Dialysis Freeze

I used to write frequently about the problems about the frigid conditions at the nocturnal dialysis clinic. I would wake up soaked in a cold sweat and then have to lie there for another half-hour or an hour or more until my treatment was finished. It was one of several reasons why the nocturnal shift was intolerable, and I eventually left.

Make no mistake, other patients and staff believed it was far too cold in that space. The ceiling vents could also be a brutal part of the equation.

Here at the other clinic, the vents have guards hanging below that disperse the air. The room temperature is never especially too cold or too warm.

But my body still has a huge problem with cold. No one has yet to figure out what causes this. As of today, I will officially note that they do not care.

Approximately 90 minutes into my 3½-hour treatment, parts of my body will get cold. Specifically, any part not covered my clothing will being to feel as if an icepack is embedded in my tissue. If I wear shorts, my legs will get cold. If I wear short sleeves, my arms will get cold. I don’t wear a ski-mask, so my face and head always feel cold. I haven’t cut a hole in a long-sleeved shirt yet, so my arm used for access gets cold.

Here’s some purposeful ALL-CAPS action.

I DO NOT HAVE CHILLS.

MY BODY TEMPERATURE IS NOT ABNORMALLY LOW.

THE DIALYSIS FLUID TEMPERATURE IS NOT ABNORMALLY LOW (37° C).

MY BLOOD PRESSURE IS FINE.

I AM NOT HYPOGLYCEMIC.

I DO NOT HAVE AN INFECTION.

AND I AM CERTAINLY NOT IMAGINING THIS.

A couple of the nephrologists have taken this problem half-seriously in the time I’ve been on dialysis. The nephrologist doing rounds this month seemed irritated that I’d bring up something that he doesn’t have an answer for and suggested peritoneal dialysis as the solution to this problem. This is like having a car that makes a horrible noise that the mechanic cannot find the source of and having him tell you to just get a different car.

The internet has been of no help to this point. If anything, it’s just led me to anecdotal suggestions that send me down the wrong path.

I will be using the internet shortly to look for lightweight ski masks, if such things exists.

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5 thoughts on “Dialysis Freeze

  1. The process of hemodialysis draws blood, WARM blood out of the body and into the machine to cleanse it. As the blood is out of your body, it loses much of the heat it got from your body. The machine cannot warm it too much as too much heat will clot the blood by cooking it. So, the blood that returns to your body is not as warm as the rest of the blood still inside your body and you get colder.

    ALWAYS wear long sleeves, socks, shoes, long pants and a WARM sweater or jacket. I wore a warm sweater with the dialysis arm out of the sleeve but with the shoulder on my shoulder. Bring a blanket if it helps and wear a hat as 90% of body heat is lost via the head.

  2. It’s a delicate balancing act. If my clothes are too heavy or I keep a blanket on for too long, I perspire more. The sweat gets cold; I feel worse. I am going to cut a whole in the access sleeve of a long-sleeve shirt, get some lightweight exercise pants, get a lightweight hat. Of course, I tend not to want to think about this stuff on my off-days, so I don’t remember to go shopping on the weekends for this stuff.

    And that nephrologist is still the biggest asshole of any doctor I’ve ever met. He has no excuse. I swear the “no weapons” signs must be specifically to protect him. (They found a big pocket knife under my chair a few weeks ago.)

  3. Have you tried wearing a moisture-wicking shirt, you know, the kind with CoolMax or DryMax or whatever it’s called, depending on the brand name you get. That way, if you layer on top of the moisture wicking shirt to stay warm, and you start to sweat, the sweat will not stay on your core, it will wick out onto the outer layers. Rob has a few of these types of shirts that are cycling-specific. I’m sure he could pick you up one or two or 3 of these shirts at a pretty low price using his employee discount. You could cut holes in the upper arm of them for your access. Oh, also, I know that they do make lightweight “ski masks” for cycling in extreme cold weather. I’ll see if I can find a link to one.

  4. I don’t think much can be done to keep dialysis patients warm without constant supervision of the thermostat and dialysate temperature. Your doctor can’t really monitor this so that is why he can’t help you. I know from doing home dialysis that my wife (the patient) likes her dialysate warmer turned almost all the way up, loves the room at 80 degrees with no ceiling fan on and a nice blanket that she makes me throw in the dryer to warm it before dialysis. I, on the other hand, wish the room was at 74 degrees with the fan on, alas my wife wins this battle. You may not be so lucky incenter.

    I’ve heard that techs will leave dialysate temperatures turned down so they don’t have to worry about blood pressure alarms. This is just a rumor I’ve heard and I don’t even know if that would help stop alarms. Most of our pressure alarms are caused by access issues.

    Blankets and Under Armour are probably your best bets at controlling body temperature.

    I think someone was selling shirts with zippers for catheter, fistula and peritoneal access online a few years ago. You could probably make your own better.

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