Any advice on how to prevent a headache after dialysis?

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Any advice on how to prevent a headache after dialysis?

Postby Claire1976 » Thu Sep 09, 2010 8:08 am

Hi everyone

My Mum has just completed her fourth week on hemo dialysis. First week was awful, and then next 2 weeks were lot better. But after the last 3 sessions she has developed a severe headache that comes on around an hour after coming off the machine and lasts most of the day.

Any one know what is causing it and why she's only just started getting it? Incidentally they are not removing any fluid during her sessions and her blood pressure is good both before and after the treatment.
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Re: Any advice on how to prevent a headache after dialysis?

Postby M3Riddler » Thu Sep 09, 2010 12:56 pm

Claire1976 wrote:Hi everyone

My Mum has just completed her fourth week on hemo dialysis. First week was awful, and then next 2 weeks were lot better. But after the last 3 sessions she has developed a severe headache that comes on around an hour after coming off the machine and lasts most of the day.

Any one know what is causing it and why she's only just started getting it? Incidentally they are not removing any fluid during her sessions and her blood pressure is good both before and after the treatment.


Claire,
Im going to take a guess and say your mom goes to in-center dialysis. This is very common with in-center.
How much fluid are they taking off during the treatment? and how long are the treatments? Also, what is the blood flow speed?
Sometimes during in-center dialysis they try to take entire too much fluid off since you have a day in between treatments and people tend to gain more fluid thus meaning more has to come off. When you pull too much off, you are stressing the body. The body can only handle a certain amount of fluid removal per hour. This level is approx .4L or 400cc per hour. This is the amount of fluid that the bloodstream can handle at one time. The fluid takes time to transfer from one of the 3 compartments of the body - tissues - cells - bloodstream. If you take more than the body can handle, you are stressing the body.
The headache may be a BUN Headache. This is where BUN is being removed at a large amount during a short period during dialysis. After dialysis, the remaining BUN in the body rushes all over including the head. this is why you may get a headache. This is called DDS ( Dialysis Disequilibrium Syndrome) read more about it here: Dialysis Disequilibrium Sundrome
Hope this helps..
///M3R
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Postby lklevy » Thu Sep 09, 2010 1:22 pm

I get headaches sometimes during dialysis they seem to be behind my eyes I thought it was just eye strain. If I feel one deveoping I take a couple of paracetamol seems to have worked so far. Thanks for for the info about DDS M3R ..I've read about it and that sounds scary!
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Postby Jill » Thu Sep 09, 2010 5:44 pm

I am the same as your mum - I don't have any fluid taken off and I too have the most awful headaches afer dialysis. My consultant told me that it is quite common. I don't think it is a proper medical term but he called it "post dialysis thunderclap headaches." Paracetamol usually does the trick. Last week I had a real stinker of a headache that lasted 2 days and I took paracetamol and codeineto shift it.
She has my sympathy.
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Postby M3Riddler » Thu Sep 09, 2010 11:45 pm

Jill wrote:I am the same as your mum - I don't have any fluid taken off and I too have the most awful headaches afer dialysis. My consultant told me that it is quite common. I don't think it is a proper medical term but he called it "post dialysis thunderclap headaches." Paracetamol usually does the trick. Last week I had a real stinker of a headache that lasted 2 days and I took paracetamol and codeineto shift it.
She has my sympathy.


Jill and others,

You dont have to remove any fluid to have the DDS ( Dialysis Disequilbrium Syndrom) Is it the BUN that is being removed that mainly causes this.
Dont let DDS Scare you. It is very common but can be controlled by:
Slowing down fluid removal
Slowing down blood flow rate and others. Please read the article for more info.
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Postby Claire1976 » Fri Sep 10, 2010 7:46 am

Thanks everyone.

I thought this was caused by fluid removal and as Mum isn't having fluid taken off I was a bit perplexed as to what is causing it - but maybe it's to do with the pump speed then?

I know that on at least 2 of the last 3 sessions where she has experienced the headache her pump was speeded up. On the first ocassion they had problems getting the needles in and as a result she was over an hour later going on the machine than the other patients, so the nurse told her he would speed up the machine, so that they could cram her 4 hour session into only 3 hours. Then on another day her transport was very late picking her up and that delayed her going on machine again, so the pump was speeded up once more.

