Estimating the dry-weight (this is the lowest possible weight of a dialysis patient after dialysis where the patient has normal blood pressure and most of excess body fluid is taken out) is hard sometimes because the patient is afraid that he/she might exceed below the actual dry weight and suffer very painful cramps, temporary hearing loss and low blood pressure. On the other hand, not reaching the dry weight after dialysis means retention of extra body fluid that may result to Edema or swelling of the legs and water is stored in the abdomen. Twice, I have experienced that situation when I lost my appetite and not being aware that excess body fluid is stored in my abdomen and my legs and I am way above my actual dry weight. If you experienced this, the right thing to do is not to abruptly take out the excess body fluid in one dialysis session but to slowly take it out one dialysis session after another dialysis session until your legs are not anymore swelling and your stomach is not feeling too heavy. You do this by lowering your estimated dry weight by 300 ml. in one dialysis session, then 500 ml. on the next dialysis session and so on until you begin to feel that your legs is about to cramp or you are about to experience temporary hearing loss. Do not eat salty food as this may cause fluid retention and excess body fluid is harder to take out. It is not necessary to reach your actual dry weight but you should always try to go near it after every dialysis sessions.
I have experienced that if I am at or near my actual dry weight, my appetite for food is increasing and the result is I get fat and I have to re-adjust my estimated dry weight until I have a big and heavy stomach and my legs begin to swell and I lose my appetite. This means that I am again way above my actual dry weight and I need to lose weight by not eating too much carbohydrate like rice, bread and pastries. I eat small amount of meat and chicken, lots of fish and some vegetables that are high in Vitamins and fiber. I drink less than one liter of water per day. My experience is that if I drink a lot of water, I have observed that I do not feel well during dialysis because my heart is stressed while the excess fluid is being taken out of my body. If I drink only the allowed amount of water, I feel well during dialysis and I can still take out more water below my estimated dry weight until I go near again to my actual dry weight.
My advice to my fellow dialysis patients: always try to stick on the dos and don’ts of dialysis as I have written in one of my articles in my blog. It is very tempting to exceed the allowed amount of food and water for dialysis patients; but I tell you, the corresponding discomfort or pain during dialysis is not worth the satisfaction you felt when you ate excess amount of food and water. I am reiterating again that we (dialysis patients) should eat to live not live to eat. If you want a longer life in dialysis, you must exercise a strong will to resist the temptation to over eat and drink. You can do it!