January 26, 2008
Saturday
El Milagro: I’m here at 4 today, choosing not to call in for an early chair because UT is playing at 7 on a channel I don’t get at home. Amanda the Tech smiles over to cannulate me. She is getting more comfortable at sticking people and therefore doing it faster, and, at least this time, a little more painfully than usual. Slow down Amanda! Going slowly and cautiously is less painful for your victims. Jo the Nurse comes by to do the nursing assessment and I touch base with Ron the Head Nurse about ordering my Sensipar… he recalls he did, although he has a kinda worried look on his face that makes me hallucinate he might not be sure.
I am listening to NPR All Things Considered Saturday version as I wait for the game… interesting story about ice skating starting in Finland 4000 years ago, when they strapped horse bones to their feet to traverse the many frozen lakes. Picture that! Also a thing on nicknames and reports on the SC primary. I drift off. Rosie the Tech comes by to warn us all that she will be doing feet checks today.
For awhile I am feeling a little funny (not the kind Steve Martin talks about when he says "I put a piece of baloney in my shoe and when I walk out on stage... I feel funny!")… a kind of tingly feeling in my lips that is bothersome. I try to ignore it at first and then pay close attention to the feelings. As I do that, they grow and pretty soon I am feeling kinda faint, have tingly numb feeling lips, and my fingers on both hands are starting to tingle too. Something is going wrong. I can’t see my machine to determine what my BP is but I suspect it is going down. When Rosie comes up to do my foot check, I tell her, “I’m feeling weird… tingly lips and faint”. She checks my BP and it is down under 100 (why didn’t the machine beep?) She ups my saline intake and asks if I want some broth. Who ever wants broth? Well, I’m feeling so shitty I want broth. I feel like I can’t move much so I just nod okay. Then she leaves and Ron the Nurse shows up and studies my readouts and asks me about my tingles. “Do you hurt anywhere?” “Nope” “Any shortness of breath?” “Nope” “Nauseous?” “Not really” “Well, I think it’s low calcium… we’ll bring you some Tums and see if that helps.” I am relieved, I guess… although I have no idea how this low calcium thing starts, or what it means. Rosie brings the Tums and I gobble 4 or 5 and realize I have no spit to add to them so they become like a glob of cement in my mouth. YUCK. “Gubme tom watah” I mumble and Rosie laughs and brings a cup. When I’m feeling so badly, I don’t have a lot of energy to find out what this is all about… I just want to feel better.
I felt so badly it was difficult to pay attention to Rosie the Tech's foot check, which they always say they do regularly but this is the first one I've had since starting dialysis a year and a half ago. Rosie takes off my socks and feels all around my foot and it kinda reminds me of an acupressure session... I like it... although I really wish I was feeling better so I could ask questions, etc. about it. Next time I'll ask for a foot check... especially if they choose to wait another one and a half years...
After about 7 tums my lips begin to feel normal and I relax back to watch the second half of the UT / Texas Tech game. We end up smearing Tech and old beady-eyed Bobby Knight grumbles across the floor to shake hands with Coach Barnes. Later on I talk more to Rosie, who says she doesn’t know why folks end up with low calcium, but it does happen to others every so often. I’m left wondering how in the heck you can be just laying there dialyzing and all of a sudden your lips go tingly and it’s downhill from there. I guess I’ll have to do some research on LOW Calcium.
Sunday: In researching yesterday’s difficulties at dialysis, I look up low calcium and find that when it is related to high PTH, it can mean a vitamin D deficiency (My PTH was high last lab results). Well, yesterday was the first time I decided to follow the vitamin instructions on my lab result report that specify I should wait until after my dialysis to take my Renal Tab. I wonder if not taking the renal tab in the morning could have anything to do with the problem in dialysis in the afternoon? I will send this post to Jennifer the Dietician and see what she thinks. More to come.
Notes: In at 76.4 and out at 77.3 Kgs.
Calcium & Kidney Disease, retrieved online from Davita’s website, http://www.davita.com/diet-and-nutrition/c/595
3 comments:
Do you confirm that you have the right "bath" when you get on the machine? You have a prescribed bath - should be something like 2k, 3.5CA - which would be a 2 potassium and a 3.5 calcium. Dialysis is diffusion across the membrane from areas of high concentration (your blood) to low (the dialysate). If the bath is lower - a 2CA - then it will tend to draw off more calcium. Which would be good if you have a high calcium but would be bad if your calcium has been normal. Glad you're feeling better.
Billp
Thanks for the comment Bill P. I did notice the nurse and techs fooling around with my bath. I am on what they call a potassium bath and I admit I should learn more about the whole dialysis process. You could very well be right in your assessment... I emailed my dietician (who, in my clinic is seemingly the person who understands more about body chemistry than anyone else) so we'll see what she says. Stay tuned. JN
Hi Jack, Well, of course, I couldn't possibly give you any insight on the calcium problem you experienced the other day, but I sure want to comment on how much I hate to hear that you had such a bad experience. It sounds awful! Anyway, I'm glad you recovered and all it took was a mouthful of cementy tums!!! Take care. Your Cheryl
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