So could this be the cause of it?

She's going to mention it to her doctor but isnt seeing him for another month.


Oh and could someone explain, in simple terms, what this BUN stuff actually is? :?
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Postby Helen Rambaut » Fri Sep 10, 2010 1:49 pm

It might be worth getting in touch with the doctor in charge of her - well before she is due to see him/her.

I did not do HD so I dont know if this is commonly done i.e. to speed up the machine to fit in with the schedule. Frankly at first sight it doesn't appear to be in the patient's best interests. So a quiet word with the Head Nurse might be a good idea to find out more.

Helen
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Postby sanela » Fri Sep 10, 2010 3:06 pm

When I was on HD I noticed that some nurses did like to up the speed on the machines to 450. When I questioned this they said that it will clear more toxins over the same 4 hours than a lower speed would. This is all logical to me but I didn't allow them to just jump from 250 to 450 right away. Instead they did it gradually over the course of 2-3 sessions and even then they would start each session at a lower speed and then increase. My sessions were never shortened to less than 4 hours.
To compare with my mum who is also on HD, she cannot tolerate a speed high than 250 as she too gets headaches and feels a strain on her heart.
Perhaps your mum is the same or similar in that she just cannot tolerate a higher speed for whatever reason.
If your mum is able to than she should say something to the nurses, or if not than you can intervene on her behalf. The nurses in the dialysis units can get very matter of fact about it but they need to get to know you and what works for you and we, the patients, need to tell them if we feel something is not right. some might not like to be told but, after all, it is our bodies and we are the ones strapped in that chair, not them.

I hope your mum gets better and that the headaches are nothing more than pump speed related.

Sanela
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Re: Any advice on how to prevent a headache after dialysis?

Postby rsweet7443 » Tue May 08, 2018 8:27 pm

ive been on hemo dialysis 21 years and have had bad headaches most of that time....ive tried a lot of different things and most dont help me...pain relivers or ER help most for me. i have been told most by doctors that it is the way fluid shifts on my brian during dialysis no matter how much or how little they pull.
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Re: Any advice on how to prevent a headache after dialysis?

Postby wagolynn » Wed May 09, 2018 3:36 pm

Headaches can have two causes - Removal of too much fluid, and your body's reaction to large changes in the blood.

In this case no fluid is being removed, so the main cause will be the chemical changes in the blood caused be the removals of the toxins left by the dysfunctional kidneys.
Without their removal we would die, so the best thing to do is to use pain killers Paracetamol is OK, Aspirin (an anti informatory) is not.
It may get better as her system begins to acclimatise to the dialysis cycle.

Pump speed - as the blood flows through the dialyser only a portion of the toxins are removed, the greater the blood flow rate the more times the blood goes through the dialyser therefore the cleaner it gets.

It should be remembered that high flow rates (high pump speed) can only be achieved with appropriate sized needles.
If blood is forced through smaller needles the blood cells are damaged causing anaemia.

See posting.php?mode=reply&f=2&t=6066 Needle capacity is on page 5
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Re: Any advice on how to prevent a headache after dialysis?

Postby chrisb » Mon Jul 09, 2018 2:10 pm

When I started heamodialysis I would also get terrible headaches afterwards. Apparently I was on HDF and they changed it to HD only. No more headaches
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Re: Any advice on how to prevent a headache after dialysis?

Postby wagolynn » Mon Jul 09, 2018 3:02 pm

HDF - Some call this Ultrafiltration.

With HDF some fluid is removed, regardless of the patients actual water content but this fluid is replaced as the blood is returned to the patient, the patients blood volume is restored to its original level.
This goes on regardless of any fluid actually being removed.

The fluid is removed by running the dialyser at a higher pressure difference (the dialysate side at a lower pressure than the blood side, normal fluid removal is achieved in the same way) this forces the dialyser to work as a filter in doing so some larger molecules that do not get expelled by normal osmotic action are removed.

In short, the blood ends up cleaner.

HD - Is normal dialysis.
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