in asking questions about dialysis equipment?

You see, I, too, am interested in the high pulse/tachycardia issue -- and especially if it can be equipment-related. Appreciated Dez's input and wish you could be just as enlightening.

quote:

Originally posted by patientwife:
Riiiiight, perhaps you were not feeling too well on 1/13 and 1/14 (There are some pts sincerely interested in every aspect of their dialysis treatments and who choose to educate themselves in an effort to minimize treatment-associated risks) -- let me ask you this. So that pts do not interfere with "technicians", will you, or someone, start a site for pt/other's use in asking questions about dialysis equipment?

You see, I, too, am interested in the high pulse/tachycardia issue -- and especially if it can be equipment-related. Appreciated Dez's input and wish you could be just as enlightening.

Do me a favor and have your local technician give you a copy of the contraindications page in the Tech and/or Operators manual of your machine. Assuming it's a Fresenius H machine (most pt's run on them), it clearly states most of the problems associated with dialysis in general. Tachycardia, hypotension, hypertension, dialysis dementia, cramping, vomiting, nasea are just a few. IMHO, the majority of discomforts that patients experience are from non compliance issues and known side effects, not equipment issues. Think about it... you're removing from your body in 3-5 hrs (generally) what the normally operating kidneys would do in 48-72 hrs. How can you think that everything should be hunky dorey during dialysis, knowing that? Unfortunately, dialysis is a very physically demanding therapy and with our current technology, there's not a whole lot we can do about it. Believe me, if there was anything in my power (and I believe I speak not only for myself, here) I could do to make a treatment more tolerable, I would.

Anyhow, I do not have a problem whatsoever helping further the patients knowledge of dialysis equipment. I am COMPLETELY for it as I am completely for MYSELF learning more about the dialysis patient's world so that I may better MY understanding of them. My problem is with this "patient". They are obviously out to start trouble. You see how they ask a general question in an attempt to get someone to answer in a way that may be manipulated to work for the "patients" benefit, not for their pursuit of knowledge. They're just trying to start trouble and I'm fed up with it. I, however, do not have any problems answering questions to the best of my ability on THIS board (don't have time for my own board). Hope this helps explain my position.

Riiight I am also interested in this issue and there is NO way that you can be sure these two people are the same. It seems to me that this person isn't stirring up the trouble and is asking a legit question. I had the fast pulse for quite a while and it was genuinley worrying and anything I/we can all learn may help us in the future.

I would absolutely LOVE to dialyze myself at home away from the understaffed dirty clinics. But, the state that I live in does not alow a patient to perform hemo alone. This is a ligit question because this happens to me at times, if it gets out of control the nephrologist gave me Labetolol and told me to break the pill in half and take to slow heart rate down. P.S. when you think you are in this type of mood, you need to turn the computer off.

quote:

Originally posted by Anon:
[B]Riiight I am also interested in this issue and there is NO way that you can be sure these two people are the same. B]

I'm sure that fact that the post just so happens to contain the SAME IP ADDRESS (no two people can have the same IP address) has nothing to do with the possibility this might be the same person posting these messages. You know... if some people would just shut up and analyze the situation before they started running their mouth they might just save themselves a little embarassment and realize that, as much as they think they are, they're not always right and maybe could take some advice from someone in a position to know. But do what you want... at this point, I'm done speaking to deaf ears. You're just gonna have to find out for yourself. Best of luck!!

I am Smarty Pants:
First of all, I'm not in any type of 'mood'. Second, this board is open to the public and I am simply stating my opinion of this 'patient' person. If the mod feels it inappropriate, they will edit/delete it. In the mean time, let's leave that decision to them. Just because I don't like YOUR post doesn't mean you CAN'T post it. I'll just have to deal with it. I'm just tired of this 'patient' person always on here posting crap. They have this poor me attitude and everyone is out to get him/her. I understand that dialysis patients aren't in the best health and do have complications and my heart goes out to all of you. I also understand that some clinics are not up to par as far as effectively and safely executing treatments. But this patient is either a) exaggerating just a smidgeon or b)really needs to address his/her concerns elsewhere with someone who can actually fix the problem(s). I would think that a problem of this magnitude (not just the one in this post, countless others) would have already been reported by not only THIS patient but several others and action would have been taken. This leaves two possibilities. One, the patient is right and by now the state should have stepped in (and believe me they would have) and made the proper corrections as they saw fit or shut down the unit. Or, 2, the patient is not being completely honest here and is just looking to start trouble. Take your pick.... anyhow, I'll just shut my mouth now, because like I said, you'll believe what you want to believe. Maybe you just need to find out for yourself.

