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ileostomy and hemodialysis
Question:
Laurie Bluedorn posted the following article in the Hemodialysis Forum http://brumley.com/renal/hemoboard.html Dated : July 28, 192000 at 08:17:00 Subject: ileostomy and hemodialysis http://brumley.com/renal/hemomessages/1399.html My father has had an ileostomy since 1970. Last year he had to go on renal dialysis. Usually when people are on dialysis they have to restrict their fluid intake, but he has not had to, probably from the fact that lots of fluid goes into the ileostomy and doesn’t build up in his system like others on dialysis. The problem he is having is that the doctors insist on drawing out (during the dialysis period) a certain amount of fluids. This is standard procedure for dialysis. Dialysis patients can’t get rid of fluid so it must be taken out during dialysis. But since my father has the ileostomy he doesn’t need all that fluid taken out. When they take out too much fluid it causes him to become dehydrated after dialysis and quite sick. Even though he has been arguing with the staff at the dialysis center for over 2 years now concerning this matter, they won’t listen to him. He has taken it to the doctors in charge but they refuse to decrease the amount of fluid they withdraw during dialysis. I can’t remember the exact figures, but they normally take out 2 kilos each time, which is too much for my father. If they only take out 1/2kilo or none (which they have done that on a few occasions) then he feels great after dialysis. His dry weight and his wet weight are almost the same. His weight doesn’t change much from day to day. He is producing no urine. Can you point me to any web pages or people who could discuss this problem with us? He is at the point of wanting to give up on dialysis. Thank you. triv…@muscanet.com
Response:
My father has had an ileostomy since 1970. Two years ago he had to go on hemodialysis. Usually when people are on dialysis they have to restrict their fluid intake, but he has not had to, probably from the fact that lots of fluid goes into the ileostomy and doesn’t build up in his system like others on dialysis. The problem he is having is that the doctors insist on drawing out (during the dialysis period) a certain amount of fluids. This is standard procedure for dialysis. Dialysis patients can’t get rid of fluid so it must be taken out during dialysis. But since my father has the ileostomy he doesn’t need all that fluid taken out. When they take out too much fluid it causes him to become dehydrated after dialysis and quite sick. Even though he has been arguing with the staff at the dialysis center for over 2 years now concerning this matter, they won’t listen to him. He has taken it to the doctors in charge, but they refuse to decrease the amount of fluid they withdraw during dialysis. I can’t remember the exact figures, but they normally take out 2-3 kilos each time, which is too much for my father. If they only take out 1/2 kilo or even none (which they have done on a few occasions) then he feels great after dialysis. His weight usually stays the same from day to day. He weighs nearly the same when he goes in for dialysis as when he is finished with dialysis. He never has symptoms of fluid retention such as swelling. His blood pressure is always low. Can you point me to any web pages or doctor who could discuss this problem with us? I am specifically looking for a doctor who would have experience with this issue. Thank you. triv…@muscanet.com
Response:
It’s time for your Dad to find a new nephrologist and possibly a new unit. At the very least, he should have the GI doctor contact the unit doctors and explain to then the workings of an iiliostomy. During my last stint on the machine, I had one and found the same thing. So, I drank what I wanted to and kept my weight pretty stable. What I don’t understand in your Father’s case is why they would take fluid off if he is not gaining weight between treatments. Again, when I came in at the same weight as what I left at the treatment before, they would not run me hard and very little fluid would come off. Something is wrong with the picture you paint. IMO you can do one of two things. The first as I said above and the second is have your Dad drink freely and monitor his weight. When he is 1.5 kilos over what he weighed out at, stop. If they are going to take it off anyway…why not. personally though, I prefer the first option. Things should be done right. BRT Kidney Tx 3/79-5/98 JHH 10/99-??? UMDMS b…@md.prestige.net "Bluedorn" <triv…@muscanet.com> wrote in message
news:39838B59.499ACF17@muscanet.com… – Hide quoted text — Show quoted text -> My father has had an ileostomy since 1970. Two years ago he had to go on > hemodialysis. Usually when people are on dialysis they have to restrict > their fluid intake, but he has not had to, probably from the fact that > lots of fluid goes into the ileostomy and doesn’t build up in his system > like others on dialysis. The problem he is having is that the doctors > insist on drawing out (during the dialysis period) a certain amount of > fluids. This is standard procedure for dialysis. Dialysis patients can’t > get rid of fluid so it must be taken out during dialysis. But since my > father has the ileostomy he doesn’t need all that fluid taken out. When > they take out too much fluid it causes him to become dehydrated after > dialysis and quite sick. Even though he has been arguing with the staff > at the dialysis center for over 2 years now concerning this matter, they > won’t listen to him. He has taken it to the doctors in charge, but they > refuse to decrease the amount of fluid they withdraw during dialysis. I > can’t remember the exact figures, but they normally take out 2-3 kilos > each time, which is too much for my father. If they only take out 1/2 > kilo or even none (which they have done on a few occasions) then he > feels great after dialysis. His weight usually stays the same from day > to day. He weighs nearly the same when he goes in for dialysis as when > he is finished with dialysis. He never has symptoms of fluid retention > such as swelling. His blood pressure is always low. Can you point me to > any web pages or doctor who could discuss this problem with us? I am > specifically looking for a doctor who would have experience with this > issue. Thank you. triv…@muscanet.com