I complained to my state surveyors and it usually takes around three months for them to come and check the alleged violation out.
Same with the networks.

You have a lot of confidence in your government. The reason I say this is I have a elderly family member in a nursing home that currently has 60 pages of tags from Medicare. I am currently requesting all incident reports on this facility and building my case against them if I walk in and find her harmed.

Because we develop renal problems does not mean our other obligations to family and society as a whole just magically disappear.
Things have a way of snowballing at a facility that has gone bad. Have a good day.

I apologize for the healthcare professional who replied to you so curtly.I applaud your effort to understand.To answer your original question,Some people do react to decreasing fluid levels in their blood by increasing the heart rate to compensate.A mild increase is not necessarily bad.Out of control heart rate is another thing,and it is up to your Dr. to determine what out of control is for you individually. Also potassium drops during dialysis(as it should) When potassium gets too low,it causes the heart muscle to be more excitable and thus risk increase heart rate and other types of heart rhythms that are not desirable.Every patients threshold is different.Does your BP drop with the increased rate? Again,I apologize for the kneejerk reaction of the original replier.This type of thing would never happen at our unit!!!!We need to look out for one another,OK?

Unfortunately since none of you apparently know the circumstances surrounding the frustration of my original post I don't think you have the right to go pointing fingers. I'm not a patient hater and I am normally a pretty nice guy. Any other person would have been met with a welcome and a kind reply. But this person has more than worn out their welcome on this board and is disliked by many people other than myself. Just because I have a problem with one person that you DON'T know the history on shouldn't be reason enough to assume that I have a 'knee jerk' reaction. Don't judge a book by it's cover or by one page for that matter. BTW, why are you apologizing for me?? I'm not sorry one bit for reacting the way I did. This person deserves every tongue lashing they have coming.

Dare to HD,
First, thank you, for your respectful and professional response to my post.

I used to be on a straight 140 sodium, would come in with bps ranging from 120 - 140, and my bp would descend to about 100 more or less.

Previously, the starting conuctivity of my machine was 14.3 and my last bp would drop as low as the mid to high 90's. At this rate I felt perfectly fine for months of txs.

When the machine technican internally recalibrated my machine at service time to a conductivity in the 13's I had uncomfortable/hurtful txs from that point on. I told the doctor and technician this. The doctor's only solution was to up my dw. And the technician told me that as long as the starting cond. was within the machine's specifications, he did not have to adjust it to make it more comnfortable for me.

To compound the situaion, I am on the machine that breaks down more than any other machine in the unit, so I am frequently switched to other machines. I've been put on a machine with starting cond. as low as 13.4. That produces a painful tx for me.

I went to a linear 145 sodium modeling program through the advice of another educated patient. Neither my doctor or my staff could answer any questions I had put to them about the SM programs.

Now that I'm on SM, I get a high conductivity rate again, but it still depends on the starting cond as to how comfortable a tx I will have, and I have found ways to work with the SM program to furthur individualize it to my comfort level.

I've noticed that now I come in with a higher bp in the 130- 150 range. My bp drops as I get on tx, but at the end it will either come down to about 115 or will rise to about 130 something. So, I don't yet understand what my bp is doing.

My pulse concerns me, as both previously, as now, it gets into the 100-110 range by the last 4 bps half the time, and when I take my final standing bp, it jumps up to 120-140 or so. My doctor is aware of what it does, but has given me no answer other than to say I'm dehydrated. I do not comprehend his reasoning as if I was dehydrated I would cramp or crash or have related sympotoms.

has anyone considered dry weight????maybe it needs to be raised

for goodness sake,, get alife,,, i took your post to be qite nasty.. here is someone who is concerned about their treatment... and if you are a nurse,, man i am glad you are not at the unit my family member is at... that is a frightening thought,, u sound very very angry

quote:

Originally posted by Riiiiight....:
Maybe someone screwed up... and maybe they don't intervene because they're bad people and they don't want to help you. Or maybe, just maybe, your just making a mountain out of a molehill. Dialysis is a physically demanding treatment. If you read all the contraindications of dialysis, you would realize that by allowing dialysis treatments to commence on your body YOU ARE TAKING A RISK!! Not everything that happens to you in dialysis is a screw up. In fact, I would bet less than 1% is a screw up. It's just a side effect. Science can only do so much along with your staff. If your so unhappy and nobody can do it right, why don't you do it yourself, smarty pants??